The SWEET network for diabetes centers consists currently of 157 centers in 64 countries all over the world with common objectives.
Becoming a member of the SWEET entails a broad variety of benefits and aspirations including e.g. a central SWEET office that coordinates all SWEET activities and maintains communication between all centers.
Other opportunities within the SWEET network include:
Differences between guidelines may influence surveillance and quality of care in pediatric diabetes. SWEET has evaluated national treatment guidelines for the care of children with diabetes across the EU. Although most countries recommend the ISPAD Clinical Practice Consensus Guidelines (CPCG), these guidelines are far from implemented across Europe. Main reasons are language barriers and the necessity to adjust the guidelines to the European context.
SWEET has aimed therefore to endorse the further translation and contextualization of the ISPAD CPCG to render it accessible to all healthcare professionals. Once implemented on a European wide level, benchmarking of carefully defined robust quality of care and quality of life indicators will allow us to improve these guidelines on a regular basis ensuring an evidence- based care for all children.
With the global expansion of the SWEET network, SWEET hopes to instigate the development of these standardized treatment guidelines, adjusted to the cultural context and endorsed, so that across different continents healthcare professionals have access to up-to-date guidelines for appropriate pediatric diabetes treatment and care.
Since diabetes management requires far-reaching lifestyle changes, it is indispensable that quality-assured and age-appropriate education is delivered to the patient, the family and other caregivers, not only at disease onset but also continuing through to adulthood. Furthermore, structured curricula, experienced and trained educators and self-care education are integral parts of long-term care.
However, only very few countries have published and implemented a structured curriculum for self-care education and evaluated programs for different age-groups and caregivers. In addition, a huge variety of creative tools, e. g. booklets, leaflets, games, videos and material for educating children of different age-groups and their parents are available – but most of them are not linked to a structured education program. In the future, SWEET will aim to harmonize and integrate these education materials into holistic, structured, quality-assured national education programs.
Healthcare professional training also shows great diversity and lack of standardization making it a complex task to have transferable education concepts and qualifications. SWEET supports therefore a standardized, accredited approach to the training and continuing professional development of healthcare professionals and the Pediatric Diabetes Multidisciplinary Team (MDT): With support of the European Commission (funding under the Lifelong Learning Program Leonardo da Vinci), a curriculum for the training of the MDT is being developed and will soon be ready for implementation.
One of the most important tasks of SWEET is benchmarking collected data, despite the major differences in the social and economic as well as cultural background of the participating centers.
Since appropriate, safe and reliable data collection is the essential basis for the evaluation and comparison of data, SWEET works with an electronic database system, DPV. DPV is a quality-management software program, allowing for structured collection and analysis of diabetes-related patient data. The program is provided to all SWEET centers and feeds into the joint database, used for benchmarking and research.
On the basis of standardized electronic health records diabetes-specific patient data are collected, anonymized and submitted to a common database. The reporting structure allows for monitoring of ongoing changes at center, national and global levels. Health, quality of life data and different approaches to pediatric diabetes care can be compared and analyzed. For data collection, statistical analysis, final evaluation and benchmarking, SWEET collaborates with Professor Reinhard Holl, founder of the DPV program. A Quality Circle, consisting of a statistician, an IT specialist and several diabetes specialists, discusses the comparable data, identifies inequalities between centers and develops solutions for reducing these inequalities.
Standardized (electronic) health records allow for the longitudinal evaluation and follow-up of clinical outcome parameters and for comparisons within and between patients and centers. Gaps and deficiencies can be revealed and current therapy recommendations can be adapted on basis of the ongoing comparisons and evaluations. Successful approaches and techniques can be disseminated as well.
For example, all certified centers are encouraged to keep a registry in which patients’ HbA1c levels are collected. On regular times, HbA1c levels can be compared and discussed among centers and best practice examples can be exchanged. As such, improved long term blood glucose values and more efficient treatment schedules can be achieved among the certified centers.
The database with health records can also be used for research purposes: e.g. for studying the effect of diabetes in childhood/adolescence on early vascular ageing and for identifying potential factors to delay accelerated biological ageing in diabetes. Over the past years, SWEET has published several articles in peer reviewed international journals and, with the increasing amount of data from centers across the world, will continue to make research a priority. New studies include research into rare types of diabetes and the investigation of factors that may affect diabetes control in children < 7 years of age.
For the certification of the SWEET CC/CoR centers, an external verification of the centers’ performance takes place. Therefore, a collaboration between SWEET and the NHS National Peer Review Team: Review of Pediatric Diabetes Services in England Program has been established. The SWEET peer review team is charged with reviewing the pediatric healthcare teams and services to determine compliance with all SWEET criteria and to assess quality of care and treatment in relation to clinical outcomes and patient experience.
The goal is to repeat this process every 5 years, so that all SWEET centers receive help and guidance on how to remain compliant with the necessary criteria for up-to-date, safe and efficient holistic pediatric diabetes care.
By creating a network of pediatric diabetes centers known for their expertise in treatment and education and connected through common objectives, SWEET will help to improve the quality of life of children and adolescents with diabetes. The network will make the newest approaches and most successful programs available for all SWEET healthcare professionals, ensuring as such equal accessibility to up to date and highly qualified diabetes care for young diabetes patients and families.
Finally, this network can generate leverage for raising pediatric diabetes-related issues, on a national, European and global level.