Written by Laurence Amand-Eeckhout.
On the occasion of World Diabetes Day, the European Parliament is expected to hold a debate on prevention, management and better care of diabetes in the EU during the November II plenary session. World Diabetes Day – marked every year on 14 November – was proclaimed by the United Nations in 2007 to raise awareness of diabetes and related complications, and to promote prevention and care, including through education.
Diabetes is a chronic disease that occurs when the pancreas is no longer able to produce insulin, or when the body cannot make good use of the insulin it produces. Insulin helps glucose get into the cells. If the body is not able to produce insulin or use it effectively, the result can be raised blood glucose levels (hyperglycaemia), causing damage to the heart, blood vessels, eyes, kidneys, teeth and nerves. People with diabetes are also more likely to become severely ill if infected by the Covid-19 virus.
There are three main types of diabetes: type 1, type 2 and gestational. Type 1 results from a lack of insulin production and is diagnosed mainly in childhood and in teenagers. Its causes are still unknown (a genetic predisposition can exist, but the inheritance pattern is unknown). Daily insulin injections are required to keep blood glucose levels under control. Type 2, which accounts for 90 % of all diabetes cases, results from the body being unable to use the insulin it produces effectively. Type 2 is diagnosed mainly in adults, although an increase in cases has recently been observed among children. Type 2 diabetes often results from excess body weight and physical inactivity. A healthy lifestyle, regular physical activity and maintaining a normal body weight can help prevent type 2 diabetes. However, those who have already contracted type 2 diabetes require oral drugs and/or insulin to maintain safe blood glucose levels. Gestational diabetes consists of high blood glucose during pregnancy. Women who are affected and their children are at increased risk of developing type 2 diabetes later in life.
‘Education to protect tomorrow‘ is the theme of the second year of the World Diabetes Days 2021-23 campaign ‘Access to Diabetes Care‘, underlining the need for better access to quality diabetes education for health professionals and people living with diabetes. Every year, the World Diabetes Day campaign focuses on a dedicated theme that runs for one or more years.
Facts and figures
According to the International Diabetes Federation (IDF), approximately 537 million adults (aged 20 to 79) around the world were living with diabetes in 2021. This number is expected to rise to 783 million by 2045. In addition, 541 million adults are at increased risk of developing type 2 diabetes.
Almost one in two (240 million) adults living with diabetes are undiagnosed.
The life expectancy of people living with diabetes is likely to be reduced as a result of their condition.
In the EU specifically, it is estimated that over 32 million people are suffering from diabetes.
Direct costs relating to diabetes reached estimated 9 % of total health expenditure in the EU in 2019, while diabetes can also result in indirect costs that are harder to measure, such as reduced work productivity.
EU action on diabetes
EU Member States are responsible for their own healthcare policies and systems. However, according to Article 168 of the Treaty on the Functioning of the European Union, EU action should complement national policies. The EU focuses on prevention, research, information and education, while also fostering cooperation between Member States.
This is an update of an ‘at a glance’ note from November 2021.
The European Commission addresses diabetes in its work on non-communicable diseases (NCDs). It is supporting Member States as they work towards reaching the nine targets on NCDs of the United Nations (UN) and World Health Organization by 2025, as well as UN sustainable development goal 3.4, which aims to reduce premature mortality from NCDs by one third by 2030. To this end, in 2018 the Commission set up a steering group on health promotion, disease prevention and management of non-communicable diseases, which identifies best practice for dissemination and transfer between countries.
The new Healthier Together EU non-communicable diseases initiative (which covers the period 2022 to 2027), launched by the Commission in December 2021, aims to support EU countries in reducing the burden of NCDs, including diabetes, while improving citizens’ health, as part of efforts to build a European health union. The EU4Health programme, adopted in March 2021, and other EU programmes will support the implementation of the initiative in the EU Member States.
In the field of prevention, the Commission’s action focuses mainly on the key risk factors for type 2 diabetes, encouraging the promotion of healthy eating and physical activity and the reduction of obesity and the harmful use of tobacco and alcohol. The EU4Health programme will continue to provide funding for prevention during the 2021-2027 period. It will also support efforts to facilitate access to medicines and medical supplies, digitalise healthcare services, and set up a European health data space to promote the exchange of and access to various types of health data.
Under the Horizon Europe research and innovation programme, the EU supports several projects geared towards preventing diabetes, improving treatment and translating new knowledge into innovative applications.
MEPs Mobilising for Diabetes (MMD)
The MEP Interest Group on Diabetes MMD, which is continuing the work of the EU Diabetes Working Group, was set up in 2020 and is co-chaired by Sirpa Pietikäinen (EPP, Finland) and Christel Schaldemose (S&D, Denmark). The group aims to foster EU policy action around a series of priorities: improving diabetes care and risk reduction; promoting better access to medicines and technologies; and eliminating discrimination against people living with diabetes. In February 2021, the group published a Blueprint for action on diabetes in the European Union by 2030. On the occasion of World Diabetes Day 2022, it will organise a breakfast symposium on ‘Improving diabetes care for more resilient healthcare systems‘.
Diabetes represents a growing threat in the EU. The ageing and increasingly overweight population, unhealthy diets and sedentary lifestyles are resulting in a rapidly increasing number of type 2 diabetes cases. Investment in prevention is essential to prevent diabetes through a healthy lifestyle starting in childhood.
This year’s World Diabetes Day focuses on education. Education plays a significant role in preventing not just diabetes but also its complications. This involves a cross-sectoral policy response relating to health, nutrition, education, mass media campaigns, social services, urban mobility, and physical and recreational activities.
Delivering better long-term care for patients living with diabetes means reducing significant disparities, both between and within Member States, so that all patients have access to quality medicines and medical devices at an affordable price. Lessons can be learned from the Covid-19 pandemic, which has highlighted health inequalities across the EU. The European Commission is organising a high-level conference on 22‑23 November 2022 on how we can better prepare ourselves for future health threats. Investment in research (e.g. innovative tools and technologies, such as continuous glucose monitoring systems and new insulin delivery systems) and improved digitalisation of health services can improve patients’ quality of life and help to reduce health inequalities.
Read this ‘at a glance’ note on ‘World Diabetes Day 2022‘ in the Think Tank pages of the European Parliament.