Diabetes, all together to face a disease worth 14 billion a year

Diabetes, all together to face a disease worth 14 billion a year

Diabetes is a paradigm. Of an increasing chronic disease that costs the National Health Service 14 billion a year in direct costs. And a similar figure is estimated for indirect ones: lost working days of sick people, care givers and carers. Prevention, as in this case, does not mean spending but investing. Because investing means making a diagnosis earlier, and being able to compensate for the disease sooner, avoiding complications and reducing cardiovascular risk first and foremost, but also renal risk.

The intolerable regional inequality

Everyone was present at the General States of Diabetes, hosted in the beautiful setting of Villa Mondragone, in Monte Porzio Catone, the conference center of the University of Rome Tor Vergata: the Minister of Health, expert politicians, diabetologists, psychologists, representatives of citizens and patients. The common thread for everyone, including the Minister of Health, is the intolerable regional inequality and, within that, there is a further inequality which affects less educated patients more.

Approximately 4 million patients with diabetes 2 diagnosed and many others who do not know they are at risk: intercepting them earlier would make the difference. Just as it would make a difference to start from primary school – reiterates Minister Schillaci – to talk about risk factors, poor nutrition, alcohol, smoking, poor physical movement. And the idea returns (launched by Sid in 2020, to tell the truth) of physical activity prescribed by the diabetologist on blank paper to make it clear that movement is an integral part of the therapy. Yes, but what does the patient do with that blank prescription? Telemedicine is no different, it should be encouraged, of course, but how many elderly people have computers and the internet to be able to access the services offered online?

Only 30% followed by specialists

And if it is true that – as the minister says – the health service is not in such a bad state, the numbers also tell something else: only 30 percent of people with diabetes access specialized centres, where in theory, in addition to the diabetologist, there should be a nutritionist, physiotherapist and psychologist, and they are rarely there. And where do all the others go, who follows them and how? And then the waiting lists, which will be among the best in OECD countries as the minister says for some services, but to citizens they seem intolerable. And uncontrolled diabetes means the risk of stroke and heart attack, renal failure, retinopathy, diabetic foot.

All these critical issues, and many others, will be included in a document – an action plan that will be delivered to Minister Schillaci – which aims to focus on some points: first of all, strengthening the diabetes network, increasing staff, providing more funds, enhancing digitalisation and the relationship between basic medicine and specialist medicine, because specialist medicine has been shown to reduce mortality by 20% and therefore we cannot be satisfied with that paltry 30% of patients followed in a diabetes centre. The hypothesis is to reach 350-400 centers that can take care of around 15 thousand people each. We need a diabetologist and a nurse for every thousand patients, therefore at least 4 thousand specialists (today they are half) and 4 thousand nurses (and we are at 1500). 800 dietitians (there are 400), psychologists and podiatrists are also essential.

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