National Diabetes Strategy „Light“ – a missed opportunity for Germany?
06.07.2020 10:49
The German Diabetes Society (DDG) welcomes the adoption of the first National Diabetes Strategy today in the Bundestag – but unfortunately, it has only become a "light strategy." Important measures recommended by the WHO for diabetes are missing, and others exist side by side without any connection. In the areas of prevention, care, research, and the promotion of young professionals in diabetology, policymakers have fallen short of their potential.
The DDG welcomes the adoption of the National Diabetes Strategy in the Bundestag on July 3, 2020. After years of demands, important points can now be implemented politically, benefiting millions of people with diabetes and future generations. "But as was unfortunately to be expected, with this resolution, Germany will only receive a 'light' National Diabetes Strategy," lamented DDG President Professor Dr. Monika Kellerer following today's plenary session. This is because the resolution agreed upon by the Bundestag today lacks essential building blocks. "The National Diabetes Strategy can only be a first draft; now expressions of intent must be followed by action," said Kellerer.
The draft particularly neglects nutrition – a key component of diabetes prevention. "The food industry must be held more accountable here, as its products contribute significantly to healthy or unhealthy eating habits," explains DDG Managing Director Barbara Bitzer. With regard to soft drinks, for example, the diabetes strategy still only states the target of a voluntary sugar reduction of 15 percent by the end of 2025. "This target is far too low and therefore virtually ineffective in preventing new cases of diabetes," says Bitzer. Politicians still place far too much emphasis on individual behavior and ignore the enormous influence of the everyday environment and the food supply. "Germany needs a National Diabetes Strategy that includes binding measures and ambitious goals in the area of nutrition; otherwise, it is not a strategy," emphasizes Bitzer.
For years, the DDG has pointed out that mandatory sugar reductions have already been successfully implemented in other countries and that positive effects have been scientifically proven. However, in this resolution, the parliamentary groups once again adopt a passive stance toward the industry. It merely states that the demands of scientific societies and health insurance companies should be "reviewed" and that efforts must be made to expand the industry's commitment. "Such a non-binding and vague statement is worthless," Bitzer said.
A lasting improvement in cross-sectoral care and translational research is necessary, in addition to preventive measures, to halt the diabetes pandemic. This was emphasized repeatedly in today's Bundestag debate. Currently, approximately 1,000 people in Germany develop diabetes every day; estimates predict an increase from the current 7.5 million to 12 million affected by 2040. Diabetes, with its associated and subsequent diseases, statistically shortens life expectancy by at least six years. "We need political will with a concrete and binding framework to better manage care and avoid overloading the healthcare system in the future," says Professor Dr. med. Baptist Gallwitz, press spokesperson for the DDG and Deputy Medical Director of the Department of Endocrinology, Diabetology and Nephrology at the University Hospital Tübingen.
The strategy also fails to adequately consider junior medical professionals in diabetology, notes Kellerer, Medical Director of the Center for Internal Medicine I at Marienhospital Stuttgart, and warns: "If the number of clinical professorships at universities continues to decline as rapidly as in recent years, there will soon be hardly any medical specialists left who can contribute to a good care structure in Germany. This important building block was not taken into account, which makes the foundation on which the National Diabetes Strategy is based porous." Measures to improve the Disease Management Program (DMP), diabetes research, and the expansion of the telemedicine infrastructure are welcome. "The increased focus on obesity in the resolution is also an important step," adds Kellerer. The clinical picture should be more strongly included in the catalog of medical continuing education and training, interdisciplinary, multimodal, individualized care should be enabled, and the expansion of professorships in this field should be promoted.
„"There are many good approaches in the draft that need to be fleshed out in the future and, ideally, supplemented," the diabetologist concludes. She points to the pending development of a key issues paper, which will ultimately serve to further develop the Prevention Act with concrete measures. The DDG hopes for significant improvements here.