ESPE Abstracts (2016) 86 WG5.2

SWEET: Developing Centers of Excellence (CoR)

Thomas Danne

Hannover, Germany

Background: SWEET ( is a non-profit entity endorsed by ISPAD aiming to create an extensive network of certified CoRs for childhood diabetes in order to ensure high quality care.

Objective and hypotheses: SWEET aims at an improved and more uniform care for people with diabetes through comparing processes and outcomes among participating members. The results of data analysis are conveyed to members through biannual benchmarking reports. In collaboration with NHS Diabetes, peer review visits to applying centers are organized so as to assess compliance with the SWEET quality criteria. Smaller centers can participate as collaborative centers.

Method: Electronic documentation of at least 150 pediatric patients with diabetes annually, with subsequent upload of anonymized data to a common database is a main prerequisite. The SWEET dataset consists of 37 clearly definable items that reflect adherence to ISPAD’s guidelines. Data can be uploaded either through the DPV software that is adapted for a multilingual group or in other electronic formats.

Results: SWEET includes all forms of pediatric diabetes. Of the 29 centers collaborating in the subgroup of “Genetic disorders of glucose and insulin homeostasis” within the application for an European Reference Network for Rare Endocrine Diseases (Endo-ERN), 10 are also participating in SWEET. Currently 48 SWEET centers from 33 countries in 5 continents have contributed data for 28,667 patients. In 2015, 19.131 patients (51.6% males, median age 14.2 y, T1D: 96.0%, T2D: 1.1%, other forms: 2.9%) with 69,028 visits were recorded. Median HbA1c was 7.8% with 39.1%, 41.4%, and 19.4% of patients having HbA1c < 7.5%, 7.5–9% and >9%, respectively. One third of all centers achieve a median HbA1c < 7.5%. Regarding treatment modality, 41.2% of all patients were pump users. Data completeness rates have significantly improved over time.

Conclusion: Benchmarking has highlighted the importance of complete and accurate data to achieve meaningful interpretation. Hopefully SWEET will therefore help to harmonize care to optimize outcomes of children with diabetes worldwide whatever the etiology of their diabetes is.

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