The GIANTT project is a regional collaborative between healthcare professionals and scientists aiming to optimize the quality of care for patients with diabetes mellitus type 2. Since 2004, routine data on diabetes type 2 treatment is collected and analyzed. The overall goal is adequate and efficient care for these patients.
The research projects are focusing on the evaluation of:
- the provided care,
- initiatives to improve the care,
- the consequences of interventions on morbidity and mortality in daily practice.
GIANTT analyses aim to provide insight in gains by changing in diabetes care.
Initiatives to optimize healthcare
There are several regional initiatives to optimize the care for patients with diabetes type 2. These include the training of specialized nurses as well as multidisciplinary guidelines and working groups. Main focus points are the organisations of multidisciplinary care and the quality of pharmacological treatment. National policy highlights the importance of prevention of complications by standardized primary care diabetes management. Drivers for this policy are (1) studies showing the generally poor control of diabetes and (2) the rapidly increasing population of patients with diabetes.
Randomized clinical trials demonstrate that personalized and sometimes more intensive diabetes treatment results in higher health gains. The gains could go hand-in-hand with increases in costs at the short-term. On the long-term however, savings are realized through the avoidance of complications and associated healthcare utilization. It has become clear that macro- en microvascular complications of diabetes patients result in poor quality of life and increased healthcare costs. Yet, the gains in real-life settings are less clear because:
- the patient population in daily practice differs from the population in trials
- in daily practice, care is provided for multiple morbidities at the same time
- there is a lack of practice-based research with sufficient longitudinal follow-up and evaluation on hard patient outcomes.
Enhanced insights into the care provided, linked with patient-level outcomes is essential for better health outcomes at favorable cost-effectiveness.