The EUCID project carried out pilot diabetes data collection

The aim of the European Core Indicators in Diabetes (EUCID) project was to collect and compare data on risk factors for diabetes, complications and quality of care indicators in (future) Member States of the European Union.

19 countries provided data for a list of 35 indicators. The data were representative at a regional or a national level, for 2004, 2005 or 2006, and were specified by age band. The precise data collection methods (surveys, registries, administrative databases) were provided. Data were age-standardized to allow comparison with the general population where possible, or with the representative regional population if the national level was not possible.

The results show large variation in coverage between the indicators

For some of the 35 indicators data was available from most of the participating countries, for others data was only available from a small number of countries. Some striking results are summarized below:

• Among the least available indicators was the incidence of blindness in people with diabetes, which was provided by only 4 countries, and impaired fasting glucose in the general population, which was provided by only 2.
• The standardized prevalence of diabetes varied from 2.6% in Finland to 7.6% in Cyprus; crude incidence of diabetes (0-14 yrs) from 11 per 100,000 in Spain to 60 per 100,000 in Finland; standardized prevalence of overweight (25-74 yrs) from 37% in Germany to 60% in Cyprus; standardized mortality rates linked with diabetes from 7 per 100,000 in Luxembourg to 56 per 100,000 in Finland.
• Among people with diabetes (>25 yrs), process indicators ranged: for HbA1c testing once a year, from 51% in Ireland to 99% in the Netherlands, France and Belgium; for lipid testing, from 45% in Ireland to 99% in the Netherlands; for microalbuminuria testing, from 25% in Finland to 97% in the Netherlands; for eye examination, from 12% in Ireland to 84% in the Netherlands.
• Risk factors in people with diabetes varied also. HbA1c>7%: 32% in Ireland to 83% in Cyprus; total cholesterol>5mmol/l: 14% in Ireland to 68% in Cyprus; microalbuminuria (enhanced protein levels in the urine): 9% in Finland to 41% in England; blood pressure>140/90mmHg: 17% in France to 46% in Sweden; smoking: 10% in Ireland to 37% in Denmark.
• Complication incidence rates were: dialysis and transplantation: 4 per 100,000 diabetes clients in Cyprus to 149 in Scotland; stroke: 37 in Cyprus to 2675 in Germany; myocardial infarction: 21 in Cyprus to 2135 in Austria; major amputation: 78 in Scotland to 574 in Spain.

Substantial improvements of comparable data collection possible

While many European countries can provide data for the list of diabetes indicators, there are gaps for some important items such as diabetes-linked blindness. Most of the European countries achieve remarkable good testing of people with diabetes. Risk factors and outcomes vary across countries, reflecting a mixture of genetic background, societal and cultural factors, as well as public health policies. Although the data collection has been carried out quite carefully, some of the large differences found may reflect methodological variations. The results of EUCID will be used within the countries both to try to influence policies with respect to interventions and to improve data collection.

Separate EUphacts are presented on Diabetes, Overweight, Smoking and Blood Pressure

This EUphocus presents data related to overweight, smoking and blood pressure, supplementing the more general data provided in the EUphacts Diabetes, Overweight, Smoking and Blood pressure. The data shown in those EUphacts have been obtained from regular sources, and sometimes differ from the data shown in this EUphocus that have been collected by EUCID.