Hyperbole is common when discussing diabetes but vivid imagery that paints the condition as a ticking time bomb or epidemic is a necessary part of understanding the scale of the problem.
Not only is it responsible for one in 10 deaths in Europe, it is also the leading cause of blindness, amputations, kidney failure and stroke, providing devastating blows to both healthcare systems and the patients they serve. It kills more people than breast cancer and prostate cancer put together and costs society more than all cancers combined.
If things were standing still they would be bad enough, but the figures continue to rise. By 2035, it’s thought that one in 10 people (some 70 million) in Europe will have diabetes. The increasing numbers of those with type 2 diabetes is linked to the rise in obesity as well as the region’s ageing population. Added to this is the unexplained increase of type 1 diabetes in children.
No country in Europe has managed to prevent the diabetes epidemic from rising
Even with numbers of this magnitude, there is what’s known as the ‘rule of halves’ to contend with when it comes to unmet needs. Up to half of all cases of diabetes are undiagnosed; of those that are diagnosed, half do not achieve adequate glucose control; and so it continues, with that down steps in outcomes that, if followed through imply that only around 6% of people diabetes (type 1 and 2) are estimated to have well-managed diabetes and desired health outcomes.
The scale of the challenge then can be seen in the burden of diabetes-related complications:
- Stroke: Risk is up to four times higher with diabetes
- Cardiovascular disease: Risk is up to four times higher with diabetes
- Diabetic retinopathy: This is the leading cause of blindness in working age adults
- Diabetic nephropathy: This is the leading cause of end-stage renal disease.
There is, of course, considerable variety in care across the region – as the recent Euro Diabetes Index showed – but there’s no room for complacency.
“No country in Europe has managed to prevent the diabetes epidemic from rising,” says João Nabais, president of IDF Europe. “We need to make sure governments across the region no longer question the need to adopt comprehensive policies to prevent, diagnose and give access to quality diabetes treatment to those who need it.”
Over the summer IDF Europe took leadership of the Policy Action Network on Diabetes (ExPAND). This was formed in 2011 by a coalition of parliamentarians, leading diabetes organisations and experts from across Europe. Its central aim is to build a strong network of parliamentarians to act on diabetes at local, national and European levels.
UK MP, and ExPAND chair, Adrian Sanders explained: “By engaging with parliamentarians across Europe, we are confident we can raise the profile of diabetes as a public health priority, exchange best practice and provide evidence to trigger concrete political action to reverse the diabetes epidemic.”
The network wants to see action on several fronts:
- Prevention
- Keeping those with diabetes healthy
- Extra responsibility for the care vulnerable groups like the young and elderly.
Checking the tide?
Against such a stark picture it is heartening to hear that recent years have seen some signs of improvement in European diabetes care – even if there are still mountains to climb.
Health Consumer Powerhouse, which monitors and compares healthcare systems among 35 countries – including all EU member states, published the latest version of its Euro Diabetes Index in September. It came six years after the report was last issued (in 2008 its forward was titled ‘killing neglect’). This year Johan Hjertqvist, founder and president of the Health Consumer Powerhouse, said they found more of a mixed picture.
“The upside is that in spite of a continuous growth of diabetes prevalence, less people die. Today, the blood-sugar level of diabetics is monitored and controlled in far more countries, an essential way to avoid complications.
“The awareness of the relation between lifestyle, manifest through diet and obesity, and diabetes has become stronger. Patient management by devices for self-monitoring and medication is spreading – a most important step to empowering individuals,” he said.
Against this backdrop there’s clearly much the industry could do – and indeed is already doing – to assist healthcare professionals and health systems.
With World Diabetes Day taking place today it will most likely be difficult to avoid industry awareness efforts. But banner events like that are not the only way pharma can help – patient education, tools for patients and healthcare professionals and – of course – research into ever more efficacious medicines could yet help check the tide of diabetes in Europe.