Act now to support people with diabetes in humanitarian settings
The International Diabetes Federation (IDF) estimates that four million people living with diabetes are displaced as a result of man-made and natural disasters.
People with diabetes need uninterrupted access to medicines and care. They need healthy food and a safe space to exercise. Managing diabetes is not always easy. It can cause unnecessary suffering for individuals and their families and place a significant burden on healthcare resources.
Caring for diabetes becomes even more difficult when disaster strikes and people are forced to flee. In these difficult circumstances, people with diabetes often struggle to manage their condition and are at increased risk of life-threatening complications. Undiagnosed and poorly controlled diabetes can lead to acute and life-threatening complications such as blindness, amputation, kidney failure, cardiovascular events and early death.
The arrival of refugees into unprepared locations also puts severe pressure on healthcare resources and poses a significant challenge. Health systems struggle to respond to the emergency and provide healthcare for the new arrivals and their existing population. Forcibly displaced people with diabetes may not be able to gain access to the medicines and supplies they need and emergency healthcare personnel are not always trained to deal with the condition. This situation is compounded by disruption to food, water and utilities.
On World Refugee Day 2018 – June 20 - I pledge to support the rights of refugees to the enjoyment of the highest attainable standard of physical and mental health by:
1. Raising awareness of the challenges faced by refugees in the prevention, management and care of diabetes and diabetes complications 2. Providing their governments with advice and direction in developing national plans to respond to the health needs of refugees 3. Contributing to the strengthening of national health systems through the provision of expert advice diabetes management and education
Afghanistan Diabetes Association Arabic Association for the Study of Diabetes & Metabolism (AASD) Asociación Costarricense Lucha contra la Diabetes (Costa Rica) Asociación Panameña de Diabeticos (APADI - Panama) Association Belge du Diabète (ABD - Belgium) Association Vaincre le Diabète au Congo (Democratic Republic of Congo) Austrian Diabetes Association Belarusian Humanitarian Non-Governmental organization « Children’s Diabetes» British Virgin Islands Diabetes Association Cyprus Assocation for People with Diabetes Diabetes Association of Barbados Diabetes association of Serbia Diabetes Association of Trinidad and Tobago Diabetes Liga vzw (Belgium) Diabetes Palestine diabetesDE - German Diabetes Aid Egyptian Diabetes Association Federación Mexicana de Diabetes, A.C. (Mexico) Georgian union of diabetes and endocrine associations Hellenic Diabetes Federation Instituto Nacional De La Diabetes (Dominican Republic) Kuwait Diabetes Society Lebanese Diabetes Association Ligue Marocaine de Lutte contre le Diabète Macedonian Diabetes Association Myanmar Diabetes Association National Diabetes Organization - DiaLeb (Lebanon) NORD University Norwegian Diabetes Association Saudi Diabetes & Endocrine Association Serbian Association for the Study of Diabetes Setif Diabetes Association Sociedad Dominicana de Diabetes (Dominican Republic) Sociedad Española de Diabetes (Spain) Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA) United Nations Relief and Works Agency for Palestine refugees (UNRWA) Upper Egypt Diabetes Association
It gives me great pleasure to invite you to the International Diabetes Federation (IDF) World Congress 2019 in Busan, Korea.
IDF 2019 marks a welcome return to the IDF Western Pacific region following the successful IDF Congress 2013 in Melbourne, Australia. The region has the largest population of all IDF regions and is home to close to 40% of all people living with diabetes. China alone accounts for the highest number of people with diabetes in the world (114 million). A cause of particular concern in the region is the large undiagnosed population, with over one in two people with diabetes in the Western Pacific undiagnosed.
With these facts in mind and the number of people with diabetes and at high risk in the region expected to exceed 340 million within the next twenty years, Korea is the ideal location to bring together the extensive global network of physicians, scientists, nurses, educators, other healthcare professionals, government officials, policy makers, diabetes associations and media that IDF represents.
IDF 2019 in Busan will provide a unique forum for knowledge exchange and sharing of best practice in diabetes prevention, education and treatment. The outcomes of the Congress will help foster the collaborations, connections and political actions required to place diabetes on top of the global health agenda and improve the lives of people living with diabetes, help protect those at risk and reduce the impact of diabetes on our societies.
I look forward to welcoming you in Busan to shape the future of diabetes through our strong and united global voice.
