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2024: The year to take European action on diabetes to the next level (Guest blog)

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 taking action on diabetes. Only through far-sighted and decisive action on diabetes can we prevent loss of life, often devastating complications, significantly improve the lives of people living with diabetes and make European health systems more sustainable and resilient.

As a diabetes community, we are rising up to the challenge by uniting our voices and showing where we need to go. Eight diabetes associations – representing people with diabetes, healthcare practitioners and researchers – and our supporting collaborators from industry have joined forces to adopt the Diabetes Community Pledge as part of our campaign to put diabetes high on the European health agenda.

Available in nine languages, the Pledge outlines 15 policy recommendations for the EU and member states to promote early detection, equitable care, people’s empowerment and science and technology. Together, these form a holistic response to flatten and ultimately reverse the curve of diabetes. There is no time to lose!

The rising tide of diabetes demands action

While the facts are well known to health economists and practitioners, policymakers may be not always familiar with the true extent of diabetes and its consequences for people and societies in Europe.

Already 31.6 million people are estimated to have diabetes in the EU. Partly due to population ageing, rising 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, such as vision loss or even amputation of lower limbs. People 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 in the EU.

Given these stark trends, inaction is simply not an option.

Fortunately, 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 in avoiding costs to our healthcare systems and economies.

Diabetes-related healthcare costs in the EU add up to around €104 billion annually.[1] To that, we can add around €65 billion in diabetes-related productivity losses every year.[2] However, the great majority of these costs are preventable

Indeed, three quarters of the healthcare costs are due to avoidable complications that can be prevented through screening and proper diabetes management that would allow people with diabetes access to the right treatment at the right time.

Furthermore, given how diabetes increases the risk of other diseases, not least renal and cardiovascular, there is a compelling case for investing in diabetes care as part of wider health system resilience and the prevention of other non-communicable diseases (NCDs).

Momentum towards a holistic approach against diabetes

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

The increasing prominence of diabetes on the European and international health policy agenda was also apparent last November when the European sections of the International Diabetes Federation and the WHO held an important high-level technical summit on diabetes. The assembled health experts and policymakers issued a Joint Declaration on accelerating action on commitments 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 strong action on diabetes. Policymakers need to understand that taking action on diabetes will also yield benefits for other disease areas, notably for cardiovascular diseases.

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). 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. Beyond these welcome actions, it is time to 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 provides a holistic approach to upgrading action on diabetes with concrete recommendations for both the EU institutions and national governments.

Around one of 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.

This is key to preventing and addressing the disease before serious complications emerge.

We also need to ensure equitable high-quality care so the right treatment is provided to the right person at the right time. Patients need affordable access to the most appropriate medicines and technologies. Healthcare professionals need training and capacities 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 cases, we can massively improve the health and quality of life of people with diabetes.

With the right support and treatment, people with diabetes flourish as fully productive and participating members of society. 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, and patients’ involvement in research, regulatory, policy and evaluation processes affecting them. Above all, stigma should have no role in diabetes diagnosis or treatment.

Finally, we need to embrace science and technology to better understand diabetes and 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 diabetes, notably to address unmet needs and leverage digitally-enabled medical technologies.

There is no doubt: 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.

Now is the time for action. We urge you to sign and share the Diabetes Community Pledge today!

[1] http://www.diabetesatlas.org/

[2] https://pubmed.ncbi.nlm.nih.gov/28456416/