Brussels, 23 Nov 2004
Experts and policymakers have called for a coordinated European approach to the prevention and treatment of diabetes, as well as an increased scientific effort. The calls came during a conference, organised by the Commission's Research DG, to look into the research challenges presented by the disease.
There are two different types of diabetes: type 1 and type 2. Type 2 diabetes is the more common form, with around 38 million Europeans believed to be suffering from the disease, a figure that is expected to rise to 44 million by 2025, according to Marja-Riitta Taskinen from the University of Helsinki in Finland.
'In the past, type 2 diabetes was commonly considered as a mild disease associated with the ageing and elderly. This tenet has turned out to be a complete misconception. Type 2 diabetes is one of the major contemporary causes of premature disability and death due to the excess rate of cardiovascular disease (CVD). In fact, nearly 80 per cent of people with diabetes die of CVD,' Professor Taskinen added.
In Western countries, she explained, around 90 per cent of type 2 diabetes is attributable to weight gain, and the increasingly high proportion of overweight people in the general population is the driving force behind the 'dramatic explosion' of the disease witnessed in recent years. Professor Taskinen blames people's high intake of energy dense foods combined with an increasingly sedentary lifestyle. 'Consequently the principle forces and processes underlying the obesogenic environment should be recognised and be the target for action at the European Commission level. The challenge is to fight obesity to prevent diabetes,' she concluded.
Despite the higher prevalence of this form of the disease, type 1 diabetes is of particular significance in Europe, as Jaakko Tuomilehto from the Finnish National Public Health Institute explained: 'Overall, its incidence is higher in European populations than in other ethnic groups, and the highest rates are found in Finland and Sardinia.'
Gyula Soltész from the University of Pécs in Hungary adds: 'Type 1 diabetes is by far the dominant form of diabetes in the young. [...] The incidence in Northern Europe is the highest in the world [and this] incidence is increasing, particularly in the youngest age group - 0 to 4 years.' The fact that this increase in incidence has occurred over a relatively short space of time, says Professor Soltész, suggests that environmental rather than genetic changes are most likely to blame.
'Several environmental risk factors have been identified which increase the risk of type 1 diabetes. Some of them - e.g. increased birth weight and increased childhood growth - are wealth-related factors. Others include older maternal age, early introduction of cows' milk proteins and cereals into the baby's diet and stressful life events,' Professor Soltész added.
But he concluded: 'In spite of the identification of several genetic and environmental risk factors, the disease mechanism which results in type 1 diabetes is largely unknown. This emphasises the urgent need for further European research effort into the cause of this major, truly European disease.'
Dr Tuomilehto highlighted a major research challenge resulting from the dramatic effect that modern lifestyles have had on the prevalence of both forms of diabetes. 'The trends in obesity and physical inactivity have been such that the data from decades ago cannot be properly used to predict or extrapolate their effects on more recent generations. We need the data as fresh as possible and for all European countries,' he argued.
At the political level, Zsuzsanna Jakab, Secretary of State in Hungary's Ministry of Health, said that health policies all around the world must be designed to prevent and manage diabetes. 'In order to be able to achieve this we must raise public awareness and the awareness of politicians, policymakers, and key stakeholders to make this issue a priority in public health and research.'
Ms Jakab continued: 'Diabetes should appear as a priority in national public health programmes: national diabetes action plans should be based on the results of the 2004 EU workshop entitled 'Towards a European framework for diabetes prevention and care'. To conclude, this workshop urges a coordinated approach in Europe to try and influence national governments to develop national action plans and to apply standards in diabetes care and prevention.
'The role of the EU can indeed be essential in funding and directing research, in including this issue as a priority in the public health strategy framework and in improving access and equity in diabetes prevention and care,' Ms Jakab concluded.