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Franz Walt, Roche Diagnostics Diabetes Care, discusses Chronic Diseases at the INSEAD Health Summit in Paris

Franz Walt, Roche Diagnostics Diabetes Care, discusses Chronic Diseases at the INSEAD Health Summit in Paris

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Franz Walt, Roche Diagnostics Diabetes Care, Chronic Diseases Presentation Presentation Transcript

  • 1. Chronic Diseases – The Everyday Epidemic The role of blood glucose self-monitoring in diabetes Franz T. Walt - 8. October 2010, Paris / France Experience what’s possible.
  • 2. | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche Every 8 seconds a person dies from diabetes-related causes. 2 Source: 1 WHO Global Report “Preventing Chronic Diseases – A Vital Investment”; 2 IDF: http://www.worlddiabetesday.org/the-campaign/unite-for-diabetes Chronic diseases account for 60% of all deaths Diabetes - the 4 th leading cause of death 1
  • 3. | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche Source: IDF Diabetes 4th ed., International Diabetes Federation, 2009 North America & Caribbean 2010: 37.4 2030: 53.2 Increase: + 42% South & Central America 2010: 18.0 2030: 29.6 Increase: +65% Africa 2010: 12.1 2030: 23.9 Increase: +98% Europe 2010: 55.2 2030: 66.2 Increase: +20% Eastern Mediterranean & Middle East 2010: 26.6 2030: 51.7 Increase: +94% South-East Asia 2010: 58.7 2030: 101.0 Increase: +72% Western Pacific 20 10: 76.7 20 30 : 112.8 Increase: +4 7 % World 2010: 284.6 2030: 438.4 Increase: +54% Diabetes is a global threat … and particularly affects low- and middle income countries in millions:
  • 4. | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche Requirements for optimal Diabetes Self-Management Information Management Systems Diabetes Management A holistic, integrated and patient center approach is needed Education & Patient Empowerment Management of Risk Factors Lifestyle Adaption Monitoring of Blood Glucose Drug Treatment
  • 5.
    • Education and self-monitoring is key
    • Blood glucose is in control
    • Prevents or delays diabetic complications
    • Provides better quality of life
    | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche Self-Monitoring of blood glucose … helps to empower patients SMBG is a personalized support for managing the disease
  • 6. | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche A blood glucose analysis system provides individual profiles and enables personalized treatment. Individualization of Therapy based on structured testing of blood glucose
  • 7. World Health Organization 2008-2013 Action Plan for the Prevention and Control of Noncommunicable Diseases
    • „ Take action to help people with noncommunicable diseases to manage their own conditions better and provide education, incentives and tools for self-management care.“
    | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche
  • 8.
    • Diabetes (and it’s complications) account for approx. 5% - 20%* of a nation’s health budget
    • In the U.S. alone, diabetes care costs have increased by 30% from 2002 – 2007
        • 91.8 bn $ to 119.4 bn $; 5.3% of the total US healthcare budget in 2007
    • ~ 80% of all expenditures for diabetes care are made in economically rich countries
        • But 80% of chronic disease deaths occur in low and middle income countries
    • Complications occur late and are the cost drivers:
        • Heart diseases & stroke
        • Kidney failure
        • Blindness & visual impairment
        • Lower limb amputations
        • Dementia
    | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche *In Germany 11.8% of the population has diabetes and accounts for 20% of the national healthcare budget; Deutsche Bank Research 2009 Source: IDF Diabetes Atlas, 4th edition, 2009 IDF Diabetes Atlas, 3rd edition, 2006 http://www.cms.gov/NationalHealthExpendData/downloads/tables.pdf World Health Organization: Preventing Chronic Diseases a vital investment Diabetes Complications are the Major Cost Drivers Global expenditures: USD 376 billion (2010)
