• 12 October - World Sight Day

    October 10 2017

    Looking at challenges eyes to eyes

    World Sight Day 2017 12 October 2017

    In Europe, over 15 million people are living with type 2 diabetes without being aware of their condition. Delayed diagnosis means they may already be suffering from at least one complication by the time they are diagnosed with diabetes. Similarly, people with known but uncontrolled diabetes are likely to develop complications sooner than people with controlled diabetes. Among the debilitating complications of diabetes, diabetic retinopathy is still one of the most feared, dramatic yet common ones. Currently, diabetic retinopathy is one of the leading causes of preventable blindness in working age adults, even in developed countries.

    On World Sight Day, we spoke to Professor Sehnaz Karadeniz, International Diabetes Federation (IDF) Europe Regional Chair, teaching Faculty at the Ophthalmology Department of Medical Faculty of Istanbul Science University and also working as an ophthalmologist at the Ophthalmology Dept. of the Istanbul Florence Nightingale Hospital. Sehnaz has type 2 diabetes.

    Outside of your voluntary commitment within IDF Europe, you are an ophthalmologist and you also teach in that field. Can you tell us more on the relation between diabetes and retinopathy ?

    As an ophthalmologist we should always keep in mind that we are not dealing with an eye disease only, but with an end organ response to a systemic disease. Consistently high levels of blood glucose, together with high blood pressure and high cholesterol, are the main causes of retinopathy. Therefore, glucose control and control of other risk factors like hypertension and dyslipidaemia are also a crucial part of the eye care in people with diabetes.

    As the number of people with diabetes increases in Europe and beyond, so are the number of people at risk for diabetic retinopathy. The prevalence of diabetic retinopathy increases with the duration of diabetes. Over 70% of people who have been living with diabetes for more than 20 years have some form of diabetic retinopathy. As an overall number it is estimated that at least one third of people with diabetes have diabetic retinopathy. And as you can read here a story written by Rachel Portelli, retinopathy can become a major handicap. 

    With 60 million people with diabetes and 32 million more at risk, diabetic retinopathy is a major health issue in the continent.

    This is alarming and mostly unknown. What can be done?

    You know, in most cases of debilitating complications linked to diabetes can be prevented and I am a great supporter of prevention and awareness strategies which are easy and cost-effective tools. We, as a federation and as a diabetes community, need to enlarge as much as possible the scope of these strategies. We also need to improve and adapt our communication to match the reality. For example, in the literature, diabetes is often mentioned as one of the leading causes of blindness. It is a reality but this is not a motivating wording and it is reductive. In fact, there is a long way from the early stages of diabetic retinopathy to the stage of blindness. So our messages should not only refer to the end-stage but also to earlier stages of the visual impairment which also negatively affects the quality of life of people with diabetes. We also need to emphasize our communication around the fact that these debilitating complications can easily be prevented by early diagnosis, regular follow-up and timely management.

    If I understand correctly, prevention is key. What should be done at the healthcare and institutional levels?

    You are right and it should be at the center of every strategy. One of the main problem is that a considerable number of people diabetic retinopathy are diagnosed late when they already have some, even major visual loss. They generally have no visual complaints in the early stages of diabetic retinopathy, and, some even till late stages, therefore people may not be aware that they have retinopathy until visual impairment affects their daily life.

    Screening for retinopathy even in asymptomatic persons with diabetes is therefore crucial. Early diagnosis, regular follow-up and timely treatment of sight-threatening disease are the only ways for saving sight in people with diabetes. And prevention is not only a question of treatment. Good blood glucose control, control of other risks factors are among the strategies to delay and slow down the arrival and the progression of diabetic retinopathy.

    Eye care in people with diabetes needs a well-coordinated and integrate approach, so the role of the healthcare system is extremely important. Early diagnosis and timely treatment of this sight-threatening disease can only be achieved by better coordination between health disciplines and better integration of care systems for people with diabetes. Besides further research on diabetic retinopathy, we should now more and more focus on translating the existent evidence base into the real life of people with diabetes.

    To this end, in 2015 the International Diabetes Federation together with the Fred Hollows Foundation produced the guide “Diabetes Eye Health: A guide for health professionals” , to reinforce the knowledge of health professionals working with people with diabetes. In 2016 we also produced in collaboration with the International Federation on Ageing and the International Agency for the Prevention of Blindness a very interesting publication “The Diabetic Retinopathy Barometer Report: Global Findings” which contain extremely interesting recommendation to optimise the outcomes for adults leaving with diabetes who are at risk of developing eye complications. I really encourage everyone involved in the management of diabetes to download it and read it. It is available here.

    At IDF Europe we are now also working on a publication looking into the challenges and barriers in integrating the evidence base into practice which should be released on time for World Diabetes Day. I hope this will also serve as a strong advocacy tool to bring these challenges and barriers to the attention of the decision-makers and will serve to constructive discussions to bridge the gaps.

    You know, as Chair of IDF Europe, representing 70 national diabetes associations in 47 countries, I can observe, on a daily basis, the disparities in access to treatment around Europe. And for me this is one of our main missions: to improve the availability and accessibility of screening and treatment options for everyone with diabetes in the Continent. In this respect, healthcare system needs to be adapted to become “chronic disease-friendly” with the person at the center of the care system. We were speaking about communication strategies earlier, and this is for me a major one. It may only be semantic but it is central in the way our healthcare system should be re-oriented. People with diabetes are persons before being patients and must be considered as such.

