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Home » Diabetes, EU Health, Health

How can Europe manage diabetes more effectively?

Submitted by on 26 Feb 2019 – 16:06

Despite 30 European countries boasting national plans covering diabetes, the disease currently affects nearly 60 million people in Europe. If this situation is to change, urgent action is required at the policy level and broader collaboration is essential among policymakers, professional societies, healthcare professionals and patient organisations. Canvassing for a change, the International Centre for Parliamentary Studies (ICPS) recently brought together key stakeholders to discuss strategies to improve prevention and management of diabetes in Europe.

Nearly 30 European countries have national plans covering diabetes and 10 countries have such a plan for the future. Ninety-five percent of them target obesity, smoking, harmful use of alcohol, and promote healthy diets and physical activity.

Yet, sadly, diabetes currently affects almost 60 million people across Europe. While several countries have made progress towards developing a systematic policy response to the diabetes burden, overall investment in and implementation of comprehensive strategies for the prevention and treatment of diabetes has varied.

To reverse this trend, it is pertinent to tackle the persisting gaps and missed opportunities in the EU battle against diabetes. In order to review the current progress of diabetes management in Europe and address the complications in managing the fatal disease, the International Centre for Parliamentary Studies brought together eminent parliamentarians, healthcare professionals, academic experts and industry stakeholders in a high-level policy roundtable.

Chaired by Prof Philip Home, former editor of reputed international diabetes journals, including Diabetic Medicine and IDF’s Diabetes Voice, the ICPS Diabetes Europe Roundtable 2018 housed over 40 experts coming from more than 20 European countries, who examined a wide assortment of issues ranging from prevention, active surveillance, the importance for data sharing and greater collaboration, reimbursement and the need for promoting active lifestyles.

Following a policy update from the European Commission, Prof John Nolan from the European Association for the Study of Diabetes (EASD) launched the European Diabetes Forum, a new initiative of EASD, which aims to address the full landscape of diabetes research and clinical care in Europe. Ambitious to advance diabetes research and care, he noted that it’s time to accelerate and strengthen our capacities to collect, analyse, and use healthcare data.

Delegates agreed that a coherent strategy on diabetes public awareness, research, prevention, management and long-term monitoring is a sine qua non, and tabled a few significant recommendations for policymakers.


Data is a key player in our fight

A central theme to emerge from the roundtable discussion was the importance of good data repository systems and the need to liberate data to strengthen our battle against diabetes.

Although the growth of the diabetes burden is undisputable, the scarcity of comparable data makes it difficult to quantify this increase at national and European levels. Given the key role of robust, comprehensive data in informing policies, it is surprising to note that more than 83% of diabetes registers are reportedly incomplete.

While numerous apps, companies, hospitals and healthcare providers collect a variety of personal data, more needs to be done to improve intelligent data collection, interconnecting data and getting better at data interpretation and sharing, in order to improve patient outcomes and treatment modalities. While maximising the use of data still remains a challenge in the light of data privacy laws, it is crucial to remain more transparent on how we process patient information. It is imperative to develop standards for data collection and usage in the treatment and management of diabetes.

It is consequently crucial for European policymakers to toughen the national capacity to collect, analyse and use representative data on the burden and trends of diabetes and its key risk factors. More needs to be done in order to improve the quality of data. Member states must develop, maintain and support a European diabetes registry. Learning from best practices and cancer registries, Europe should build a centralised patient-focused data registry to improve analysis of data on patient experiences.


Is Diabetes losing out to other diseases like cancer?

Delegates at the ICPS Diabetes Europe 2018 call on policymakers and politicians to necessitate, as soon as possible, a societal change towards diabetes and table a few significant recommendations to improve management of the fatal disease

Despite political engagement efforts and the work of international and national diabetes associations across Europe, politicians are yet to understand the gravity of the situation at hand.

We need stronger political mobilisation and investment. Delegates agreed that more awareness should be created at the political level to implement national strategies to manage diabetes.

