Is the National Diabetes Strategy coming?
29.06.2020 12:04
After the political decision on an urgently needed national diabetes strategy was delayed for years, the German Diabetes Society (DDG) welcomes the fact that the deliberations in the Bundestag on July 2, 2020 are once again moving towards a possible legislative initiative. The Corona crisis in particular shows how important prevention, research and good care are in order to prevent chronic diseases such as diabetes mellitus or to minimize associated secondary diseases and infection risks. Only an overall strategy that combines concrete measures for prevention, early detection, care and research can stop the steadily increasing number of diabetes cases in Germany and reduce health risks for society as a whole, such as those caused by the corona pandemic.
With around seven million people affected, Germany has the second highest diabetes rate in Europe. Every year, over half a million people develop diabetes. It is estimated that by 2040 there will be 12 million people affected. The WHO and the International Diabetes Federation (IDF) speak of a diabetes pandemic. “This is also due to the fact that we still have no political framework plan against this widespread disease,” explains DDG President Professor Dr. med. Monika Kellerer. “While countries such as Great Britain, Finland and Austria have already decided and implemented their own national strategies, there is still no concept in Germany as to how we can contain the increasing number of illnesses and the increasingly poor care situation.” She therefore welcomes the next step towards a strategy developed by the DDG long-requested legislative initiative for a national diabetes strategy on July 2nd. “We hope that the coalition partners will now tackle the issue consistently and that we can finally implement the WHO recommendations that have been in place for years.”
At the beginning of the year, the National Diabetes Strategy was in danger of failing because those responsible in the government coalition were unable to agree on measures for mandatory sugar reduction in foods and a ban on advertising sugary foods to children. A healthy diet plays a crucial role in preventing diabetes. “We welcome the fact that the common thread that was first woven six years ago with a Federal Council resolution on the National Diabetes Plan and resulted in the 2018 coalition agreement is now being taken up again.1 The previous non-binding and voluntary individual measures are practically ineffective. We need a concept for society as a whole that ranges from prevention, research and early detection to interdisciplinary and cross-sector care concepts,” demands Barbara Bitzer, Managing Director of the DDG. It would also be negligent to delete specific packages of measures for political reasons and thereby put the health of future generations at risk.
The DDG appeals for essential interlocking core points of the framework plan that it has drawn up together with other diabetes associations to be retained.2 “A lot still needs to be done, especially in terms of care and the promotion of young talent,” emphasizes Kellerer, medical director of the Center for Internal Medicine I at the Marienhospital Stuttgart. In contrast to almost all other internal medicine specialties, the number of hospital beds specializing in “endocrinology and diabetology” has fallen dramatically in the last two decades. At the same time, the number of clinical chairs in diabetology with directive rights is falling rapidly. At the current 37 state medical faculties in Germany, the subject is only represented with eight bed-leading chairs. This development endangers the availability of young medical talent because medical students and trainees in other medical professions have too little contact with the field of “diabetes”. The expansion of digital care offerings would also have to be promoted, especially in structurally weak regions - all of this is missing in the current draft law.
Comprehensive, high-quality diabetological care can avoid complications and secondary diseases of diabetes and, for example, reduce the high numbers of diabetes-related dialysis, vascular complications and amputations in Germany and ultimately also the high diabetes-related mortality. Diabetes that is diagnosed too late and not adequately treated shortens lifespan by around six years3. “With millions of people affected, this also has an impact on the costs for society as a whole. The care of diabetes patients, including their accompanying and secondary diseases, currently costs over 21 billion euros annually,” explains Bitzer.
Literature:
1German Diabetes Society welcomes discussions by the Federal Council on the “National Diabetes Plan” initiative http://www.deutsche-diabetes-gesellschaft.de/fileadmin/Redakteur/Stellungnahmen/DDG_Stellungnahme_Bundesrat_Diabetes_Plan_01072014.pdf
2National diabetes strategy – key points of a national framework plan
3Seshasai et al. Centers for Disease Control and Prevention National Diabetes Fact Sheet 2011,N Engl J Med 2011;364:829-41; 2. http://www.diabetesincontrol.com/wp-content/uploads/PDF/ndep_diabetes_facts_2011.pdf
Motion from the Alliance 90/The Greens faction “Immediately initiate a national diabetes strategy”: https://dip21.bundestag.de/dip21/btd/19/143/1914389.pdf
Jacobs E et al. Burden of Mortality Attributable to Diagnosed Diabetes: A Nationwide Analysis Based on Claims Data From 65 Million People in Germany. Diabetes Care 2017; 40: 1703-9
WHO Resolution: Prevention and Control of Diabetes mellitus
https://apps.who.int/iris/bitstream/handle/10665/172224/WHA42_R36_eng.pdf?sequence=1&isAllowed=y
WHO: Information about diabetes: https://www.who.int/health-topics/diabetes#tab=tab_1