Effective cost management of diabetes

27/05/2024 03:17 PM


In the morning of May 25th, in Hanoi, Vietnam Social Security (VSS) and the Danish Embassy in Vietnam held a workshop titled "Effective cost management of diabetes".

Attending the event were: Deputy General Director of VSS Nguyen Duc Hoa; Ms. Katrin Riisgaard Pedersen, Medical Counselor - Danish Embassy in Vietnam; 300 delegates from units under VSS of 22 insurance security ofices of provinces and cities, experts and guests from the Ministry of Health, Hanoi University of Pharmacy, National Hospital of Endocrinology, Pediatric Association Vietnam, Novo Nordisk Company.

Deputy General Director of VSS Nguyen Duc Hoa spoke at the Conference

Opening the Workshop, Deputy General Director of VSS, Nguyen Duc Hoa said that the event is under the framework of cooperative activities between VSS and the Danish Embassy in Vietnam, based on the Memorandum of Understanding which has been signed between the two parties in the field of health insurance for the period of 2023-2025; so as to provide more information, increase knowledge for assessors about diabetes and effectively manage diabetes costs.

Deputy General Director Nguyen Duc Hoa assessed that diabetes is one of the urgent health problems world-wide, which can slow down the process of economic development  and hinder the process of achieving sustainable development goals, especially in low and middle-income countries.

According to a report by the World Health Organization (WHO), by 2025, the number of people with diabetes will reach 330 million world-wide. In particular, the disease progresses silently, if not detected and treated promptly, it will lead to a high mortality rate. Diabetes is still considered a "silent killer" of all mankind in the modern time.

Currently, the rate of diabetes in Vietnam is estimated at over 6% of the population, and another 10% of the population has pre-diabetes. The increased status makes Vietnam become one of the countries which has an increased rate of this disease. Although the number of people receiving treatment has increased in recent years, there are still many patients who have not been detected and treated early. According to a report from the Ministry of Health, only 28.9% of people with diabetes are managed at medical facilities. According to statistics, every year, the health insurance fund spends thousands of billions of dong to diagnose and treat diabetes cases and this cost continues to increase every year.

“The problem is that resources spent on health care are always limited, health insurance funds are also limited, so, it is necessary to manage and monitor the most effective and reasonable treatment of diabetes, ensuring the rights of patients, reduce social burden and ensure the solvency of the health insurance fund" - Hoa shared.

Sharing the same opinion, speaking at the Conference, Ms. Katrin Riisgaard Pedersen, Medical Counselor - Danish Embassy in Vietnam, said that diabetes is a problem for millions of the Vietnamese people. Diabetes is not only a disease but also a social problem. It has been a significant financial burden on the health system because it accounts for a significant portion of health care expenditures. Costs include direct ones such as (medication, doctor visits, hospitalization...) as well as indirect ones (taken days off work, lost productivity, early retirement,...). In addition to these costs, there are emotional tolls on individuals and their families related to stress, anxiety and depression.

In Vietnam, the number of patients with diabetes is increasing rapidly and many people have not been detected and treated early. Therefore, recently, the Danish Embassy in Vietnam has coordinated with many relevant agencies to evaluate and find solutions to this problem. Recently, in April 2023, the Danish Embassy in Vietnam coordinated with Novo Nordisk Company and the Vietnam Pediatric Association to reach and support more than 500 children with type 1 diabetes in Vietnam via the Program for Changing Diabetes in Children and Adolescents initiated by Novo Nordisk.

At the Conference, the experts has provided delegates with information about the situation of diabetes and the cost component of treatment in Vietnam; the current status of paying for diabetes costs and the burden of treatment; Current status of insurance payments for diabetes treatment drugs in Vietnam. In addition, there is also provided information about the management and payment of diabetes costs at medical examination and treatment facilities in many localities...

Attending the Workshop, delegates gained more useful practical experience in managing and treating diabetes, and have more scientific basis for choosing appropriate drugs for highly effective treatment, helping to reduce the burden and reduce the burden, ensuring the quality of life of patients.

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Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin. In the past 3 decades the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. There is a globally agreed target to halt the rise in diabetes and obesity by 2025. 

About 422 million people worldwide have diabetes, the majority living in low-and middle-income countries, and 1.5 million deaths are directly attributed to diabetes each year. Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades. 
Over time, diabetes can damage blood vessels in the heart, eyes, kidneys and nerves.

People with diabetes have a higher risk of health problems including heart attack, stroke and kidney failure.

Diabetes can cause permanent vision loss by damaging blood vessels in the eyes.

Many people with diabetes develop problems with their feet from nerve damage and poor blood flow. This can cause foot ulcers and may lead to amputation.

Type 1 diabetes
Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin. In 2017 there were 9 million people with type 1 diabetes; the majority of them live in high-income countries. Neither its cause nor the means to prevent it are known.

Type 2 diabetes
Type 2 diabetes affects how your body uses sugar (glucose) for energy. It stops the body from using insulin properly, which can lead to high levels of blood sugar if not treated.

Over time, type 2 diabetes can cause serious damage to the body, especially nerves and blood vessels.

Type 2 diabetes is often preventable. Factors that contribute to developing type 2 diabetes include being overweight, not getting enough exercise, and genetics.

Early diagnosis is important to prevent the worst effects of type 2 diabetes. The best way to detect diabetes early is to get regular check-ups and blood tests with a healthcare provider.

Symptoms of type 2 diabetes can be mild. They may take several years to be noticed.  Symptoms may be similar to those of type 1 diabetes but are often less marked. As a result, the disease may be diagnosed several years after onset, after complications have already arisen.

More than 95% of people with diabetes have type 2 diabetes. Type 2 diabetes was formerly called non-insulin dependent, or adult onset. Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in children.

Gestational diabetes
Gestational diabetes is hyperglycaemia with blood glucose values above normal but below those diagnostic of diabetes. Gestational diabetes occurs during pregnancy.

Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. These women and possibly their children are also at increased risk of type 2 diabetes in the future.

Gestational diabetes is diagnosed through prenatal screening, rather than through reported symptoms.
Impaired glucose tolerance and impaired fasting glycaemia
Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes. People with IGT or IFG are at high risk of progressing to type 2 diabetes, although this is not inevitable.

Prevention
Lifestyle changes are the best way to prevent or delay the onset of type 2 diabetes.

To help prevent type 2 diabetes and its complications, people should:

reach and keep a health body weight
stay physically active with at least 30 minutes of moderate exercise each day
eat a healthy diet and avoid sugar and saturated fat
not smoke tobacco.
Diagnosis and treatment
Early diagnosis can be accomplished through relatively inexpensive testing of blood glucose. People with type 1 diabetes need insulin injections for survival.

One of the most important ways to treat diabetes is to keep a healthy lifestyle.

Some people with type 2 diabetes will need to take medicines to help manage their blood sugar levels. 

VSS