Professor Nam H. Cho President, International Diabetes Federation
Welcome to Busan
On behalf of the Organising and Programme Committees, we are delighted to welcome you to the IDF World Congress 2019 in Busan, Korea.
The IDF biennial congress is the most significant global diabetes event and one of the largest medical congresses. Through its innovative, diverse and engaging scientific programme, satellite symposia, exhibition and Global Village, the IDF Congress convenes and mobilises the international diabetes community, helping to shape the future of diabetes care, prevention and treatment.
Busan is Korea's second most populous city and the economic and the cultural and educational centre of southeastern Korea. It will host a scientific programme comprised of eight streams that will build on the learnings and experiences of previous IDF Congresses and continue to explore new areas in diabetes research, education and public health. Key objectives include improving the understanding of the global diabetes pandemic and influencing the implementation of healthcare initiatives to improve the lives of people of diabetes and those at risk. A dedicated stream on living with diabetes will again give prominence to the role of people affected by diabetes in healthcare decision-making and design.
The BEXCO Busan Exhibition and Convention Centre (BEXCO) provides the ideal venue for IDF 2019, featuring a beautiful auditorium, an adjacent modern convention hall and a spacious exhibition centre equipped to showcase the latest advances in diabetes care and technology. The various session types – from abstract-driven presentations to symposia, meet the expert and workshops – combined with satellite meetings and affiliated events will provide IDF’s diverse and international audience with an exceptional opportunity for professional development and networking. We look forward to welcoming you to Busan for an inspiring and memorable IDF World Congress.
This stream deals with general aspects of common and rarer diabetic complications, the latest research into these complications and up-to-date prevention politics and treatments.
After attending a session in the Diabetes Complications stream the participant will be able to:
Understand the epidemiology, physiopathology, diagnosis, prevention and treatment of the complication developed in the session
Decide how to individualise the diagnostic, prevention and treatment tools in the setting where he/she operates as healthcare practitioner
Define the appropriate moment to refer the patient to a level of greater complexity
This stream deals with general aspects of the diabetic foot as well as the epidemiology and public health challenges presented by the condition. It also focuses on education and care needed for management and prevention of diabetic foot.
After attending a session in the Diabetic Foot stream the participant will be able to:
• Identify the importance of prevention of diabetic foot and to be able to detect the risk factors for it
• Understand the latest innovations in diabetic foot treatment
• Better understand the impact of diabetic foot problems on patients, their families and on the health system
• Use available resources to improve the outcome of patients with diabetic foot
• Correctly plan the establishment of diabetic foot centres
Foot - Peripheral Arterial Disease
Peripheral Arterial Disease (PAD) is frequent in people with diabetes being one of the strongest predictors of non-healing foot ulcers and amputations and an independent factor for increased mortality due to associated cardiovascular and cerebrovascular diseases. PAD in diabetes is largely asymptomatic until an advanced stage. It is usually present at an earlier age and progresses more rapidly and extensively than in non–diabetic patients. There is strong evidence to show that early detection of PAD with interventions targeted on risk factor modification and revascularisation will reduce the rates of disease progression and amputations. In real life, many patients still have no vascular assessment even when having a foot ulcer or before amputation. The prevention and management of neuroischaemic ulcers is overlooked and underused in high-risk patients. To change this paradigm, healthcare services for people with PAD should include multidisciplinary trained teams with clear definitions of tools and objectives to be attained including the use of specific educational programmes.
After attending sessions in the Foot - Peripheral Arterial Disease stream, participants will be able to:
• Know and discuss epidemiology of foot ulceration and diabetic peripheral arterial disease
• Know the pathophysiology of arterial disease in diabetic foot (mechanisms, specificities, and risk factors)
• Know how to screen patients with diabetic foot for PAD and be able to make clinical diagnoses
• Know the treatment of PAD- lifestyle and risk factor. modifications, drug therapy and vascular interventions
• Make the correct decision and timely referral for a specialist
• Understand and recognize the importance of new technics and technology in diagnosis and treatments for PAD
• Discuss different health care organization models for the best care in PAD
Foot - Ulcers and Infection
The scientific session on “foot ulcer and infections” will teach current concepts on how to recognize, evaluate and manage patients with diabetes related foot and ankle conditions, complicated by peripheral neuropathy, vascular diseases, foot ulcers and infection. Medical and surgical treatments as well as an overall review of diabetes will enhance the attendees’ knowledge to improve care in their practice.
After attending sessions in the Foot - Ulcers and Infection stream, participants will be able to:
• Learn and review the basic science of wound healing, the advances in technologies apply to the process of healing, and some of their challenges.
