2021 Report to Parliament
The annual “Report to Parliament on current knowledge and new findings in the field of diabetes mellitus – Law n. 115 of 16 March 1987, containing Provisions for the prevention and treatment of diabetes mellitus” provides an overview of diabetes and ongoing efforts to fight this condition. The 2021 Report to Parliament, which focuses on the 2019-2020 period, was published in May 2022.
The report starts by analysing diabetes prevalence data in Italy and worldwide. In 2021, the International Diabetes Federation (IDF) estimated that nearly 10% of the global adult population (536.6 million people) suffered from diabetes, and 1.2 million children and adolescents (<19 years of age) had type 1 diabetes. The percentages in Italy are lower: 5.6%, according to the National Institute of Statistics (ISTAT), and 4.7%, based on data collected by the PASSI surveillance system among adults aged 18-69 years. Both ISTAT and PASSI found prevalence to be higher in the southern regions than in the central and northern regions.
Use of diabetes medications
According to the 2020 OsMed Report of the Italian Medicines Agency (AIFA), consumption of diabetes medications remained relatively stable over the period 2014-2020, rising slightly from 61.8 to 64.6 DDDs (defined daily doses) per 1,000 inhabitants per day, with an average annual variation of about 1%. In the southern regions, consumption was 33% higher than in the north (76.7 vs 57.6 DDDs) and 19% higher than the national average (64.6 DDDs).
Diabetes care during the COVID-19 emergency
Between February and March 2021, the Italian Association of Diabetes Doctors (AMD) conducted a survey among its members to assess the impact of the SARS-CoV-2 pandemic on the volume of care provided by diabetes services in Italy, and to analyse the measures taken during the national lockdown. Below are some of the findings:
- 87% of respondents reported reduced activities in their clinics during lockdown
- On average, face-to-face consultations dropped by 70%. However, almost all doctors taking part in the survey (92.4%) said that face-to-face consultations continued to be provided to the most urgent cases, and two thirds of respondents said they were provided to pregnant women and new cases of type 1 diabetes
- Nearly all participants (98.2%) stated that measures were taken to help reduce the risk of spreading the virus
- 96% of respondents claimed that measures were implemented in their clinics to simplify updating of treatment plans, while two thirds of the participants said that direct distribution of medicines and devices to patients was ensured by hospital pharmacies (43%) or diabetes services (24%)
- In most facilities (88%), remote activities were implemented (e.g. consultations with patients or between doctors) to ensure continuity of care, especially via telephone (82.2%) or email (72%)
- 46% of respondents reported no changes to diabetes consultations for hospitalized patients during lockdown, 38% said only remote consultations were offered, and 8% said all consultations were suspended.
Prevention of diabetes and its complications
The report recalls the actions undertaken at the national level to help reduce the burden of disease secondary to diabetes, also in the context of a more general fight against chronic diseases. Such actions include:
- The Guadagnare Salute (Gaining Health) programme, which aims to address the environmental factors and socio-economic determinants associated with the development of chronic diseases, promoting a life-course approach and implementing intersectoral policies to comply with the principles of the “Health in All Policies” strategy
- The National Prevention Plans (NPPs):
- The 2005-2009 and 2010-2013 NPPs identified obesity and diabetes as priority health issues in Italy, and provided for the implementation of regional projects aimed at preventing their complications through the adoption of integrated management programmes
- The 2014-2019 NPP addressed diabetes in the context of broader efforts to prevent chronic Non-Communicable Diseases (NCDs), in line with the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020
- With regard to the prevention of NCDs, the 2020-2025 NPP aimed to strengthen and improve the results achieved with the previous NPPs, and focused on interventions that could have a cross-cutting impact on all the determinants of health and equity
- The guidelines on physical activity. In line with the 2020-2025 NPP, this document reiterates the importance of supporting physical activity through broad intersectoral collaboration, to ensure that actions taken across various sectors work towards the same health objectives
- The diabetes awareness activities conducted during World Diabetes Day, on 14 November
- The diabetes plan, which sets out strategic goals to improve diabetes prevention, treatment and rehabilitation, and to promote clinical pathways that ensure consistency and continuity of care for patients
- International Joint Actions CHRODIS and CHRODIS Plus, whose main objective is to facilitate the exchange and transfer of “good practices” between partner countries, identifying the best approaches to preventing and treating chronic diseases (especially cardiovascular diseases, stroke and type 2 diabetes), with a specific focus on health promotion, multi-morbidity and diabetes management
- Urban health initiatives to encourage planning that helps promote healthy lifestyles
- Health literacy, i.e. the ability of individuals to understand, access and use information in ways which promote and maintain good health. Italy has joined the Action Network on Measuring Population and Organizational Health Literacy (M-POHL) which, between 2019 and 2021, conducted a survey to establish a baseline level of health literacy, which could serve as a reference to plan health policy measures for improving health literacy and monitor the health outcomes of such measures over time.