Diabetes: a different level of support for the benefit of patients and the healthcare system

World Diabetes Day is intended to raise awareness on the growing prevalence of this chronic condition, its complications and its management. It is important to remember the scale of the issues at stake, not only for patients but also for the healthcare system. Optimizing the care pathway for people living with diabetes is vital if we want to respond collectively to these challenges.

A health, economic and societal challenge 

According to The Lancet¹, diabetes is "a critical disease of the 21st century", with the number of people living with diabetes worldwide expected to more than double to 1.3 billion by 2050. In France, by 2020, diabetes was already affecting almost 1 in 15 people². It is a particularly complex metabolic disease that requires close monitoring, 24 hours a day, throughout life. In view of the prevalence of the disease and its mental burden on patients and their families, diabetes represents a major health challenge.

Diabetes is also a major economic challenge. In France, the cost of treating diabetes already represents more than €9.5 billion a year, or 5% of total Health Insurance expenditure³. Of this total expenditure, almost 80%⁴ is due to the many cardiovascular complications, which have very serious consequences.

Lastly, diabetes is a major societal challenge, as the way it is managed varies widely from one region to another, which means that not all patients can be guaranteed the same quality of care. 

To meet these challenges, however, there is an approach that creates value for patients and the healthcare system. It involves optimizing the opportunities offered by home healthcare.

Transforming care at home

The services offered by home healthcare providers aim to facilitate access to treatments in order to improve clinical outcomes and the quality of life for people living with a chronic disease, in close collaboration with healthcare professionals.

Real-life qualitative studies^5,6 were published on the satisfaction and needs of people treated with insulin pumps and hybrid closed loop systems in France. They demonstrate the unique role played by home healthcare providers in meeting patients' individual expectations and making up for support requirement differences. However, this need for personalization of care is not recognised and therefore does not address the specific needs people may have when managing their diabetes, e.g. children, the elderly, or pregnant women. The innovative technologies introduced in recent years open up real opportunities to help people reach their therapy goals and reduce the mental burden. However, they also require dedicated support as patients and healthcare professionals alike need help to learn how to use these technologies and get the most from them. 

By providing support for all, including those who are far from academic centers or specialists, home healthcare providers offer a solution to overcome social and territorial inequalities in access to care and facilitate the uptake of technological innovations. It promotes an understanding of the specific needs of each individual, the provision of scalable solutions, and the measurement of clinical outcomes or outcomes that matter to patients. A better monitoring of the disease as part of personalized care plans, leveraging digital solutions to interact with patients and healthcare professionals, will ultimately reduce the risk of complications and improve people’s quality of life. 

Last but not least, personalized care can also make it possible to respond to the rising healthcare costs, by avoiding the need for hospitalization and reducing the risk of complications. The approach advocated by the work of Michael Porter and Elizabeth Olmsted Teisberg⁷, who set out the principles of Value-Based Healthcare, enables a transformation based on patient-reported health outcomes in relation to the costs for achieving them.

It is now essential that the public authorities seize the opportunity to enable this transformation and encourage a value-based approach to provide more equitable and efficient support for the millions of French people living with diabetes. The aim is not only to improve their health and quality of life on a daily basis, but also to ensure the long-term economic sustainability of our healthcare system through better allocation of resources.