The Diabetes Association of the Republic of China yesterday launched a new “Goal 50+” program to help people better understand, monitor and manage their diabetes and comorbidities, and improve the shared care of diabetes and chronic kidney disease.
About 2.21 million people have diabetes in Taiwan, association president Huang Chien-ning (黃建寧) said.
Although the crude mortality rate has fallen about 17 percent and the hospitalization rate dropped 21 percent in the past few years, the number of people aged 75 or older and 40 or younger with diabetes has increased, Huang said.
Photo: CNA
The association launched the five-year “Goal 50” program in 2018 to improve integrated care of diabetes and comorbidities, and as most of those goals have been met or surpassed, the group is launching the enhanced initiative, he said.
Goal 50+ is supported by the Health Promotion Administration (HPA), the National Health Insurance Administration (NHIA), the Taiwanese Association of Diabetes Educators and the Taiwan Society of Nephrology, he said.
The first program aimed to achieve at least a 50 percent coverage rate among people with diabetes in keeping glycated hemoglobin levels below 7 percent, getting routine urine albumin-to-creatinine ratio (UACR) tests and helping those with diabetic kidney disease to receive sodium-glucose cotransporter-2 inhibitors.
NHIA Director-General Shih Chung-liang (石崇良) said that diabetes is one of the most common diseases in Taiwan, and chronic kidney disease ranks first among annual National Health Insurance costs for treating a single disease, with most of it used on hemodialysis, while diabetes ranks third.
Most people with diabetes develop multiple comorbidities, which often requires interdisciplinary shared care, he said.
Diabetes management is also closely linked with lifestyle factors, such as medication use, eating behavior, physical activity, sleep patterns and stress, so a person’s disease awareness and participation is crucial to the quality of their health management, he added.
The NHIA has been working with the HPA to improve people’s health awareness in disease prevention and encouraging them to seek intervention when they receive abnormal test results, Shih said, adding that the National Health Insurance Mobile Easy Access (全民健保行動快易通) app can help people track their health conditions.
Huang said that as more people are diagnosed with diabetes younger, they would need to control the disease and prevent comorbidities for longer, which is why the new five-year Goal 50+ program aims to increase the coverage of disease awareness, routine testing and integrated care.
The initiative aims to achieve at least a 50 percent coverage rate among people with diabetes in: being aware of their risk of developing chronic kidney disease; having glycated hemoglobin levels below 7 percent, blood pressure below 130 millimeters of mercury (mmHg) over 80mmHg and low-density lipoprotein levels below 100 milligrams per deciliter; receiving regular UACR tests and precision medicine according to diabetic kidney disease treatment guidelines; and participating in a new diabetes and chronic kidney disease shared care program.
A 2021 survey showed that about 52 percent of people with diabetes have insufficient knowledge about the risk of developing chronic kidney disease, while a 2018 survey found that only 44.1 percent have good control of their glycaemia levels, 36.3 percent have good control of their blood pressure and 70.9 percent have good control of their low-density lipoprotein levels, he said.
A 2019 survey showed that only 35.8 percent of people with diabetes receive regular UACR tests, Huang said.
As of Feb. 2, of the more than 770,000 people with diabetes and early chronic kidney disease who are eligible to join the shared care program, only 84,187 people did so, or 10.9 percent, he said.
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