• Learn about how the foot function affects the risk of developing a foot ulcer, and how to offload the foot to heal difficult wounds.
• Learn advances in the treatment of diabetic foot soft tissue infections and osteomyelitis, specifically controversies in diagnosis, medical, and surgical management.
• Learn about evidence-based assessment and medical treatment of vascular diseases related to diabetes and to the foot and ankle. The audience will also learn to recognise podiatric issues related to vascular problems to better manage the patients in a timely manner.
Foot - Peripheral Diabetic Neuropathy and Charcot
The diabetes pandemic is forcing a necessary and much needed mandatory preventative approach to diabetic neuropathy on a global level. We are urging all healthcare practitioners to fully understand the pathway of destruction of the diabetic foot and alternatively the much more favoured pathway to prevention in managing the diabetic foot. Only with full understanding of neuropathy and its role in the formation of ulcers, amputations and the Charcot foot are we able to prevent foot complications. An urgency to intervene in the “Window of Presentation” (risk category 1 and 2 before progression to 3) will be reviewed with participants. Research on the treatments for painful and painless neuropathy will be reviewed. The focus of will be on real life treatment protocols, as well as management in developing countries, as the burden of diabetes are in these countries. Through education and fully understanding the IDF Diabetic Foot Stream Guidelines we can decrease the morbidity of foot complications globally and keep diabetic patients active, walking and mobile.
After attending sessions in the Foot - Peripheral Diabetic Neuropathy and Charcot stream, participants will be able to:
• Fully understand the IDF Diabetic Foot Stream Guidelines
• Fully understand current screening techniques and diagnosis for Diabetic Neuropathy
• Fully understand early intervention in assessing, risk categorising and treating neuropathy
• Recognise the urgency to intervene in the “Window of Presentation”
• Understand how intervention and protection of the neuropathic foot in developing countries is done; this is the burden of the newly diagnosed cases
• Understand current medical and non-medical treatment of painless and painful diabetic neuropathy
• Fully understand how to intervene to prevent the destruction of the neuropathic foot from progressing into the Charcot foot
• Be able to manage the Charcot foot
• When to refer to the multidisciplinary foot clinic
Cardiovascular Risk Factors
Diabetes mellitus is a major health problem globally as a consequence of the aging of the population, unhealthy lifestyle and the resultant epidemic of obesity. Cardiovascular disease is the leading cause of morbidity and mortality in people with diabetes and is the largest contributor to health care costs for diabetes. A number of cardiovascular risk factors co-exist in people with diabetes including hypertension, hyperlipidaemia, insulin resistance and obesity. There is good evidence that management of risk factors such as blood pressure, dyslipidaemia and glucose can lead to improved microvascular and macrovascular complications in individuals with type 2 diabetes mellitus and also legacy benefits of multifactorial risk factor control. In addition, lifestyle factors such as nutrition and physical activity also influence cardiometabolic risk factors. International guidelines therefore consider people with diabetes and cardiovascular risk factors and microvascular disease as having high cardiovascular risk and recommend regular assessment and management of cardiovascular risk factors in these populations.
After attending sessions in the Cardiovascular Risk Factors stream, participants will be able to:
• Understand the epidemiology of risk factors associated with cardiovascular outcomes in people with diabetes
• Understand the evidence for multifactorial risk factor management in people with diabetes
• Discuss the evidence base for lifestyle interventions in people with diabetes
• Understand individualisation of risk factors targets for people with diabetes
• Will be able to manage risk factor using evidence based therapies in people with diabetes
• Recognise the importance of novel risk factors such as hypoglycaemia and albuminuria for cardiovascular complications in people with diabetes
• Understand the epidemiology of gestational diabetes and vascular aging in relation to cardiovascular complications
• Discuss different health care organization models for the best care in PAD
Coronary Heart Disease and Heart Failure
Cardio-renal disease has emerged as a central target in patients with diabetes. This has now extended to all vascular areas within the insulin resistant patient. Translational information on the disease process starts in some cases with parents and then extends to their offspring. Individuals with insulin resistance or diabetes in combination with one or more of these risk factors (obesity, HT, lipids, poor lifestyle) are at even greater risk of heart disease or stroke. However, by managing their risk factors, patients with diabetes may avoid or delay the development of heart and blood vessel disease. In this section, we will focus on clinical cardio-renal disease in relation to insulin resistance in high-risk patients.
