Follow us on twitter Follow us on X

2024: The year to take European action on diabetes to the next level

Stefano Del Prato1, Bart Torbeyns2, Chantal Mathieu3, on behalf of the European Diabetes Forum Board

1Interdiscliplinary Research Center ‘Health Science’, Sant’Anna School of Advanced Studies, Pisa, Italy

2EUDF, Brussels, Belgium

3Department of Endocrinology, UZ Gasthuisberg, Leuven, Belgium

Corresponding author: Stefano Del Prato, stefano.delprato@unipi.it

Received : 4 April 2024

Read/download this on SpringerLink here

A silent epidemic is on the rise in Europe: the epidemic of diabetes. With health systems strained and prevalence steadily rising, policymakers at all levels must commit to acting on diabetes. Only through far-sighted and decisive action can we prevent further increase of the number of people developing diabetes, reduce excess loss of life, limit debilitating complications, improve the lives of people living with diabetes and make European health systems more sustainable and resilient.

With European elections coming up in June, the European Diabetes Forum (EUDF) wants to rise up to the challenge by uniting voices and showing where we need to go. Eight diabetes associations (the European Association for the Study of Diabetes [EASD], the European Foundation for the Study of Diabetes [EFSD], the Foundation of European Nurses in Diabetes [FEND], the International Diabetes Federation Europe [IDF Europe], the International Society for Pediatric and Adolescent Diabetes [ISPAD], the Juvenile Diabetes Research Foundation [JDRF], Primary Care Diabetes Europe [PCDE], and the Société Francophone du Diabète [SFD]),  representing people living with diabetes, healthcare practitioners and researchers, together with the EUDF-supporting collaborators from industry, have joined their forces to adopt the Diabetes Community Pledge [1] as part of a campaign to put diabetes high on the European health agenda during the next mandate of the European Institutions.

Available in nine languages (accessible at https://www.eudf.org/), the Pledge encompasses 15 policy recommendations that we believe the EU and member states should adopt to promote:

  • Early detection of diabetes;
  • Equitable care;
  • Empowerment of people living with diabetes; and
  • Embracing science and technology.

We believe the adoption of these policies is required to flatten and ultimately reverse the prevalence of diabetes, to improve the quality of life of people living with diabetes and to allow them to remain active members of the societies they live in.

The rising tide of diabetes demands action

Already, 31.6 million people are estimated to have diabetes in the EU (Fig. 1). Partly due to population ageing, rising prevalence of obesity and societal changes, that figure is set to rise to 33.2 million by 2030. Lack of timely diagnosis and poorly managed diabetes can mean devastating complications. People living with diabetes are ten times more likely to suffer kidney failure and three times more likely to develop cardiovascular diseases. Indeed, 686,000 people die due to diabetes or a related condition every year.

Visual representation showing an estimated 31.6 million people in EU live with diabetes
Fig. 1 The estimated number of individuals living with diabetes in the EU

Given these stark trends, inaction is simply not an option as it has already been recognised with the Motion for a Resolution on prevention, management and better care of diabetes in the EU released on the occasion of World Diabetes Day in 2022 [2]. That Resolution should represent the basis for improving the lives of millions of European citizens, while the Pledge points to the actions needed to be put in place. New technologies and treatments are enabling people with diabetes to better manage their disease and empower them to fully live their lives and play an active role in their society. However, leveraging these breakthroughs precisely requires more action for systematic screening to detect the disease and enable access to the best care and technologies for all.

The economic case for investing in diabetes prevention and care

The economics of diabetes make one thing crystal clear: investing in diabetes prevention and care can lead to massive savings by avoiding costs to our healthcare systems and economies. Diabetes-related healthcare costs in the EU add up to around €104 billion annually [3] (Fig. 2). Another €65 billion in diabetes-related productivity losses every year needs to be factored in [4]. Although exorbitant, the great majority of these costs are preventable. Three quarters of the diabetes-related healthcare costs are due to avoidable complications as they can be prevented through screening, proper diabetes management and equitable access to the right treatment at the right time for all people living with diabetes.

Visual representation showing total diabetes-related cost in EU is 104 billion euros; 75% are due to avoidable complications.
Fig. 2 A large proportion of diabetes-related costs could be prevented

Furthermore, given that diabetes increases the risk of other diseases, not least renal and cardiovascular disease, there is a compelling case for investing in diabetes care as part of a wider health-system resilience plan. Of relevance, these actions are also expected to improve the prevention of other non-communicable diseases.

