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Abbreviation
Three-letter country code
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DEU |
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Country
Official name of the country
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Germany |
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Demographics and Epidemiology
Population Size
(0 - 14 years)
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11487000 |
Rank: 1 of 27
| centiles: |
25 |
50 |
75 |
| 527561 | 1526000 | 3130721 |
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Is there a geographically defined pediatric diabetes register?
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yes |
yes: 20 (74.07%)
no: 7 (25.93%)
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What is the scope?
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three federal states, plus a widely disseminated system of quality control DPV |
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Name of the register
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Baden-WÃ - ¼ - rttemberg, Sachsen and Nordrhein-Westfalen - national-wide DPV system |
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Remarks to the register
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Although there is no national pediatric diabetes register reported in Germany, several diabetes registers exist at the level of federal states: Baden-WÃ - ¼ - rttember, Sachsen and Nordrhein-Westfalen. Moreover, most pediatric diabetes centres document their patients through the DPV system, which currently hosts the documentation of more than 17,000 patients < 18 years. |
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Were the country data published in the last Eurodiab report?
(Lancet 2009;373(9680):2027-33)
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yes |
yes: 16 (59.26%)
no: 11 (40.74%)
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Are mortality data available?
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no |
no: 11 (40.74%)
data available from the past: 9 (33.33%)
prospectively collected data: 5 (18.52%)
not answered: 2 (7.41%)
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Type 1 Diabetes Epidemiology
Diabetes incidence rates (0-14y)
average, new cases per 100,000 and year
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15.5 |
Rank: 10 of 27
| centiles: |
25 |
50 |
75 |
| 11.5 | 14.8 | 17.2 |
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Source of incidence data
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Lancet 2009 - 373:2027: data 89 - 03 - the larger of the registers |
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Estimated number of cases with childhood diabetes (0-14y),
total in the country
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14600 |
Rank: 2 of 27
| centiles: |
25 |
50 |
75 |
| 600.0 | 1576.0 | 4700.0 |
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Source of the number of cases
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source: Deutscher Gesundheitsbericht Diabetes |
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Period of ascertainment of the above data
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Source of the above epidemiological data
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Type 2 Diabetes
Summary of type 2 diabetes
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According to the DPV, a German Pediatric Diabetes Registry, 4 to 5% of the newly diagnosed 11 to 18 year old children were classified as having type 2 diabetes. The national recommendations for the screening of type 2 diabetes in childhood are available, and published in the updated evidence-based guidelines. |
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Patient organizations
The most important organization for children with diabetes in the country.
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Bund diabetischer Kinder und Jugendlicher |
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Its web address
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www.bund-diabetischer-kinder.de |
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Is this organization exclusively for childhood diabetes?
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yes |
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Organization for health professionals and physicians
Organization for physicians and/or health professionals focused on diabetes.
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Deutsche Diabetes Gesellschaft (DDG) |
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Its web address.
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www.deutsche-diabetes-gesellschaft.de |
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Other organization for physicians and/or health professionals focused on diabetes.
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Its web address.
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Summary of the organization of the care
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In Germany, qualified pediatric diabetologists have the main responsibility, they treat more than 80% of pediatric patients. In some cases a diabetologists for adults is designated to take care of pediatric diabetes. Pediatricians or general practitioners only prescribe glucometers and strips in a few cases. |
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Pediatric diabetes centres
Are there officially recognized pediatric diabetes centres in your country?
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yes |
yes: 19 (70.37%)
no: 8 (29.63%)
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Who renders the status of the centre?
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Diabetes Society |
Ministry of Health: 10 (37.04%)
n/a: 8 (29.63%)
Diabetes Society: 2 (7.41%)
Ministry of Social Affairs: 1 (3.7%)
Ministry of Health, Diabetes Society, health insurance companies : 1 (3.7%)
authorities outside the Ministry of Health and Diabetes Society: 1 (3.7%)
health insurance companies: 1 (3.7%)
Ministry of Health, Diabetes Society, health insurance companies: 1 (3.7%)
Diabetes Society, health insurance companies: 1 (3.7%)
Ministry of Health, Diabetes Society: 1 (3.7%)
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Are there defined criteria for being a center?
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yes |
no: 10 (37.04%)
yes: 9 (33.33%)
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Is the status of the centre permanent?
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no, reapplication is necessary |
yes: 12 (44.44%)
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Does a centre have to participate in a QC programme?
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yes, in a mandatory unified program |
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Remarks to participation in a national QC system
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Quality control of pediatric diabetes care
Is there a system of quality control in pediatric diabetes care at the national level?
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yes |
no: 19 (70.37%)
yes: 8 (29.63%)
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Who organizes this system?
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DPV, FQSD (Forum Qualità - ¤ - tssicherung in der Diabetologie) |
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Glycated hemoglobin levels
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yes |
no: 1 (3.7%)
yes: 9 (33.33%)
n/a: 17 (62.96%)
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Other indicators
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What is the feedback from the system?
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electronic on-line statistics |
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Frequency of DKA with hospitalization
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yes |
no: 1 (3.7%)
yes: 9 (33.33%)
n/a: 17 (62.96%)
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Frequency of severe hypoglycemia requiring assistance
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yes |
no: 2 (7.41%)
yes: 8 (29.63%)
n/a: 17 (62.96%)
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Growth data
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yes |
no: 3 (11.11%)
yes: 7 (25.93%)
n/a: 17 (62.96%)
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Data on quality of life
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no |
no: 10 (37.04%)
n/a: 17 (62.96%)
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Microalbuminuria levels
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no |
no: 6 (22.22%)
yes: 4 (14.81%)
n/a: 17 (62.96%)
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Further indicators
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yes |
no: 5 (18.52%)
yes: 5 (18.52%)
n/a: 17 (62.96%)
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Education of a diabetic patient
Is the content of education of diabetic childred regulated?
