As I begin my term as IDF Europe Regional Chair, I would like to share some reflections and a vision for the future. We have seen extraordinary discoveries and progress in diabetes treatment and management over the past 10 years which have vastly improved the lives of those with the condition. Despite this, 66 million people currently live with diabetes in Europe (10% of adults) and many more are at risk of developing it in the near future, particularly in relation to obesity. Early detection of people at risk using modern technologies and decisive intervention with disease-modifying therapies, along with greater equality in access to diabetes technologies and medications, are perhaps the most important areas where I believe we, at IDF Europe, can make a difference providing we unite our voices and engage with people living with diabetes (PwD) on all levels.
We must intensify our efforts to improve early detection of all diabetes types. It is estimated that approximately one in three people currently living with Type 2 diabetes (T2D) in Europe have not yet been diagnosed. Delays in detecting diabetes can result in long periods of hyperglycaemia which can contribute significantly to the risk of various diabetes-related complications. These have a marked impact on individuals and their families, as well as on health systems, accounting for 75% of diabetes costs. Screening for intermittent hyperglycaemia in people at risk with the help of artificial intelligence (AI)-assisted modern technologies coupled with early and decisive intervention with disease-modifying medications and technology-assisted behavioural modification can prevent progression to T2D and induce long-lasting remission. T2D in its early stages must become a preventable and curable condition. We need population-based screening programmes for early detection of stages 1 and 2 of Type 1 diabetes (T1D) to avoid life-threatening diabetes ketoacidosis presentations at stage 3. This can also potentially induce at least partial remission with innovative medications, delaying the onset of stage 3 where possible. The use of automated insulin delivery (AID) with close-loop systems is now the standard of care for people living with stage 3 T1D and must become available to all. We must tackle current inacceptable disparities in access to optimal care. Furthermore, cell therapies and perhaps even gene therapies may help bringing us closer to the cure of T1D.
The use of technology and AI-assisted decision support systems (DSS) in diabetes self-management across all types of diabetes can decrease the burden of managing the condition and provide valuable and individual management insights for PwD. Despite these benefits, access to modern technologies including insulin pumps, AID and continuous glucose monitoring (CGM) remains limited across Europe. CGM technology has been shown to significantly improve the rate and timing of detection of dysglycaemia in those who are at risk of intermediate hyperglycaemia or T2D, further strengthening the call to address gaps in access to this technology. These disparities are highlighted in IDF Europe’s recently released publication – “An overview of access to diabetes care in Europe”. This publication celebrates areas of strengths and identifies gaps in diabetes prevention and care in Europe across the areas of policy frameworks; access to medicines, technology and care; education, support and screening; and health system organisation. Importantly, IDF Europe is working with the European Parliament and Commission to ensure appropriate safety and quality standards for diabetes technology that are currently absent in our region. The final goal of new legislation is to ensure the safety of all medical devices.
Building on the momentum of the 2022 European Parliament Resolution on Diabetes and the 2023 IDF Europe-WHO Europe Declaration, we must take the opportunity of the upcoming UN High-Level Meeting to advocate for action on diabetes and to immediately bridge the gaps between current evidence and practice to address the unmet medical needs of those living with diabetes or with the risk for developing it, particularly in relation to obesity.
All this will contribute to reducing and finally eliminating the stigma of diabetes and obesity, early stages of diabetes, and improving the wellbeing, both body and mind, of all PwD and families. IDF Europe is the central voice of people with lived experience of diabetes. With our Member Associations and other stakeholders as a strong coalition of positive will, we will relentlessly pursue our goals until all PwD and those at risk in our region are relieved of the current burden.
I invite everybody to collaborate with us and help make the difference we all strive to achieve.
