Diabetes is a global epidemic that affects everyone. The numbers are staggering: 415 million people were living with diabetes in 2015, another 318 million people were at high risk of developing type 2 diabetes, and diabetes was responsible for 5 million deaths. Worryingly, the epidemic shows no signs of relenting, with the number of people living with diabetes expected to reach 642 million by 2040. Diabetes has an enormous human, social and economic impact, with one in eight health dollars currently spent on treating the disease and its associated complications.
Despite these alarming statistics, cost-effective solutions exist to reduce the global burden that diabetes currently poses. Much can be done to prevent the onset of type
2 diabetes, as outlined in the IDF Cost-effective solutions for the prevention of type 2 diabetes report, which provides an overview of the latest evidence on the different programmes available to tackle the rise of the most prevalent form of diabetes. The wide range of options presented and their cost-saving implications give cause for optimism that the current situation can be reversed.
Intensive lifestyle modification, involving the adoption of healthy diets and increased physical activity, remains the cornerstone for the prevention of type 2 diabetes. This report discusses in detail the components of a successful lifestyle modification programme, the benefits of using certain medications for primary prevention, and provides an analysis of different public health measures to promote healthier behaviours.
The intention of this report is to provide policy makers and diabetes advocates with an accessible and comprehensive summary of the current data on the clinical effects of primary prevention programmes, the costs associated with their delivery, and the resulting benefits for our societies. Evidence on actionable solutions is also included to inform policy development.
Successful prevention of type 2 diabetes will only be achievable through concrete and effective action at the community level. We hope that the practical solutions outlined in this report will help those active on the ground to change the diabetes landscape to achieve a healthier future for all.
Driving early action in type 2 diabetes
In December 2016, diabetes experts representing 38 countries convened in Berlin to launch The Berlin Declaration, a global call to action urging policy makers to reduce the growing burden of type 2 diabetes.
Their recommendations focus on four pillars of ‘Early Action’ in type 2 diabetes: preventing diabetes, diagnosing it early, controlling it early and ensuring early access to the right personalised interventions. If adopted by national health systems, the recommendations are expected to help countries meet voluntary global diabetes targets set by the United Nations1 and the World Health Organization.2 If policy makers fail to take action, health system costs are expected to increase by $129 billion by 2040.
Experts issued their call for early action at the Global Diabetes Policy Forum on Early Action in Type 2 Diabetes in Berlin on 13-14 December 2016. The meeting was organised and funded by AstraZeneca in collaboration with the International Diabetes Federation (IDF), Primary Care Diabetes Europe (PCDE), and the World Heart Federation (WHF), and supported by German Diabetes Aid (GDA). The Forum took forward the work begun under the banner of ‘Early Action in Diabetes’ at the first Global Diabetes Policy Summit, held in Barcelona, Spain, in November 2015. Participants in the Berlin Forum included leading clinical experts in diabetes as well as patient group representatives, policy makers and political leaders.
The Berlin Declaration is the output of the work of 23 diabetes experts from 11 countries who volunteered to participate in four international working groups established at the 2015 Summit in Barcelona. The groups were tasked to review best practice in policy making in diabetes prevention, early detection, early control and early access to the right interventions. Each group convened at least twice during 2016 in order to contribute to The Berlin Declaration.
“I’m delighted that the International Diabetes Federation is helping to champion this important initiative,” said IDF president Dr Shaukat Sadikot. “What sets ‘Early Action’ apart from other campaigns is its focus on real action on the ground, aimed at producing concrete benefits for people with diabetes in countries at all levels of income. Every six seconds, someone in the world dies from diabetes. This sobering fact makes it absolutely critical that policy makers take action now, and that a broad range of stakeholders come together to encourage and support needed policy reform.”