Momentum towards a holistic approach against diabetes

Diabetes has been rising on the European political agenda in recent years. The Mobilising for Diabetes intergroup (MMD) of Members of the European Parliament (MEPs) has done remarkable work in bringing the stakes of diabetes to the attention of European lawmakers. In October 2022, a century after the seminal discovery of insulin, the European Parliament adopted a historic resolution [2] calling for stronger national and EU action for prevention, management and better care of diabetes.

The increasing prominence of diabetes on the European and international health policy agenda also became apparent last November when the European sections of the International Diabetes Federation and the WHO held an important high-level technical summit on diabetes [5]. The assembled health experts and policymakers issued a Joint Declaration [6] on accelerating actions to improve diabetes detection and quality of care.

Now, in 2024, EUDF and its members are engaging in a year-long campaign to make sure Europe builds on this momentum and takes policy action on diabetes to the next level.

As the political parties finalise their election manifestos, they must seize the opportunity to propose and adopt strong action on diabetes. Policymakers need to understand that an effective action on diabetes will also yield benefits for other disease areas, notably for cardiovascular disease (Fig. 3).

Visual representation showing 1/3 PwD will develop vision loss. Also a lower limb is lost to diabetes somewhere in the world every 30 seconds. PwD are 10 times more likely to suffer kidney failure. PwD are up to 3 times more likely to develop cardiovascular diseases.
Fig. 3  Effective action on diabetes can prevent blindness, lower limbs amputation, kidney failure, cardiovascular problems and many other complications. PwD, people with diabetes

The potential of such synergies has already been recognised by the European Commission with the launch of the EU Joint Action on Cardiovascular Diseases and Diabetes (JACARDI) [7]. Armed with €53 million in funding from the Commission to execute 142 pilot projects, this is the largest EU joint action on health so far.

It is now time to leverage all these initiatives and entrench policy measures to strengthen diabetes prevention and care in the years and decades to come.

Concrete actions for people with diabetes

The EU should build on this momentum by developing a supportive European framework and helping member states design the right policies on diabetes. The Diabetes Community Pledge [1] provides a holistic approach to upgrading action on diabetes with concrete recommendations for both the EU institutions and national governments.

Approximately one in three people living with diabetes in the EU are unaware of their condition. That’s why we need to boost early detection through health check programmes for all age groups, monitoring pathways, and enhancing primary and community care to identify people with diabetes and those at risk as soon as possible. This is key to preventing and addressing the disease before serious complications emerge.

We also need to ensure equitable high-quality care, making sure the right treatment is provided to the right person at the right time. All people living with diabetes need equitable access to the most appropriate medicines and technologies. Healthcare professionals need training and capacity to be able to fully support people with diabetes in both primary and secondary care. By overcoming therapeutic inertia and swiftly managing and treating diabetes, the health and quality of life of people living with diabetes can be massively improved.

With the right support and treatment, people living with diabetes can flourish, fulfilling their life expectations and remaining fully productive and participating members of the society they live in. For this, we need to empower people to be able to manage their condition and contribute to broader efforts against diabetes. This includes shared decision-making between people with diabetes and healthcare professionals, as well as patients’ involvement in research, regulatory, policy and evaluation processes affecting their lives. Above all, the diagnosis of diabetes or treatment of the disease must not bring in any stigma.

Finally, Europe needs to embrace science and technology as this is key to further understand diabetes and to develop the care and management options of the future. Digital innovation offers tremendous opportunities, not least in terms of clinical data collection, including real-world evidence. EU research programmes should tackle all aspects of diabetes, including unmet needs and adoption of digitally-enabled medical technologies.

Sign and share the Diabetes Community Pledge! Let's promote early detections, empowerment of people, equitable care, embracing science and technology
Fig. 4 Sign and share the Diabetes Community Pledge today

The EU and its member states need to adopt a full-spectrum response to really tackle the rising tide of diabetes. This will save and improve lives, as well as make both our economies and health systems more sustainable and resilient. The EUDF has united all the main voices in diabetes across Europe, but we need the Pledge to be seen, discussed, distributed and adopted by future members of the EU parliament. For this reason, we seek the support of all those who care about people living with diabetes. Now is the time for action and we urge you to sign and share the Diabetes Community Pledge today [1] (Fig. 4)!

