Are there more people with diabetes under the age of 40? Experts reveal: The sudden increase in the population with "comorbid heart and kidney diseases" may become the biggest threat to people with diabetes
Is the age gap among diabetics widening? Are there more patients over 75 and under 40?
According to statistics from the Taiwan Health Promotion Administration, approximately 2.21 million people in Taiwan are suffering from diabetes, and on average, 1 in 10 people is a diabetic patient. As care continues to improve, the Diabetes Yearbook survey found that although the death rate among Taiwanese people has declined, the number of people with diabetes over the age of 75 has increased by 21%, and the incidence rate among young people under the age of 40 has also increased to 7.6% year by year. It is obvious that diabetes has reached advanced age. The development trend of modernization and rejuvenation.
The Diabetes Society of Taiwan has promoted the “GOAL 50” plan since 2018, striving to optimize diabetes and comorbid care, and has achieved outstanding results in the first phase. In 2023, it will propose an upgraded version of the “GOAL 50+Beyond 50” plan, inviting Taiwan The Ministry of Health and Welfare, Health Promotion Administration, the Department of Health Insurance, the Diabetes Health Education Association of Taiwan and the Taiwan Renal Medicine Association jointly responded, hoping to gather the power of the government and the medical community to continue to improve from the “five major aspects” and lead the Asia-Pacific diabetes and comorbidities Take care of and protect the “heart and kidneys” of Taiwanese people with diabetes.
The risk of chronic kidney disease is 9 times higher than that of ordinary people! “Cardio-renal comorbidity” has become the biggest problem for people with diabetes
Huang Jianning, Chairman of the Diabetes Association of Taiwan, shared that there was once a 70-year-old male patient who was diagnosed with diabetes and hypertension since he was in his 50s. I have been controlling my blood sugar and blood pressure through diet and medicine for many years. However, after I retired, due to the inconvenience of cooking alone and living alone, my blood sugar gradually became uncontrollable. Recently, due to the COVID-19 epidemic, I did not go to the doctor regularly to track my condition, which resulted in my blood sugar getting out of control quickly.
It was only after his son and daughter visited him in recent years that the patient discovered that his swollen legs and wheezing while walking were worsening, so he went to the hospital for treatment. The doctor diagnosed that diabetes has been complicated by severe kidney disease, and he may need “kidney dialysis” to survive in the future. The children considered that kidney dialysis would require dedicated care, so they sent Uncle Zhang to a nursing home. The long-term medical and nursing expenses also increased the psychological and financial burden on the children.
Chairman Huang Jianning reminded that the above situation may not be a single case. Aging and prolonged disease will greatly increase the risk of comorbidities among patients. According to statistics from the Type 2 Diabetes Yearbook, the number of people with diabetes and chronic kidney disease increased significantly from 2000 to 2014; the number of people with type 2 diabetes and heart failure increased by 1.9 times. In addition, the Taiwan Kidney Disease Annual Report pointed out that 45.4% of new dialysis patients were diagnosed with diabetes, and 51.2% of dialysis patients had diabetes, which means that on average, 1 out of every 2 dialysis patients has diabetes.
Continuing the outstanding achievements of “GOAL 50”, all walks of life responded to the “GOAL 50+” upgrade plan
According to the 2022 annual health insurance expenditure statistics of the National Health Insurance Administration, acute renal failure and chronic kidney disease amount to 58.7 billion, while diabetes follows closely behind with 40.2 billion. Comorbidities not only increase patients medical care needs, but also increase the economic burden, leading to a decline in patients quality of life in the future. discount. Although the quality of diabetes care in Taiwan has been successfully improved, with the overall crude mortality rate decreasing by 16.8% and the total hospitalization rate also decreasing by 21%, the number of patients over 75 years old is increasing year by year, and about 40% of most type 2 diabetes patients have been suffering from the disease for 10 years above.
Chairman Huang Jianning said that from 2000 to 2014, the number of patients with diabetes complicated by heart failure and chronic kidney disease doubled. Without early intervention, it may cause socioeconomic problems. Therefore, early intervention and treatment of diabetic heart and kidney comorbidities are urgent. In particular, Taiwan is about to enter a super-aged society and the average life expectancy is increasing. We should protect the hearts and kidneys of people with diabetes as soon as possible to reduce unhealthy years of disability and help people with diabetes maintain a good life in old age.
Looking forward to the “GOAL 50+” vision in 2028! 4 major aspects to protect the heart and kidney care of diabetes patients
The Diabetes Society of Taiwan has promoted the “GOAL 50” plan until 2022, and has achieved personalized HbA1c control in 55% of patients, completed proteinuria testing in 68% of patients, and 48% of patients with high risk of diabetic chronic kidney disease following international guidelines for treatment. Assess key outcomes such as patient risk for comorbidities.
With the joint efforts of partners from the Health Education Association and the Renal Medicine Association, the National Health Insurance Department officially launched the “Integrated Diabetes and Early Chronic Kidney Disease Care Plan” in 2022 to encourage medical institutions to form cross-disease care teams. So far, more than 500 medical institutions and about 85,000 patients have joined the diabetes and kidney care plan. In the next phase, 130,000 diabetes patients will be actively recruited to prevent chronic kidney disease.
Actively solve the problem of “heart and kidney comorbidities” among people with diabetes and challenge the “5 major indicators”, hoping to exceed 50% in 5 years
This year (2023), the Diabetes Association of Taiwan has further upgraded its goals for diabetes and kidney control. It launched the “GOAL 50+ Beyond 50 Plan” on June 6 and announced the latest model goals for diabetes control. It is expected to strengthen diabetes control in the next five years. The screening rate of patients with heart and kidney comorbidities, the comorbidity care rate in Taiwan, and the continued promotion of international treatment guidelines have increased the following five goals by more than 50%:
Ability to recognize diabetes and comorbidities
ABC compliance rate: The three major indicators of glycated hemoglobin, blood pressure, and cholesterol are controlled and achieved.
Detection rate of urine albumin to urine creatinine ratio (UACR)
Guideline medication compliance rate
Coverage rate of diabetes and early-stage chronic kidney disease care plans
Chairman Huang Jianning said that the “heart and kidneys” of people with diabetes are the “prosperity” of the country. He hopes that the screening and care awareness rate for diabetic kidney disease (DKD) will gradually increase in the future; he will also continue to work with the National Health Insurance Department to optimize diabetes and kidney care. Benefit conditions, strive for appropriate benefits, and reduce the burden of multiple chronic disease care in the future.
In addition, the Diabetes Association, the Diabetes Health Education Association, and the Renal Medicine Association will continue to actively cooperate and continue the common care goals. Strengthening the care of health teachers can improve patients’ self-care and co-morbidity awareness, and support the concept of “green kidney” medical sustainability. Implement early screening and early treatment of chronic kidney disease, and actively solve the three major challenges of chronic kidney disease, aging, and heart and kidney comorbidities.
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