The diabetes challenge in Chile Ole Henriksen, Partner 13 th November 2015
Editors – thank you
The facts There are more than 1.5 million people with diabetes in Chile today That is more than 12% of the adult population Chile has the highest prevalence of diabetes in South America Every five minutes a person develops diabetes in Chile Every hour a person dies from the disease Chile spent 21.2 billion US dollars on healthcare in 2014, of which 10.2% was spent on diabetes. This averages out at 1,427 dollars per person with diabetes
The Challenge 1,513,410 people with diabetes in Chile today 78.5% are diagnosed – 1,187,876 people with diabetes 52.1% are in pharmacological therapy – 787,730 people with diabetes 34.3% meet the blood glucose control target (HbA 1c <7) – 519,402 people with diabetes 1.7% also meet targets for glycaemic control, blood pressure and cholesterol – 25,728 people with diabetes
Key messages in the book: Prevention of diabetes needs to start early – both adult and childhood obesity and overweight is a major challenge Improving the quality of care – Chile is on track with high quality of care, but the potential could and should be further exploited Patient education is key – the potential for achieving better outcomes is a shared responsibility and empowering patients to manage diabetes is key
The potential for prevention People with obesity are seven times more likely to develop type 2 diabetes Being overweight increases the risk of developing diabetes nearly threefold People who have severe obesity have a risk of developing type 2 diabetes that is up to 60 times higher than those of normal weight In Chile, 22.8% or 3.3 million people have obesity while 2.3% or 330,000 have morbid obesity and a BMI of more than 40 Obesity and overweight affects 63.1% of the population in Chile and it is rapidly growing
Prevention of diabetes needs to start early Children who are overweight or have obesity are likely to also have obesity as adults 23.4% of children in Chile under the age of 10 are overweight and 10.8% have obesity Chile has the ninth highest rate of overweight among children out of all OECD countries
Improving the quality of care People with diabetes not meeting blood glucose targets (HbA 1c >7%). People with diabetes meeting blood glucose targets (HbA 1c <7%). People with diabetes who, in addition to meeting blood glucose targets, also meet blood pressure and cholesterol targets (three targets).
The IMS CORE Diabetes Model – estimating the 10 year effects from switching between the groups The IMS Core Diabetes Model (CDM) is an interactive computer simulation model of diabetes We modeled the effects over 10 years from switching between the groups in 1,000 patients 1,000 times through the model
Ambitionus but realistic targets 50% of people with diabetes reaching HbA 1c <7% 20% of people with diabetes reaching the combined target for blood glucose, blood pressure and cholesterol.
Three scenarios first scenario , it is assumed that the proportion of people with diabetes that meet target blood glucose is improved by 20% from 29.8% to 35.8% second scenario , it is assumed that the proportion of people with diabetes that meet blood glucose targets is improved to reach the 2014 level, with 44% meeting blood glucose targets and 12% also meeting blood pressure and cholesterol targets third scenario , it is assumed that the proportion of people with diabetes that meet blood glucose targets is improved to reach 50% , and that 20% would also meet additional blood pressure and cholesterol targets
Results – large scale reductions in complications and costs Compared to the situation in 2011 achieving the 50%, 20% target could: reduce the 10-year risk of blindness by 18.8% and prevent 13,983 people from going blind over 10 years reduce the 10-year risk of renal failure by 25.7% and prevent 26,418 people from experiencing renal failure over 10 years reduce the 10-year risk of myocardial infarction blindness by 14.2% and prevent 12,539 people from experiencing an MI over 10 years increase 10-year survival by 2% or save 22,464 lives over 10 years save more than 1 trillion pesos on renal transplants and dialysis, and more than 40 billion on heart attacks and strokes
Patient education is key to achieving better outcomes Targets on: blood glucose Cholesterol blood pressure Nephropathy Nutrition Smoking physical activity alcohol consumption only 0.2% meet all the targets in 2010 If people in Chile have two visits in clinics per year, they have to care for their disease for the reminding 8,759 hours per year
Prevention of diabetes needs to start early Improving the quality of care Patient education is key
THANKYOU
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