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Demographics and Epidemiology
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Country
Official name of the country
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Germany
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Abbreviation
Three-letter country code
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DEU
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Level of data
Are the data applicable to the whole state, or specific to a region / nation / federal state?
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name of the region / nation / state
Where are the data from?
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Population size
(0 - 14 years)
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11.487.000
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Is there a geographically defined pediatric diabetes register?
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yes
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What is the scope?
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three federal states, plus a widely disseminated system of quality control DPV
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Name of the register
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Baden-Württemberg, Sachsen and Nordrhein-Westfalen - national-wide DPV system
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Remarks to register
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Although there is no national pediatric diabetes register reported in Germany, several diabetes registers exist at the level of federal states: Baden-Württemberg, Sachsen and Nordrhein-Westfalen. Moreover, most pediatric diabetes centres document their patients through the DPV system, which currently hosts the documentation of more than 17,000 patients < 18 years.
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Were the country data publishes in the last Eurodiab report?
(Lancet 2009;373(9680):20207-33)
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yes
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Diabetes organizations
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Patient organizations
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The most important organization for children with diabetes in the country
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Bund diabetischer Kinder und Jugendlicher
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Its web address
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www.bund-diabetischer-kinder.de
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Is this organization exclusively for childhood diabetes?
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yes
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Organization for health professionals and physicians
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Organization for physicians and/or health professionals focused on diabetes
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Deutsche Diabetes Gesellschaft (DDG)
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Its web address
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www.deutsche-diabetes-gesellschaft.de
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Other organization for physicians and/or health professionals focused on diabetes
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Its web address
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Organization of pediatric diabetes care and education
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Who treats pediatric diabtetes
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The table indicates what is the usual distribution of competence in pediatric diabetes care using a scale from 1 to 5, where 1 = never, 5 = always.
PED DIA = pediatric diabetologist, ADU DIA = Diabetologist for adults, PED = pediatrician, GP = general practitioner
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| PED DIA | ADU DIA | PED | GP |
| Prescribes Insulin | 5 | 2 | 1 | 1 |
| Prescribes glucometers and strips | 5 | 2 | 2 | 2 |
| Provides education | 5 | 2 | 1 | 1 |
| Prescribes insulin pumpls | 5 | 2 | 1 | 1 |
| Provides long-term follow up, including complication screening | 5 | 2 | 1 | 1 |
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Summary of the organization of the care
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In Germany, qualified pediatric diabetologists have the main responsibility, they treat more than 80% of pediatric patients. In some cases a diabetologists for adults is designated to take care of pediatric diabetes. Pediatricians or general practitioners only prescribe glucometers and strips in a few cases.
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Education of a diabetic patient
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Is the content of education of diabetic childred regulated?
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no
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Who determines the content of education?
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individual centres
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Is education reimbursed?
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with limits
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Remarks to education
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Education for children and adolescents with diabetes in Germany is partly reimbursed by the health insurance company which foresees in a re-education every 2 years in an outpatient setting.
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Pediatric diabetes centres
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Are there officially recognized pediatric diabetes centres in your country?
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yes
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Who renders the status of the centre?
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Diabetes Society
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Are there defined criteria for being a center?
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yes
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Is the status of the centre permanent?
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no, reapplication is necessary
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Does a centre have to participate in a QC programme?
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yes, in a mandatory unified program
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Remarks to participation in a national QC system
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Quality control of pediatric diabetes care
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Is there a system of quality control in pediatric diabetes care at the national level?
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yes
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Who organizes this system?
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DPV, FQSD (Forum Qualitätssicherung in der Diabetologie)
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List of quality indicators regularly collected by the system.
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Glycated hemoglobin levels
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yes
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Frequency of DKA with hospitalization
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yes
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Frequency of severe hypoglycemia requiring assistance
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yes
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Growth data
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yes
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Data on quality of life
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no
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Microalbuminuria levels
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no
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Other indicators
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yes
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List these indicators
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What is the feedback from the system?
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electronic on-line statistics
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National standards/guidelines of diabetes care
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National criteria for diabetes control in pediatric age
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Are there defined national standard criteria for diabetes control in pediatric age?
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yes
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Who issued these criteria?
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Deutsche Diabetes Gesellschaft (DDG)/AGPD
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Have they been published in professional journals?
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yes
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If no, do you use adult criteria of diabetes control?
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National guidelines defining the surveillance for chronic diabetes complications
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Are there national guidelines defining the surveillance for chronic diabetes complications and diabetes-associated diseases that are applicable to pediatric practice?
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yes
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Who issued these guidelines?
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DDG/AGPD
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Are they ISPAD compliant?
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in most instances
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The guidelines apply to following complications
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diabetic retinopathy
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yes
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diabetic nephropathy
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yes
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diabetic neuropathy
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no
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autoimmune thyroid disease
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yes
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celiac disease
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yes
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hyperlipidemia
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yes
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psychological disorders
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yes
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other, please list
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no
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other complications - list
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Current* status of reimbursement for diabetes treatment
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*) year of last revision
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Recombinant human insulin
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yes
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Rapid acting insulin analogues
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yes
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Long acting insulin analogues
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yes
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Specification of restrictions on insulin reimbursement
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Insulin pens
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yes
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Specification of restrictions on reimbursement of insulin pens
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Insulin pumps
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yes
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Specification of restrictions on reimbursement of pumps and material
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Personal glucometers
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restricted
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Specification of restrictions on reimbursement of meter strips
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Blood glucose monitoring meters
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restricted
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Specification of restrictions on reimbursement of glucometers
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Continuous glucose monitoring - intermittent/diagnostic use
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restricted
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Continuous glucose monitoring - continuous use
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restricted
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Specification of restrictions on reimbursement of CGM
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Lancets
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yes
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Specification of restrictions on reimbursement of lancets
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