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Diagnostic - Therapeutic - Assistance Paths (DTAP) for type 1 diabetes mellitus: summary of the document of the Italian

G.La Penna, A.Girelli, F.Bertuzzi, R.Celleno, M.Scavini, P. Tripodi, M. Zanon,R.Stara & P.Di Bartolo

Young age onset and long-life expectancy of type 1 diabetes mellitus (T1DM) people make it essential to achieve an early, stable and optimal glycemic control to prevent chronic complications and ensure good quality of life.

These goals can only be achieved by having a healthcare organization that guarantees patient equity of access, quality and continuity of care, with an appropriate use of resources.

To make the treatment organization efficient and appropriate, various health systems have implemented Diagnostic Therapeutic Assistance Paths (DTAP). DTAPs aim to share decision-making processes and healthcare organization for specific groups of patients on the basis of existing guidelines and in relation to the available resources, during a well-defined period of time.

In Italy, the Italian Association of Diabetologists (AMD) scientific society, in association with Association of Pediatric Endocrinologists and Diabetologists (SIEDP), and voluntary diabetes associations (i.e. Diabetes Italia) developed a national DTAP for T1DM. Five DTAP models were defined, focusing on 5 different disease stages or treatment process: onset of illness or first referral from another diabetes clinic, routine visit in good metabolic control, uncontrolled hyperglycemia, advanced technologies, transition from pediatric to adult diabetes clinic. Objectives, healthcare professionals involved, visits organization, and educational contents for each of these PDTAs are detailed in the core document.

This DTAP will be disseminated through the AMD regional referents to the Regional Healthcare Systems. Each Region will be asked to implement the DTAP through multi-professional working groups, with the participation of regional AMD referents and representatives of Patient Associations.

The DTAP effectiveness will be evaluated using an indicators’ system every year.