Improvement of Care & Outcome


Jessica C. G. Bak, Dick Mul, Erik H. Serné, Harold W. de Valk, Theo C. J. Sas, Petronella H. Geelhoed-Duijvestijn, Mark H. H. Kramer, Max Nieuwdorp, Carianne L. Verheugt

DPARD: rationale, design and initial results from the Dutch national diabetes registry. BMC Endocr Disord. 2021 Jun 16;21(1):122.

During the last few decades the prevalence of diabetes has almost doubled to about half a billion people worldwide. In the Netherlands the number of people with diabetes is expected to rise from 1.2 to 1.4 million by 2040. Achieving treatment targets can markedly reduce diabetes-related complications, relieving the ever increasing burden on health care services. National disease-specific registries form an important tool for improving health care quality and efficacy and several countries have succesfully set up diabetes registries. In the Netherlands there existed a need for a registry including the outpatient diabetes population: up to now prevalence and outcome data mostly came from general practice databases. In 2017 the BIDON foundation initiated the Dutch Pediatric and Adult Registry of Diabetes (DPARD), with the goal of acquiring an insight into the characteristics of the Dutch diabetes outpatient population and improve treatment strategies, aiming to decrease disease burden and improve quality of life. Diabeter is one of the participating centers in DPARD.


The study described here, co-authored by Dick Mul and Theo Sas of Diabeter, describes DPARD’s rationale and its first results.

Key findings:

  • 11% of all Dutch hospitals (8 centers: 2 tertiary care centres, 5 secondary hospitals, and 1 independent diabetes treatment centre [Diabeter]) have transferred data of about 20.000 people to DPARD
  • 18 other centers are being connected and another 18 centers are interested
  • The registry now includes 22% people with type 1 diabetes, 28% people with type 2 diabetes and 4% people with secondary diabetes (e.g. drug-induced, MODY; mainly women)
  • Of 46% of people with diabetes, classification was not specified by the hospitals
  • Compared with people with type 1 diabetes (mainly children), people with type 2 diabetes (mainly adults) were older and had a higher BMI, while gender distribution was similar
  • HbA1c levels were similar for children and adults with type 1 diabetes, but for type 2 diabetes children had lower HbA1c levels than adults
  • Almost all people with type 1 diabetes used insulin monotherapy (93%) while most people with type 2 diabetes used insulin therapy in combination with oral glucose-lowering medication (59%)
  • The least frequently provided parameter was blood pressure, while all hospitals provided age, sex and HbA1c (which also had the lowest of missing data of all laboratory parameters)
  • There were marked differences in missing data between people with type 1 diabetes, type 2 diabetes and unclassified diabetes


Concluding, the authors state

"Within 2 years, we expect to include all outpatient diabetes clinics across the Netherlands with data containing diabetes classification of every patient included and far less missing values across all data due to advancements in data scripts and resources both in hospitals and on a national level. …….. This enables us to benchmark quality information between hospitals to identify areas in need of improvement in order to enhance diabetes care in the Netherlands, as well as allowing for comparison of diabetes care on an international level" -

Please click here for the pdf file.

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