Franz Walt, Roche Diagnostics Diabetes Care, Chronic Diseases Presentation

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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

    1. 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. 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. 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. 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. 5. <ul><li>Education and self-monitoring is key </li></ul><ul><li>Blood glucose is in control </li></ul><ul><li>Prevents or delays diabetic complications </li></ul><ul><li>Provides better quality of life </li></ul> | 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. 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. 7. World Health Organization 2008-2013 Action Plan for the Prevention and Control of Noncommunicable Diseases <ul><li>„ Take action to help people with noncommunicable diseases to manage their own conditions better and provide education, incentives and tools for self-management care.“ </li></ul> | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche
    8. 8. <ul><li>Diabetes (and it’s complications) account for approx. 5% - 20%* of a nation’s health budget </li></ul><ul><li>In the U.S. alone, diabetes care costs have increased by 30% from 2002 – 2007 </li></ul><ul><ul><ul><li>91.8 bn $ to 119.4 bn $; 5.3% of the total US healthcare budget in 2007 </li></ul></ul></ul><ul><li>~ 80% of all expenditures for diabetes care are made in economically rich countries </li></ul><ul><ul><ul><li>But 80% of chronic disease deaths occur in low and middle income countries </li></ul></ul></ul><ul><li>Complications occur late and are the cost drivers: </li></ul><ul><ul><ul><li>Heart diseases & stroke </li></ul></ul></ul><ul><ul><ul><li>Kidney failure </li></ul></ul></ul><ul><ul><ul><li>Blindness & visual impairment </li></ul></ul></ul><ul><ul><ul><li>Lower limb amputations </li></ul></ul></ul><ul><ul><ul><li>Dementia </li></ul></ul></ul> | 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. 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. 10. Conclusion <ul><ul><li>Diabetes is a chronic disease and its health & economic consequences need to be taken seriously. </li></ul></ul><ul><ul><li>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. </li></ul></ul><ul><ul><li>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! </li></ul></ul> | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche
    11. 11. | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche Thank you!
    12. 12. Type 1 diabetes <ul><li>Is usually diagnosed in children or young adults </li></ul><ul><li>Occurs when the insulin producing cells in the pancreas (beta cells) are destroyed; as a result, the pancreas does not produce enough insulin </li></ul><ul><li>Symptoms appear quite rapidly and are dramatic due to the high blood glucose levels and metabolic dysregulation </li></ul><ul><li>From the onset of disease, everybody with type 1 diabetes depend on daily insulin injections to survive </li></ul><ul><li>Type 1 diabetes : autoimmune disease , i.e. the body’s immune system destroys the insulin producing cells </li></ul><ul><li>5 - 10% of people with diabetes have type 1 diabetes </li></ul><ul><li>5 – 10 % have a family history of type 1 diabetes </li></ul><ul><li>LADA (latent autoimmune diabetes in adults) </li></ul> | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche
    13. 13. Type 2 diabetes <ul><li>More than 90 – 95 % of all cases of diabetes </li></ul><ul><li>Affect people at any age, more common in older people </li></ul><ul><li>Symptoms tend to develop slowly and are less obvious </li></ul><ul><li>Almost half of all people with type 2 diabetes are not aware of their condition - until complications appear </li></ul><ul><li>Treated with lifestyle measures, oral antidiabetics, insulin </li></ul><ul><li>Type 2 diabetes is characterized by insulin resistance (ineffective use of insulin) and a relative rather than absolute deficiency in insulin production. </li></ul> | Chronic Diseases – The everyday epidemic | Franz T. Walt October 8, 2010 www.accu-chek.com © 2010 Roche
    14. 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 <ul><li>Explanatory notes </li></ul><ul><li>Stage I: insulin secretion begins to increase as amount of insulin needed to control BG-level rises due to impaired glucose tolerance </li></ul><ul><li>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 </li></ul><ul><li>Stage III: insulin secretion comes under the insulin baseline; insulin therapy is necessary </li></ul>Type 2 diabetes mellitus Insulin secretion during the progress of disease
    15. 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

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