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no |
no: 23 (85.19%)
yes: 4 (14.81%)
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Who determines the content of education?
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individual centres |
individual centres: 22 (81.48%)
a national plan / guidance for education: 5 (18.52%)
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Is education reimbursed?
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yes, with limits |
yes: 11 (40.74%)
no: 7 (25.93%)
yes, with limits: 3 (11.11%)
with limits: 2 (7.41%)
yes, with limits (only if given during hospital care): 1 (3.7%)
yes, with limits (only one session per patient): 1 (3.7%)
yes, with limits (four sessions per year): 1 (3.7%)
yes, with limits (10 sessions): 1 (3.7%)
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Remarks to education
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Education for children and adolescents with diabetes in Germany is partly reimbursed by the health insurance company which foresees in a re-education every 2 years in an outpatient setting. |
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National diabetes program/plan
Is there a national diabetes plan / program?
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no |
no: 14 (51.85%)
yes: 13 (48.15%)
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Details on the diabetes plan?
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There is currently no national diabetes plan in Germany. According to the Diabetes Audit (2008), a national plan is in preparation. However, the first draft of this plan has been discussed controversially and the further progress is presently unclear. |
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National criteria for diabetes control in pediatric age
Are there defined national standard criteria for diabetes control in pediatric age??
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yes |
yes: 18 (66.67%)
no: 9 (33.33%)
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Who issued these criteria?
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Deutsche Diabetes Gesellschaft (DDG)/AGPD |
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Have they been published in professional journals?
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yes |
yes: 10 (37.04%)
no: 5 (18.52%)
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If no, do you use adult criteria of diabetes control?
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National guidelines defining the surveillance for chronic diabetes complications
Are there national guidelines defining the surveillance for chronic diabetes complications and diabetes-associated diseases that are applicable to pediatric practice?
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yes |
yes: 16 (59.26%)
no: 11 (40.74%)
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Who issued these guidelines?
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DDG/AGPD |
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Are they ISPAD compliant?
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in most instances |
in most instances: 11 (40.74%)
n/a: 11 (40.74%)
yes, completely: 3 (11.11%)
in part: 2 (7.41%)
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diabetic retinopathy
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1 |
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diabetic nephropathy
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1 |
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diabetic neuropathy
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0 |
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autoimmune thyroid disease
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1 |
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celiac disease
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1 |
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hyperlipidemia
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1 |
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psychological disorders
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1 |
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other, please list
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0 |
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other complications - list
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Monogenic diabetes
Is MODY analysis available?
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yes |
yes: 22 (81.48%)
no: 3 (11.11%)
question not answered: 2 (7.41%)
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What types of MODY are tested in the country?
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all MODY types |
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What types of MODY are testes abroad?
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- |
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Injectable insulin
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yes |
yes: 27 (100.0%)
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Rapid acting insulin analogues
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yes |
yes: 22 (84.62%)
restricted: 4 (15.38%)
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Long acting insulin analogues
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yes |
yes: 21 (80.77%)
restricted: 4 (15.38%)
no: 1 (3.85%)
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Insulin pens
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yes |
yes: 24 (100.0%)
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Insulin pumps
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yes |
yes: 18 (72.0%)
restricted: 3 (12.0%)
no: 4 (16.0%)
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Blood glucose monitoring strips
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restricted |
yes: 18 (66.67%)
restricted: 9 (33.33%)
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Blood glucose monitoring meters
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restricted |
yes: 19 (73.08%)
restricted: 3 (11.54%)
no: 4 (15.38%)
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Continuous glucose monitoring – intermittent/diagnostic use
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restricted |
yes: 9 (36.0%)
restricted: 7 (28.0%)
no: 9 (36.0%)
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Continuous glucose monitoring – continuous use
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restricted |
yes: 3 (12.0%)
restricted: 5 (20.0%)
no: 17 (68.0%)
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Lancets
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yes |
yes: 20 (74.07%)
restricted: 3 (11.11%)
no: 4 (14.81%)
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Lipid testing
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yes |
yes: 22 (84.62%)
restricted: 1 (3.85%)
no: 3 (11.54%)
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Micro/macro albuminuria
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yes |
yes: 25 (96.15%)
restricted: 1 (3.85%)
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Retinopathy screening
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yes |
yes: 24 (92.31%)
restricted: 1 (3.85%)
no: 1 (3.85%)
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Blood pressure meters
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restricted |
yes: 5 (18.52%)
restricted: 4 (14.81%)
no: 18 (66.67%)
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Education
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restricted |
yes: 14 (51.85%)
restricted: 7 (25.93%)
no: 6 (22.22%)
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Psychologists
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restricted |
yes: 8 (33.33%)
restricted: 10 (41.67%)
no: 6 (25.0%)
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Dietician
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restricted |
yes: 16 (61.54%)
restricted: 3 (11.54%)
no: 7 (26.92%)
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remarks to reimbursment
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While the majority of diabetes treatment is currently reimbursed, there is growing controversy surrounding the reimbursement decisions for many of the new treatments. Restrictions on the reimbursement for diabetes treatment are expected over the next two years. |
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