In patients with type 2 diabetes, the risk of heart attack or stroke is doubled, and the risk of arterial occlusive disease is even quintupled. With a focus on prevention, the “National Strategy on Cardiovascular Diseases, Stroke and Diabetes” defines the priority need for action for the next eight years.
The “National Strategy on Cardiovascular Diseases, Stroke and Diabetes” launched in November 2016 specifically addresses the phenomenon of multimorbidity in cardiovascular diseases and addresses the risk factors. Cardiovascular disease, stroke and diabetes are treated as a common action area. Special emphasis is placed on diabetes. Worldwide and also in Switzerland, there are signs of an increase – especially in older patients and in men.
Obesity and genetic factors
In the 75-plus age group, 18 percent of men and 9 percent of women have been diagnosed with diabetes at some point in their lives. The main cause of this increase is the spread of obesity in the population. However, genetic factors also play a role, which explains, among other things, why the disease is more common in certain population groups with a migration background.
As these diseases increase, so do the resource needs. The direct medical costs of all chronic diseases (NCDs) exceeded CHF 51 billion in 2011 and accounted for 80 percent of total healthcare costs. Cardiovascular diseases and diabetes are the top direct cost drivers with a total of CHF 11.3 billion per year.
Modifiable risk factors
According to recent estimates, modifiable risk factors are responsible for 60 to 80 percent of cardiovascular diseases, which can be favorably influenced by lifestyle adjustments or medical prevention. These risk factors are in particular: Obesity, excessive alcohol consumption, high blood sugar/diabetes, tobacco consumption, high blood pressure, lack of exercise, stress/psychosocial factors, unfavorable blood lipid levels/cholesterol, unbalanced diet. Overall, the strategy defines the priority need for action in three fields: 1. prevention and early detection, 2. to provide appropriate care for the patients and their environment, 3. data, quality and funding.
Expansion of case management
For diabetes patients, the additional priority need for action is to improve counseling and expand case management across the entire patient pathway. Another focus is on improving the prevention and early detection of diabetes-related diseases and complications.
The aim of diabetes prevention and early detection is to reduce the number of diabetes cases by promoting a healthy lifestyle and creating suitable conditions. Individuals at increased risk should be supported by professionals to optimize their lifestyle and thereby minimize or treat diabetes-related risk factors. The strategy also states that type 2 diabetes should be diagnosed at an earlier stage.
Source: CardioVasc Suisse (2016) “National Strategy Cardiovascular Diseases, Stroke and Diabetes 2017-2024”.
The strategy paper can be downloaded in German and French at www.cardiovascsuisse.ch/strategie.
CARDIOVASC 2017; 16(1): 26-27
