So, what is the EU doing about diabetes?

The EU currently has 25 member states with an approximate total population of 450 million people, of whom more than 25 million have diabetes (www.diabetesconference.at [accessed 20.06.2006]). There is a clear consensus at EU Parliamentary level that diabetes is a serious condition; however, across the EU member states there is still a lack of any strategy to tackle the condition’s increasing prevalence. The exchange of expert knowledge between the member states has to be intensified. Of special importance is the development of framework programmes, primary prevention initiatives and other special programmes (such as those for socially deprived populations).

For its presidency of the EU (from January 2006 to June 2006) Austria has chosen diabetes as one of two health issues to tackle (the other is women’s health). In order to draw up recommendations and joint strategies, a conference was held by the Austrian Health Institute on 15–16 February 2006, in Vienna.

More than 180 experts from across 34 countries attended the conference. All EU member states were represented, as were Israel, Russia, Switzerland, Ukraine and the US.

The following four parallel working groups were established:

• Prevention of cardiovascular disease in diabetes
• Disease management – reducing diabetes complications
• Early prevention of type 2 diabetes
• Social, societal and gender aspects of type 2 diabetes.

The recommendations of the working groups were presented at a plenary session and amalgamated into a single document. Maria Rauch-Kallat, the Austrian Federal Minister for Health and Women, suggested that the recommendations be put forward to the EU Council of Health Ministers as the ‘Vienna Declaration on Diabetes’.

The declaration highlighted the need for an EU diabetes strategy to include the following:

• a recommendation on diabetes prevention, diagnosis and management
• a forum for exchange of best practice
• a collection of comparative data and long-term monitoring of individuals with diabetes.

Prevention strategies are required both at the whole-population level and for high-risk populations. With regard to high-risk groups, early detection and diagnosis combined with a range of lifestyle interventions are vital from a prevention perspective.

What should the EU member states be doing?
Firstly, considering the needs of people already diagnosed with diabetes, EU member states should develop and implement diabetes management programmes. Secondly, considering the impact of diabetes and cardiovascular disease upon the individual, national health services and national economies, the need for greater awareness was highlighted. It is important to ensure equitable access to appropriate management and care on the basis of EU guidelines.

It was proposed that an EU council recommendation should particularly target socially deprived populations and also women, especially in their child-bearing years. It was agreed by all present at the conference that discrimination (on grounds of race, age, sex or socioeconomic status) has to be tackled actively at the EU level. Moreover, it was stressed that the EU and its individual member states have to provide more funding for diabetes research.

The declaration
In addition to the conference, a written declaration on diabetes, which was signed by the majority of Members of the European Parliament (MEPs), was submitted by John Bowis, MEP for London. It called upon the EU to prioritise diabetes, to develop an EU-wide diabetes strategy and to draft an EU council recommendation for its prevention, diagnosis and control.

The Vienna Declaration on Diabetes was presented to the informal meeting of EU Health Ministers on 27 April 2006 and was warmly received. The formal meeting of the council took place on 2 June 2006  and it is hoped that its outcomes will influence the future direction of diabetes care in Europe.

Further details are available at www.diabetesconference.at