Acknowledgements EUDF board: Chantal Mathieu (EASD), Stefano Del Prato (EFSD), Anne-Marie Felton (FEND), Niti Pall (IDF Europe), Carine de Beaufort (ISPAD), Carmen Hurtado del Pozo (JDRF), Xavier Cos (PCDE) , Jean-François Gautier (SFD).

Funding The activities of EUDF are financially supported by EASD, EFSD, FEND, IDF Europe, ISPAD, JDRF, PCDE, SFD, EFPIA and MedTech Europe

Authors’ relationships and activities SDP consulted for Abbott, Amarin Corporation, Applied Therapeutics, AstraZeneca, Eli Lilly and Company, Eva Pharma, Menarini International, Novo Nordisk, Sanofi and Sun Pharmaceuticals, and received funding for these consulting services; received grant support from AstraZeneca and Boehringer Ingelheim; and received speaker fees from Abbott, AstraZeneca, Boehringer Ingelheim, Eli Lilly and Company, Laboratori Guidotti, Menarini International, MSD, Novartis Pharmaceuticals, Novo Nordisk and Sanofi.

CM serves or has served on the advisory panel for Novo Nordisk, Sanofi, Eli Lilly and Company, Novartis,  Boehringer Ingelheim, Roche, Medtronic, Imcyse, Insulet, Biomea Fusion and Vertex. Financial compensation for these activities has been received by KU Leuven; KU Leuven has received research support for CM from Medtronic, Imcyse, Novo Nordisk, Sanofi and ActoBio Therapeutics; CM serves or has served on the speakers bureau for Novo Nordisk, Sanofi, Eli Lilly and Company, Medtronic and Boehringer Ingelheim. Financial compensation for these activities has been received by KU Leuven. CM is president of EASD. All external support of EASD is to be found on www.easd.org

References

[1] European Diabetes Forum (2024) Diabetes community pledge for the 2024 European elections. Available from: https://jimdo-storage.global.ssl.fastly.net/file/71e5f49a-475c-4c56-86ff-5a41b9511951/Diabetes%20Community%20Pledge%20EU%20Elections.pdf. Accessed 04 04 2024

[2] Weiss P, Schaldemose C, Ries F, Metz T, Kopcińska J, Konečná K (2022) Motion for a resolution on prevention, management and better care of diabetes in the EU on the occasion of World Diabetes Day. Available from www.europarl.europa.eu/doceo/document/B-9-2022-0492_EN.html. Accessed 04 04 2024

[3] International Diabetes Federation (2012) IDF Diabetes Atlas, 10th edn. Brussels, Belgium. Available from http://www.diabetesatlas.org/. Accessed 04 04 2024

[4] Bommer C, Heesemann E, Sagalova V et al (2017) The global economic burden of diabetes in adults aged 20-79 years: a cost-of-illness study. Lancet Diabetes Endocrinol Jun;5(6):423-430. https://doi.org/10.1016/S2213-8587(17)30097-9

[5] World Health Organization (2023) Accelerating action on commitments to improve diabetes detection and quality of care. Available from  https://www.who.int/europe/news-room/events/item/2023/11/28/default-calendar/accelerating-action-on-commitments-to-improve-diabetes-detection-and-quality-of-care. Accessed 04 04 2024

[6] International Diabetes Federation (2023) IDF Europe welcomes the Joint Declaration adopted during the High-Level Technical Summit on Diabetes co-organised with WHO Europe and calls on Member States to take additional action to accelerate progress. Available from https://idf.org/europe/news/idf-europe-welcomes-the-joint-declaration-adopted-during-the-high-level-technical-summit-on-diabetes-co-organised-with-who-europe-and-calls-on-member-states-to-take-additional-action-to-accelerate-pro/. Accessed 04 04 2024

[7] Sciensano (2023) 21 European countries unite in the EU Joint Action JACARDI to reduce the burden of cardiovascular diseases and diabetes. Available from  https://www.sciensano.be/en/press-corner/21-european-countries-unite-eu-joint-action-jacardi-reduce-burden-cardiovascular-diseases-and. Accessed 04 04 2024

All News
Top