ESPE Abstracts (2018) 89 P-P2-096

ESPE2018 Poster Presentations Diabetes & Insulin P2 (63 abstracts)

The Incorporation of Available Technologies for Diabetes Care Among Different Worldwide Centers: The ESPE/ISPAD Working Group on Diabetes Technology Survey

Klemen Dovc a , Shlomit Shalitin b , Ragnar Hanas c , Charlotte Boughton d , Gianluca Musolino d , Tadej Battelino a, , Revital Nimri b & Moshe Phillip b

aDepartment of Paediatric Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, University Medical Centre Ljubljana, Bohoriceva 20, SI–1000 Ljubljana, Slovenia; bInstitute for Endocrinology and Diabetes National Center of Childhood Diabetes Schneider Children’s Medical Center of Israel, Petah Tikva, Israel; cNU Hospital Group, Department of Pediatrics, Uddevalla, Sweden and Sahlgrenska Academy, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden; dUniversity of Cambridge Wellcome Trust-MRC Institute of Metabolic Science, Cambridge, UK; eFaculty of Medicine, Ljubljana, Slovenia

Objective: International Societies for diabetes care are aiming to facilitate and improve the uptake of diabetes technologies. This survey investigated healthcare professional (HCP) evaluation of the role of technology in diabetes care within their centres.

Methods: Between April to November 2017, 215 HCPs from six continents (132 Europe, 36 Asia, 23 North and 7 South America, 9 Africa and 8 Australasia) replied to an online survey and provided data for analysis.

Results: Of those participants responding to the survey, the mean number of patients with diabetes within each service was 702, ranging from 10 to 10 000. Eighty percent of respondents reported provision of 24/7 support for patients and 35.3% had an organized national diabetes registry. The mean number of visits to clinic by patients was 4.4/year. Insulin pumps were used by 35.3% of patients and glucose sensors by 23.0%. One fifth of centres had over 50%, and 10 centres had over 80% of insulin pump users within their service. The proportion of technology users varied greatly between continents; highest usage of technology was reported in Australia (51.5% insulin pumps and 58.1% glucose sensors), followed by North America (45.8% and 28.3%) and Europe (42.0% and 24.5%). The availability of diabetes technology was relatively low in Asia (13.3% and 13.8%), Africa (4.4% and 4.2%), and South America (4.0% and 1.3%). Reimbursement for insulin analogues was provided by 89.3% centers, for insulin pumps by 75.3%, and for glucose sensors by 59.5% of responding centers. In 73% of centers, insulin pump initiation was performed in an outpatient setting. Eight centers (3.7%) reported a lower age limit for insulin pump initiation and seven (3.3%) for glucose sensor use. The majority reported an individualized approach for technology induction. Each centres’ multidisciplinary diabetes team consisted of on average, per 100 patients, 1.1 consultant physicians, 0.9 nurses, 0.9 dietitians and 0.5 psychologists/social workers with a mean of 3.2 HCPs/100 patients. The lowest number of HCPs/100 patient ratio was reported in North America (1.5) and Africa (1.6), followed by Asia (2.4), Australia (2.6), South America (3.6), and Europe (3.8).

Conclusions: Despite increased availability, the incorporation of technology within diabetes care remains a challenge, especially in lower income regions. Ensuring that individuals with diabetes have access to both technology and sufficient trained personnel to educate and support appropriate usage is paramount to broaden uptake to allow safe achievement of optimal glycaemic control.

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