**6. What the changing epidemiology implies for future health care**

Until now, the treatment of type 1 diabetic patients has been the duty of pediatricians, internal specialists, or diabetologists. The consultation prevalence of type 1 diabetic pa‐ tients in the general practitioners' consultation hour was low (Frese, Sandholzer et al. 2008). However, if the present trends continue, a doubling of new cases of type 1 diabe‐ tes in European children younger than 5 years is predicted between 2005 and 2020, and prevalent cases younger than 15 years will rise by 70% (Patterson, Dahlquist et al. 2009). Adequate health-care resources to meet these children's needs should be made available (Patterson, Dahlquist et al. 2009). It is important to ensure appropriate planning of serv‐ ices and that resources are in place to provide high-quality care for the increased num‐ bers of children who will be diagnosed with diabetes in future years (Patterson, Dahlquist et al. 2009).

In Germany, the costs of pediatric diabetes care exceeded €110 million in 2007. Com‐ pared with estimates from the year 2000, average costs per patient had increased by 20% and direct total costs for German pediatric diabetes care by 47% (Bachle, Holl et al. 2012). The treatment costs rose because of new therapeutic strategies and an increase in diabe‐ tes prevalence. This illustrates that type 1 diabetes will be an increasing challenge for fu‐ ture health care.

Regarding future health care, it should be kept in mind that elderly and old patients with type 1 diabetes represent a growing population that requires thorough diabetes care. Espe‐ cially type 1 diabetic patients older than 60 years will suffer from a longer diabetes duration, a doubled risk for severe hypoglycemia, and a higher percentage of cardiovascular compli‐ cations (Schutt, Fach et al. 2012). In order to provide an adequate health care service, treat‐ ment strategies for adults and elderly persons suffering from type 1 diabetes have to be implemented in practice and the knowledge of involved physicians, especially general prac‐ titioners, has to be enhanced.