  • 9. | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche Example Germany Costs for self-monitoring of blood glucose remain constant … and account for less than 2% of the overall costs * Heart attack, Stroke, Amputation, Blindness and Dialysis / Cost per patient Source: Weber, C.; Neeser, K.; Wenzel, H.; Schneider, B.. J Med Econ 2006; 9; 45-54 Year after diagnosis SMBG: < 2%
  • 10. Conclusion
      • Diabetes is a chronic disease and its health & economic consequences need to be taken seriously.
      • Rethinking should focus around primary care where d iabetes management requires a holistic approach with individualized patient self-management as an important part of it.
      • BG monitoring with less than 2% of total cost has a great potential to influence the other 98% and is therefore not part of the problem but part of the solution!
    | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche
  • 11. | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche Thank you!
  • 12. Type 1 diabetes
    • Is usually diagnosed in children or young adults
    • Occurs when the insulin producing cells in the pancreas (beta cells) are destroyed; as a result, the pancreas does not produce enough insulin
    • Symptoms appear quite rapidly and are dramatic due to the high blood glucose levels and metabolic dysregulation
    • From the onset of disease, everybody with type 1 diabetes depend on daily insulin injections to survive
    • Type 1 diabetes : autoimmune disease , i.e. the body’s immune system destroys the insulin producing cells
    • 5 - 10% of people with diabetes have type 1 diabetes
    • 5 – 10 % have a family history of type 1 diabetes
    • LADA (latent autoimmune diabetes in adults)
    | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche
  • 13. Type 2 diabetes
    • More than 90 – 95 % of all cases of diabetes
    • Affect people at any age, more common in older people
    • Symptoms tend to develop slowly and are less obvious
    • Almost half of all people with type 2 diabetes are not aware of their condition - until complications appear
    • Treated with lifestyle measures, oral antidiabetics, insulin
    • Type 2 diabetes is characterized by insulin resistance (ineffective use of insulin) and a relative rather than absolute deficiency in insulin production.
    | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche
  • 14. | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche Fasting blood glucose Baseline insulin secretion Stage I Impaired glucose Tolerance Stage II Type 2 diabetes Sufficient insulin secretion Stage III Type 2 diabetes Pancreas insufficiency Insulin secretion Diagnosis
    • Explanatory notes
    • Stage I: insulin secretion begins to increase as amount of insulin needed to control BG-level rises due to impaired glucose tolerance
    • Stage II (time of diagnosis): after a peak the insulin secretion begins to fall again due to ß-cell failure  fasting blood glucose begins to increase
    • Stage III: insulin secretion comes under the insulin baseline; insulin therapy is necessary
    Type 2 diabetes mellitus Insulin secretion during the progress of disease
  • 15. | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche * 6,5 % according to DDG Practical Guidelines 7,0 % according to ADA Guidelines Source: adapted from: Matthaei S et al, Medikamentöse antihyperglycämische Therapie des Typ-2-Diabetes, Diabetologie 2009;4:32-64. Explanatory notes: Therapy phase 1: Lifestyle changes & OAD If HbA1c is ≥ 6,5% after 3-6 months Therapy phase 2: combination of two or more OAD If HbA1c is ≥ 6,5% after 3-6 months Therapy phase 3: combination of OAD & insulin If HbA1c is ≥ 6,5% after 3-6 months Therapy phase 4: intensive insulin therapy (MDI or pump therapy) Phase 1 Phase 2 Phase 3 Phase 4 HbA1c ≥ 6,5 %* after 3-6 months ≥ 7,5 % < 7,5 % HbA1c ≥ 6,5 %* after 3-6 months ~ year 2-3 ~ year 4 ~ year 7-9 diagnosis approx. time span from diagnosis to different therapy phases 11 % Distribution of therapy forms by percentage ( German market data ) 39 % 15 % CT: 17 % ICT: 16 % 2 % HbA1c ≥ 6,5 %* after 3-6 months Type 2 diabetes mellitus Therapy ladder OAD Multiple OAD Insulin MDI Insulin pump OAD + Insulin Diet & physical activity