Delegates at the ICPS Diabetes Europe 2018 call on policymakers and politicians to necessitate, as soon as possible, a societal change towards diabetes and table a few significant recommendations to improve management of the fatal disease.

Policy recommendations

1. There’s a need for a systemic and societal change regarding public attitudes towards diabetes. European policymakers should do more to increase awareness about risk factors and the disastrous complications of the fatal disease.

2. Europe should fill the key gaps in the diabetes knowledge base. It is pertinent to make an honest analysis of failed initiatives. More importantly, we need to analyse what strategies worked well and what did not. In particular, lessons from the past need to be articulated well in order to plan for the future of diabetes care in Europe.

3. We should build the capacity of ministries of health to exercise a strategic leadership role, engaging stakeholders across sectors and society. Accountability of national diabetes plans should be increased and prevention strategies should be implemented at the European level.

4. Europe must prioritise actions to prevent people from becoming overweight and obese, beginning before birth and in early childhood. We should implement policies and programmes to support women with gestational diabetes, to increase the consumption of healthy foods and to discourage the consumption of unhealthy foods, such as sugary sodas, thereby increasing regulation on food producers.

5. Two patient communities that require maximum attention and care are the children and adolescents and the elderly. Special care needs to be taken in drafting specific strategies to improve prevention, diagnosis, care and management of diabetes within these factions of society.

6. Member states should invest more in the foundations of lifelong physical well-being in our youngest children; create communities that foster health-promoting behaviours and broaden health care to promote health outside the medical system.

7. There should be greater focus on education and health literacy for children and populations at high-risk, to improve prevention and reduce the cost burden of diabetes.

8. Europe needs to create more supportive social environments for physical activity. A combination of fiscal policies, legislation, changes to the environment and raising awareness of health risks works best for promoting healthier diets and physical activity at the necessary scale.

9. There is an urgent need to develop strong nutrition standards for school lunch, reduce marketing and access to unhealthy food at schools and create healthier food environments.

10. It is essential that we pursue pragmatic solutions to manage diabetes. Whilst every European country is finding its own way to solve common challenges in managing diabetes, anything that is common and can be used to compare should be used, in order to build a data framework to better manage the fatal disease.

11. As the specialist nurse occupies a central position in caring for and supporting patients and their families over the course of the disease, greater importance should be given to the role of the specialist nurse. Due to the complexities of modern diabetic care, at least one named specialist nurse should be assigned to a patient at every level of care.

12. It is pertinent to bridge the gaps between technology providers, pharmaceutical companies, science, regulators and academia to better understand the missed opportunities and challenges in managing diabetes. Europe should embrace innovation more effectively, support new initiatives and take the lead in stakeholder consultation.

13. Europe should find new approaches for a patient-centred and personalised approach to diabetes management.

14. It is crucial that industry and healthcare systems work hand-in-hand to provide access to medicines, improving prevention and care of diabetes in Europe. There is also an urgent need to increase availability and access to insulin pumps and improve reimbursement mechanisms of self-monitoring tests. In addition, Europe should do more to improve and efficiently regulate self-management interventions.

15. The huge increase in low-cost health-related apps to improve management of lifestyle diseases raises three important issues: Are apps developed according to evidenced-based guidelines or on any evidence at all? Is there any evidence that apps are of benefit to people with diabetes? And what are the current regulation mechanisms for healthcare apps? Despite the high potential of low-cost health-related apps in improving healthcare, more needs to be done to insist on regulation of mobile medical applications at the European level.

There are no simple solutions to address diabetes but coordinated, multi-component intervention can make a significant difference. Everyone can play a role in reducing the impact of all forms of diabetes.

Governments, health-care providers, people with diabetes, civil society, food producers and manufacturers and suppliers of medicines and technology can collectively make a significant contribution to halt the rise in diabetes and improve the lives of those living with the disease.