Diabetes - short update from the Commission

European Parliament Diabetes Working Group 15 July 2008

Michael HübelHead of Unit Health Determinants Directorate General for Health and Consumers

Nathalie VERCRUYSSEScientific OfficerMedical and Public Health ResearchDirectorate General for Research

Nutrition and physical activity

White Paper on nutrition and physical activity – May 2007

Better informing the consumer, such as through better labelling on food products Making the healthy option available, such as making fruits and vegetables available to schools Encouraging physical activity, such as by encouraging community initiatives or by raising awareness of Community funds to develop the physical environment to encourage walking/cycling and other forms of activityFocus on priority groups and settings, such as children and schoolsDeveloping the evidence base to support policy making, such as by carrying out research into behaviour change in relation to food and nutrition Developing monitoring systems, such as by working with the WHO to identify effective local actions

Implementing EU Nutrition and physical activity policy

Monitoring of progress Leading to report by European Commission in 2010

EU Platform Diet, Physical Activity and Health

Industry and NGO stakeholders

Nutrition and physical activity Network: Support to the High Level Group

Community/local action orientated partnershipsCommunity action involving civic leadership, businesses, local government, schools etc

EU sectoral policies E.g. Food,

Agriculture, Transport

Member State High Level Group

Each Member State to nominate a high level representative from each Member State

National Stakeholder Forums. Follow events in EU Platform, develop local partnerships

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EU, national level research to assess policy impact. Support of WHO to develop database of interventions internationally (nutrrition and physical activity surveillance)

Developing evidence base

White Paper Activities (HLG)High Level Group for Nutrition and Physical Activity to improve coordination and joint actionFocus on salt reduction initiative

Joint targetsJoint meeting with the European Platform (2 July 2008)

Develop shared commitment with stakeholders

Meeting in October with National Platforms

White Paper on Nutrition Platform Activities

183 ongoing commitments92 on lifestyles including ex. School interventions, PA commitments and work place commitments

One of those is the IDF Europe - Diabetes Prevention Forum commitment18 on labelling (nutrition labelling)20 on reformulation (incl. portion sizes)

Commitment from IDF Europe - Diabetes Prevention Forum

Short term – Establish a European wide diabetes prevention forum by March 2008Medium term – A Web site dedicated to the Forum by 2008 Commitment ongoing until 2010

Food labelling

Proposal for revised nutrition labelling Directive – December 2007

Proposed to make nutrition labelling mandatory on the majority of processed food (except for wine, spirit and beer)Consumers are interested and want to have such informationTo encourage healthier dietary choicesIncentive to the food industry to reformulate products

Mandatory nutrition information

On front of packenergyfatsaturatescarbohydratesugarsSalt (sodium expressed as salt equivalents)

Form of nutrition declarationper 100g / per 100mlon a per portion basis alone when:

prepacked as an individual portionafter harmonisation of portion size for categories of foods at the Community level

indication of the percentage of the reference intake value provided by the food (does not have to be front of pack)

Health programme:Guidelines for health professionals

Public Health Programme FundingIMAGE - Development and implementation of a European guideline and training standards for diabetes prevention Technische Universität Dresden (2006-)

Main outcomes:develop intervention standards in European practice-oriented guidelines for diabetes prevention;develop a European training programme for healthcare professionals;develop European standards for the assessment of the occurrence of type 2 diabetes and its risk factors in order to monitor/report systematically;build a European e-health training portal for prevention managers.

Health programme: Indicators

Improving indicators and registration for diabetes

• Final report of the European Core Indicators for Diabetes Mellitus project (EUCID) coordinated by the Dutch Institute for Quality in Health Care (http://www.eucid.eu/eucid/home.do)• Aim: collect and compare data about risk factors for diabetes, complications and quality of care indicators in EU countries or future Member States.• 19 countries provided data for a list of indicators by age band representative at a regional or a national level for 2004, 2005 or 2006. • The indicators for this project were designed during the EUropean Diabetes Indicators Project  - EUDIP.  Data were age-standardized for comparisons performed in the general population.

Improving indicators and registration for diabetesEuropean Core Indicators for Diabetes Mellitus project (EUCID)

Conclusions:

• While European epidemiologic systems can provide the majority of diabetes indicators, some major indicators such as blindness are still missing. • Most of the European countries make progress on testing of people with diabetes. • Risk factors and outcomes vary across countries, reflecting a mixture of genetic background, societal and cultural factors, as well as public health approaches  •List of indicators defined

Improving indicators and registration for diabetes The European Health Examination Survey (EHES)

• Health examination survey (HES) is a population based survey were the measurements go beyond the questionnaire based data (interview or self-administration), such as blood pressure, blood samples, test of functional capacity etc. •Phase I: Call for Tender for a European Reference Center for the EHES (July 2008)Pilot survey in 11 Member States. Planning and preparing for a national HES in 11 countries in 2008-2010

• Phase II: Joint Action for the Pilot European Health Examination Survey (First Quarter 2009)Implementing the Pilot survey in Member States during 2008-2010

•Phase III: Full-scale HES In the 27 Member States and Norway is scheduled for 2010-2012 with funding from the FP7 Programme.

Improving indicators and registration for diabetesSummary

• Efforts will be done to create a sustainable data collection on diabetes indicators on the basis of the list of indicators defined by EUCID, incorporating the data from the future EHES (European Health Examination Survey) when available.

•Improving the capacity and interoperability of the scarce number of regional diabetes registers using the EUBIROD Project (2008+)

Research

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FP7 Cooperation Programme € 32.4 billion (2007-2013)

Socio-economic sciences and the

humanities2%

Security4%Space

4%

Health19%

Food, agriculture, biotechnology

6%Transport13%

Nanosciences, nanotechnologies,

materials, production

technologies11%

Environment6%

Energy7%

ICT - Information and

Communication Technologies

28%

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ResearchHealthhttp://cordis.europa.eu/fp7/health/abouthealth_en.html

Third call will be published early September

ICT (and health)http://cordis.europa.eu/fp7/ict/

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Topics from first calls in diabetes/obesityin Translating research for health

5 topics in Call 1(2007) : ~ 21 m. €4 Topics in Call 2 (2007): ~ 19.5 m. €:

- Nutritional signals & development of new diabetes/obesity therapeutic agents (2 projects)

- Markers & treatment for diabetic neuropathy complications

- Geno- & phenotypical differentiation of type 2 subjects + monogenic subjects

- Use of beta cell imaging in diabetes mellitus

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EU current eHealth Agenda R&D – FP7current Workprogramme

Personalisation of Healthcare

Risk assessment and improving patient safety

€ 30 Million Call 1 May 07

Predictive Medicine – Virtual Human

Modelling/simulation of diseases

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Diamap Road map for Diabetes research in Europe www.DIAMAP.eu

Objectives : Survey of research activities and funding for diabetes research, both public and private, at regional, national and European levelIdentification of gaps, strengths and weaknesses, and opportunities

Coordinating Organisation: EURADIA

Apr. 2008- 2010

FP7 200701A Road Map for Diabetes Research in Europe