Expert: New European Commission should focus on the outcomes of diabetes

Professor John Nolan: "Diabetes is not getting the attention it deserves neither from the public in general nor from public policy makers, despite the serious health consequences." [Shutterstock]

The new European Commission should focus on the outcomes of diabetes rather than on the processes within the healthcare system, which have been chronically fragmented and lacking strategic focus, Professor John Nolan told EURACTIV.com in an interview.

“Diabetes is not getting the attention it deserves neither from the public in general nor from public policymakers, despite the serious health consequences,” he added.

John Nolan is a professor of endocrinology and metabolism (adjunct) and president of the European Diabetes Forum (EUDF). He spoke to EURACTIV’s Sarantis Michalopoulos on the occasion of the World Diabetes Day (14 November).

What’s the importance of the World Diabetes Day?

World Diabetes Day gives recognition to the escalating health challenge of diabetes. Diabetes now affects close to 10% of people in Europe and more than 10% of people in China and India and is a global health threat. 90% of cases are type 2 diabetes, which can be prevented in people at risk.

The complications of diabetes are the main cause of suffering and the main reason for the high healthcare costs, approaching 10% of all health expenditure.  The complications (heart disease, kidney failure, blindness, amputations) can be prevented by currently available treatments, anywhere in the world.  World diabetes day is an important occasion to draw public attention to diabetes and focus on the importance of prevention.


Do you believe that diabetes is getting the policy attention it deserves? What would you ask from the next Commission?

Diabetes is not getting the attention it deserves neither from the public in general nor from public policymakers, despite the serious health consequences, despite the rapid increase in prevalence and the spiralling healthcare costs arising from diabetes and its complications.

Because diabetes is insidious over years and because of its serious complications present in other areas of healthcare (cardiovascular diseases – heart attack, stroke, kidney failure, blindness, amputations), the negative impact of diabetes is diffuse and fragmented.  Diabetes lags behind heart disease and cancer for policy attention, because both of these conditions present much more acutely with immediate threat to life.

I would ask the new EU Commission to focus on the outcomes of diabetes rather than on the processes within the healthcare system, which have been chronically fragmented and lacking strategic focus.  I would ask the Commission to engage with EUDF on 3 strategic priorities, which are:

People with diabetes: Engaging directly with those living with diabetes.  Prioritizing self-care, supporting technology and digitalisation.

Data and Registries: supporting the development of diabetes registries and data systems in Europe that can measure and register care quality and outcomes. Many countries and regions have no such diabetes data systems from which to assess status of care quality and to monitor progress over time.

The healthcare system: Supporting the full integration of diabetes care between primary and secondary care.  Crucial to policy is to deliver and fund diabetes care based on outcomes and value rather than on process and output.

What have you achieved so far with EUDF?

The EUDF was launched in October 2018 in Berlin and is a new multi-stakeholder forum to include all the stakeholders in the diabetes landscape, including people with diabetes, clinicians in primary, secondary and tertiary care, nurses, other paramedical staff, researchers, regulators, payers, politicians and public decision makers, as well as industry – both pharmaceutical and medical technology.

The EUDF has brought a new focus on diabetes outcomes in Europe.  During the past year, the EUDF has engaged with many of the key stakeholders in European diabetes and has received input and contributions to strategy both at European and at national level.  The focus on diabetes outcomes has resulted in the articulation of the priority areas: data/registries, support of self-care and the integration of the healthcare system for diabetes.  The response to the EUDF at national level has been rapid and energised.  National versions of EUDF, i.e. national multi-stakeholder diabetes fora, have already been initiated in Romania, Belgium and Bulgaria.  Many other countries in Europe are engaged in the process and contributing to specific strategic goals based on local experience and expertise.

When it comes to the national level, what actions would you suggest?

Ultimately the delivery of diabetes care takes place at national level.  While a clear Europe-wide strategic framework and systems such as data and registries are important, the same multi-stakeholder environment needs to come together in each country in Europe in order to address and improve diabetes outcomes.  The EUDF is already engaging with local stakeholder groups in many European countries and supporting their national policy dialogue and strategic focus.

[Edited by Zoran Radosavljevic]

In recent years, an explosion in diabetes incidence occurred, not only in the EU, but throughout the world. According to the latest WHO statistics, about 422 million people worldwide have diabetes, a number likely to more than double in the next 20 years. According to IDF (International Diabetes Federation) data, the absolute number of diabetics in the EU-27 will rise from approximately 33 million in 2010 to 38 million in 2030. Read more.

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