Two example from EUCID data: Eye examination and prevalence of dyalisis or renal transplantation

This section focuses on data collected on the complications of diabetes. In total, eleven indicators are included in this EUCID category:

• Fundus tested
• Retinopathy
• Retinopathy and timely laser treatment
• Incidence of blindness
• Creatinine tested
• ESRF (end-stage renal failure)
• Incidence of dialysis and transplantation
• Prevalence of dialysis and transplantation
• Incidence of stroke
• Incidence of myocardial infarction
• Incidence of major amputation

These indicators provide data on the complications of diabetes. While the aforementioned indicators were concentrated on prevention of these complications, these indicators give the end points of diabetes care for several organ systems, including both process and outcome indicators. The complete set of indicators can be found in the final report of the EUCID project.

Two examples from the EUCID project are presented here: the regular eye examination (fundus test) for the prevention of diabetic blindness (process indicator), and the prevalence of dialysis/transplantation in diabetics (outcome indicator). .

Percentage of diabetic population that have had their eye fundus inspected in last 12 months

10 countries were able to provide this indicator in the EUCID project, as shown in The crude percentages of the diabetic population with eye fundus inspection during the last 12 months.

Annual inspection of the eye fundus is advised in most guidelines. Some guidelines advise an inspection of the fundus once every two years if the fundus is normal and there are no other risk factors for the development of retinopathy. Whenever symptoms of decreasing vision or vision defects develop, the damage on the fundus is already considerable and treatment is often too late. Therefore, screening in a phase where there are no symptoms is the only way to diagnose diabetic retinopathy in time.

The percentage of the diabetic population that have had their eye fundus inspected in the last 12 months varies widely from 12 (Ireland) to 84 (The Netherlands).

The prevalence of dialysis or renal transplantation in diabetics ranges from 3 to over 600 per 100,000.

Renal failure is one of the microvascular complications of diabetes. Its treatment by dialysis or renal transplantation is dependent on the availability of facilities and on the policy to dialyse patients with diabetes and end-stage-renal-failure.

11 Countries were able to provide data on this indicator, as seen in the Prevalence of dialysis/transplantation per 100,000 diabetic population. The data show large variation between countries, which may be caused by differences in facilities or policies, but also by differences between the data sources.