Nearly 600 delegates attended the 2006 annual Federation of European Nurses in Diabetes (FEND) conference in Copenhagen – ‘the largest audience in its 11-year history,’ said Anne-Marie Felton, (FEND Chair), in her opening address to delegates.
The theme of the conference was Diabetes: Health Crisis of the 21st Century and this served as a link between every lecture and masterclass.
Anne-Marie explained that the diabetes epidemic is not geographically constrained. The alarming increase in the prevalence of the condition throughout all countries globally is a clear reminder of the seriousness of diabetes and of the responsibilities and commitments inferred upon nurses and other healthcare professionals.
The enormity of the challenge is recognised by the International Diabetes Federation (IDF), indicated by their timely and pertinent commitment to the campaign for a UN Resolution on diabetes (which was passed by the UN on 21 December 2006). Anne-Marie emphasised the pride FEND members felt in supporting this mission.
In terms of the clinical management of diabetes, delegates heard about new pharmaceutical interventions and the positive impacts associated with innovative education programmes for people with diabetes.
The former were described by Cliff Bailey (Professor of Clinical Science and Head of Diabetes Research Aston University Birmingham) who spoke about exenatide, an injectable analogue of the gut hormone glucagon-like peptide-1 (GLP-1) which has been launched in the US as Byetta (Amylin Pharmaceuticals Inc., San Diego, CA and Eli Lilly and Company, Indianapolis, IN). Exenatide stimulates glucose-induced insulin secretion, making it particularly effective in the control of prandial hyperglycaemia and will also facilitate control of basal hyperglycaemia without itself causing overt hypoglycaemia. GLP-1 analogues also reduce glucagon secretion, slow gastric emptying, exert a satiety effect and assist weight loss.
Professor Bailey also mentioned the imminent introduction of the first inhaled insulin, Exubera (Pfizer, Walton-on-the-Hill), following regulatory approval, indicated by NICE for use in people with acute needle phobia or problems with injection sites. He went on to discuss a new oral anti-obesity agent, rimonabant, which inhibits the endocannabinoid receptor CB1. While this mainly reduces appetite, it has been shown to reduce HbA1c levels in obese people with type 2 diabetes and may infer additional reductions in cardiometabolic risks beyond those expected from weight loss alone.
In relation to non-pharmaceutical interventions, Alain Golay (Professor of Medicine in Switzerland) spoke about his team’s use of therapeutic education and art therapy which, he said, ‘…allowed individuals to improve their knowledge and skills not only in regard to their condition but also in regard to their treatment. Such awareness brings a better quality of life, a greater therapeutic concordance and a reduction in complications.’
Professor Golay talked about the use of art and dance therapy as a means of allowing people to express their painful life experiences in a non-verbal manner. As part of a multidisciplinary approach in therapeutic education, such sessions allow people with diabetes to become emotionally and physically empowered to recognise personal resources and progressively modifying their behaviour.
UN Resolution on diabetes
Professor Martin Silink, President-Elect of the IDF, received a standing ovation later in the day for his inspirational lecture on the IDF’s quest for a UN resolution for diabetes. The Unite for Diabetes campaign, which persuaded the UN to recognise the global burden of diabetes, focused in particular on the special needs of children, older people, pregnant women, migrant populations and indigenous people with the condition. The campaign’s small blue circle lapel badge was worn by all delegates during the conference.
Since this conference took place the UN passed the Resolution on 21 December 2006, thereby recognising the global threat of the diabetes epidemic.