Diabetes care in The Netherlands: now and in the future

The prevalence of diabetes mellitus (DM)‐in The Netherlands is rapidly increasing. In 2000, the total number of people with DM is estimated at 462‐000 out of a total of 16 million inhabitants. The rapid growth is especially found in the group with type 2 DM (85%). The financial burden of direct and indirect costs is high. Access to care is at present easily available and almost fully reimbursable. Most hospital organisations have diabetes teams available for type I DM patients. The care for type 2 DM is mainly concentrated in primary care. The role of diabetes specialist nurses and podiatrists has grown in importance in the last decade. Guidelines on care and prevention are amply available but not fully implemented. A nationwide reduction (34%) on lower extremity amputations during the last 10 years has been reported recently. Looking at the future, shared care initiatives are underway. There are concerns about the rapid growth in prevalence, the increase of obesity and the possible shortage of general practitioners. Copyright © 2004 John Wiley & Sons, Ltd.