After attending sessions in the Coronary Heart Disease and Heart Failure stream, participants will be able to:
• Understand of the translational science that relates to guidelines in clinical practice for diabetes patients.
• Understand global impact of insulin resistance in the development of cardiovascular disease
• Know of the impact of diabetes on the myocardium
• Know of the mechanism involved in the development of vascular disease
• Have new insights into the treatment of normal and reduced ejection fractions in patients with diabetes
• Have new insights into the beneficial effects on the CV system with new cardio-renal agents that reduce glucose
• Review the current standards of care in the treatment of global risk factors
• Understand the future consideration in vascular and renal protection in diabetes patients
Diabetes and Kidney Disease
The scientific sessions in the Diabetes and Kidney Disease stream will offer researchers and health care professionals the unique opportunity to review recent advances in diabetic kidney disease, hot topics and controversies with emphasis on sharing ideas and knowledge.
After attending sessions in the Diabetes and Kidney Disease stream, participants will be able to:
• Understand the epidemiology, pathophysiology, genetic, diagnosis, prevention and treatment of the kidney complications developed in the session
• Decide how to individualise the diagnostic, prevention and treatment tools in the setting where they operate as healthcare practitioner
• Define the appropriate moment to refer the patient to a level of greater complexity
• Identify recent advances in the diagnosis and management
Diabetic Eye Disease
The increasing global prevalence of diabetes has led to a corresponding epidemic of diabetic eye disease. Screening and timely intervention in the presence of sight threatening diabetic eye disease can prevent visual loss, however, diabetic retinopathy remains the leading cause of visual loss in many countries. A holistic approach is mandatory as diabetic eye disease is an end organ response to a systemic disease – diabetes. Awareness, metabolic control and control of other risk factors are the mainstay in this respect. Besides further research on the pathophysiology, and primary and secondary prevention of diabetic eye disease, we need to focus on translating the evidence available to prevent visual loss, into public health action which will impact the lives of people with diabetes. This will be facilitated by the development and proper implementation of new/existing nation-wide/region-wide/global initiatives. Only in this way can we decrease the global morbidity cause by diabetic eye disease.
After attending sessions in the Diabetic Eye Disease stream, participants will be able to:
• Review current diagnosis of diabetic eye disease and current screening recommendations and future developments
• Review current treatment strategies for diabetic eye disease and future developments
• Recognise the importance of holistic approach to the diabetic eye disease
• Recognise the importance of translation of evidence base into the real life to reduce the burden of diabetic eye disease
The theme for World Diabetes Day 2018 and 2019 is The Family and Diabetes.
A two-year timeframe has been chosen to best align the World Diabetes Day campaign to the current IDF strategic plan and facilitate planning, development, promotion and participation. Materials and actions that IDF will develop over the two years of the campaign will aim to:
Raise awareness of the impact that diabetes has on the family and support network of those affected.
Promote the role of the family in the management, care, prevention and education of diabetes.
Diabetes concerns every family
Over 425 million people are currently living with diabetes. Most of these cases are type 2 diabetes, which is largely preventable through regular physical activity, a healthy and balanced diet, and the promotion of healthy living environments. Families have a key role to play in addressing the modifiable risk factors for type 2 diabetes and must be provided with the education, resources and environments to live a healthy lifestyle.
1 in 2 people currently living with diabetes is undiagnosed. Most cases are type 2 diabetes. Early diagnosis and treatment are key to prevent the complications of diabetes and achieve healthy outcomes. All families are potentially affected by diabetes and so awareness of the signs, symptoms and risk factors for all types of diabetes are vital to help detect it early.
Diabetes can be expensive for the individual and family. In many countries, the cost of insulin injection and daily monitoring alone can consume half of a family’s average disposable income, and regular and affordable access to essential diabetes medicines are out of reach for too many. Improving access to affordable diabetes medicines and care is therefore urgent to avoid increased costs for the individual and family, which impact on health outcomes.
Less than 1 in 4 family members have access to diabetes education programmes. Family support in diabetes care has been shown to have a substantial effect in improving health outcomes for people with diabetes. It is therefore important that ongoing diabetes self-management education and support be accessible to all people with diabetes and their families to reduce the emotional impact of the disease that can result in a negative quality of life.
Campaign messages, materials and promotional actions for World Diabetes Day 2018-19 will be made available soon to help the diabetes and wider community prepare for awareness activities throughout the month of November.