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iPDM: 1. Introduction

1. Introduction: The Diabetes Problem in Europe

Today, diabetes affects close to 60 million citizens in Europe. Managing the disease is a daily struggle.

When you reflect on how you imagine spending your retirement, it is likely that your goals include remaining active, traveling to exciting places or spending time with your family and loved ones. These goals are common, yet the prospect of achieving them will be limited to many people due to the impact chronic diseases are having on our societies.

Diabetes currently affects close to 60 million citizens in Europe. In 2017 almost half a million people passed away due to diabetes or related complications at a total health care expenditure exceeding 150 billion Euros in Europe alone.[1]

People with diabetes need to manage their disease for 24 hours a day, 7 days a week. Yet they will most likely only see a health care professional for a few hours per year[2][3]. Therefore, they need to make important therapy decisions regarding their medication, nutrition and physical activity on a daily basis. Managing diabetes is a daily challenge!

This is one of the reasons why recent studies have shown that only around 50% of people with type 2 diabetes are achieving their treatment goals in regard to blood glucose levels as measured by the marker Hemoglobin A1c or HbA1c[4]. Indeed, if additional metabolic targets such as blood pressure and levels of LDL cholesterol are also considered, studies have demonstrated that the number of people achieving this triple goal is below 10%[5]. This means that less than 1 in 10 people with type 2 diabetes are achieving all three of these important metabolic treatment goals!

At the personal level this, for example, implies that if a woman is diagnosed with type 2 diabetes on her 50th birthday, she will, on average, live about 6 years shorter than her identical twin without diabetes[6].

International Diabetes Federation. IDF Diabetes Atlas, 8th edn. Brussels, Belgium: International Diabetes Federation, 2017.

Barnes et al. Little time for diabetes management in the primary care setting. Diabetes Educ. 2004; 30(1): 126–35.

Chen et al. Primary care visit duration and quality: does good care take longer? Arch Intern Med. 2009; 169(20): 1866–72.

Pablos-Velasco et al. Current level of glycaemic control and its associated factors in patients with type 2 diabetes across Europe: data from the PANORAMA study. Clin Endocrinol (Oxf). 2014; 80(1): 47–56.

Stone MA et al Diabetes Care. 2013 Sep; 36(9):2628-38. doi: 10.2337/dc12-1759. Epub 2013 Apr 29.

Rao et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med. 2011; 364(9): 829–41.

Please find all references here.