  • 11 October - World Obesity Day

    October 10 2017

    World Obesity Day

    Our future does not look slimmer

    Earlier this year, the World Health Organisation Europe launched a new report “Adolescent obesity and related behaviours: trends and inequalities in the WHO European Region, 2002–2014”. The report confirms that the number of obese adolescents is continuing to rise in many countries across the Region. Levels are increasing particularly in eastern European countries, are very high in the vast majority of countries, and are especially high in countries of southern Europe. This trend is also visible in the adult population.

    High prevalence of overweight and obesity has serious health consequences. Raised Body Mass Index (BMI) is a major risk factor for diseases such as cardiovascular disease, type 2 diabetes and many cancers. It is estimated that overweight and obesity account for 65% to 80% of the increase in the prevalence of type 2 diabetes.


    On World Obesity Day, we spoke to Nathalie Farpour-Lambert, a paediatrician specialized in childhood obesity, sports medicine as well as global health policy  and President-Elect of the European Association for the Study of Obesity (EASO).


    Nathalie, the data on childhood obesity produced by WHO Europe are alarming. How did we reach this situation?

    Unfortunately, there is not one simple answer, so not one simple solution. The cause of childhood obesity, which is the consequence of an imbalance between energy intake and energy expenditure, is multifactorial; genetic predispositions for obesity affecting biological mechanisms, culturally associated behaviours, such as diet, physical activity and body image, and the environmental context including socioeconomic status and the environment. An obesogenic environment comprises factors that support children being obese, for example unsafe walking or cycling paths; reduced physical education at school; access to television, computers and smartphones; food technological changes in food production that reduced the time-cost of consuming calories; the evolution of food prices which incentivize people to consume more calorie-rich and unhealthy food; or marketing of junk food for children.

    These factors contribute to the worldwide development of childhood obesity, especially in children under 5 years old, and results in massive societal and economic costs.

    This is indeed complex. What are the potential consequences for these children when they become adults?

    It has been shown that childhood obesity has a strong association with adult mortality and morbidity. The length of exposure to obesity is also associated with the risk of developing related co-morbidities over time, in particular non-communicable chronic diseases (NCDs), such as type 2 diabetes. childhood obesity has a strong tendency to track into adulthood, most of obese children and adolescents will become obese adults and will have a significant lifelong exposure.

    The data on type 2 diabetes you produce are impressive. 60 million people have diabetes, mostly type 2 and 32 million are already at high risk of developing it because of overweight and obesity. And if you take the data from the WHO Europe, our future does not look slimmer: one in three 11-year olds is overweight or obese in Europe and two thirds of adolescents are insufficiently active, leading to overweight and obesity.

    Childhood is therefore a unique window of opportunity to have a lifetime impact on health, quality of life and prevention of disabilities.

    IDF Europe is part of an EU funded consortium Feel4diabetes, which aims to develop, implement and evaluate an evidence based and potentially cost effective and scalable intervention programme to prevent type 2 diabetes primarily focusing and families and vulnerable groups. As a paediatrician specialized in childhood obesity, what is, according to you, the role of the family to prevent obesity and its complications such as diabetes?

    Parents play an essential role for the physical and emotional development of their children. They provide role model, determine the family environment and habits, and support child behaviour changes. Therefore, family-based multidisciplinary programs are considered the gold standard treatment for childhood obesity. The aim is to modify the shared family environment and promote healthy behaviours in order to prevent further increases in obesity and to reduce as much as possible the risk of related ill health. The treatment of childhood obesity can involve a wide range of professional services including family counselling, behaviour modification, sports and activity training, nutrition and dietetics and, where necessary, pharmaceutical and surgical interventions.

    If I follow you correctly, the answer can not only be individual and require a team work. What should be the role of the society and its representative institutions?

    You are totally right. Achievement of meaningful impacts on childhood obesity requires more than single interventions, such as taxing sodas or traffic light food labelling. Although individual-level changes are a necessary component of obesity prevention and treatment, they are only one part of a whole system response, and must be supported by upstream actions that focus on promoting healthier physical, economic and social environments. Prevention of child obesity involves the child, the family, the school, the health services, the industries, the community and society at large. A child’s environment contains many inducements that encourage weight gain, and the child cannot be expected to resist these alone. Healthier choices need to be easy ones for a child to make, and need to be fully supported by all those responsible for children’s health. Where necessary, regulations must be applied to ensure that children are not induced to make choices which could damage their health. As the world urban population is continuously rising, cities can provide a healthy environment and contribute to obesity and type 2 diabetes prevention.

    The EASO Childhood Obesity Task Force (COTF) is convinced that considering obesity as a chronic disease is a crucial step for increasing individual and societal awareness, enhance the development of novel preventive interventions and health policies, and improve the care of children with obesity worldwide. Treating obesity early prior to the appearance of co-morbidities, may prevent its escalation into significant clinical and psychosocial problems such as type 2 diabetes. Healthcare systems should therefore be adapted, costs of treatment should be covered, and professionals should be trained.

  • 10 October - World Mental Health Day - Diabetes Burnout Webinar

    October 10 2017

    webinar WMHD

    This year's World Mental Health Day theme, which is held on 10 October, is Mental Health at Work.

    On the occasion of World Mental Health Day, to raise awareness of diabetes burnout (which can be related to work environment) among people living with diabetes, IDF Europe, and Young Advocates are holding a webinar to share information, tips, and their personal stories.

    The webinar will be hosted online at CET 19:00 - 20:00 on 10 October.

    You can sign-up for the webinar at and join the Facebook event at

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