Council conclusions on promotion of healthy lifestyles and prevention of Type 2 diabetes
Date: 2006-06-23
Institutions: Council of the European Union
Subjects: diabetes, disease prevention, health policy, living conditions, quality of life

23.6.2006

EN

Official Journal of the European Union

C 147/1

I

(Information)

COUNCIL

Council conclusions on promotion of healthy lifestyles and prevention of Type 2 diabetes

(2006/C 147/01)

THE COUNCIL OF THE EUROPEAN UNION

— On 2 December 2003, the Council adopted Conclu-

1. NOTES that the citizens of the European Union attach
great importance to the highest possible levels of human
health and consider it to be an essential prerequisite to a
high quality of life;

2. NOTES further that EU action needs to address major
causes of death and premature death and major causes of
reduced quality of life for the citizens of the European
Union.

3. RECALLS THAT:

— Article 152 of the EC Treaty provides that Community
action is to complement national policies and be
directed towards improving public health, preventing
human illness and diseases, and obviating sources of
danger to human health. Community action in the
field of public health shall respect the responsibilities
of the Member States for the organisation and delivery
of health services and medical care;

— On 29 June 2000, the Council adopted a Resolution

on action on health determinants (1);

— On 14 December 2000, the Council adopted a Resolu-

tion on Health and Nutrition (2);

sions on Healthy Lifestyles (4).

4. RECALLS ALSO THAT:

— On 2 June 2004, the Council took note of information
from the Irish Presidency on the potential for a Euro-
pean strategy for diabetes (5);

— On 15 March 2005,

the European Commission
launched the EU Platform on Diet, Physical Activity
and Health;

— On 8 December 2005,

the European Commission
adopted a Green Paper on Promoting healthy diets and
physical activity: a European dimension for the preven-
tion of overweight, obesity and chronic diseases, which
addresses the determinants underlying the onset of
Type 2 diabetes;

— On 3 April 2006, the European Parliament adopted a

Written Declaration on diabetes (6).

5. NOTES the conclusions of the Austrian Presidency Confer-
ence ‘Prevention of Type 2 Diabetes’ held on 15-16
February 2006 in Vienna, Austria, with the participation
of experts from Member States, acceding States and candi-
date countries, including health professionals and represen-
tatives of diabetes associations and patient groups, that are
reflected in the Annex.

— On 2 December 2002, the Council adopted Conclu-

sions on Obesity (3);

6. EMPHASISES that diabetes is one of the major causes of
death and premature death as well as of reduced quality of
life for the citizens of the European Union.

(1) OJ C 218 of 31.7.2000, p 8.
(2) OJ C 20 of 23.1.2001, p. 1.
(3) OJ C 11 of 17.1.2003, p. 3.

(4) OJ C 22 of 27.1.2004, p. 1.
(5) Doc. 9808/04740153
(6) Written declaration 1/2006

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7. STATES that health determinants have an impact on
diabetes and that, apart from family history and increasing
age, the main risk factors of Type 2 diabetes are excess
body weight, a sedentary lifestyle, tobacco use and/or high
blood pressure, which can be influenced by taking action
in respect of the underlying factors. Other contributory
factors include gestational diabetes (diabetes during preg-
nancy),
impaired glucose tolerance or impaired fasting
glycaemia.

8. RECOGNISES that Type 2 diabetes and its complications
are
ocular
(cardiovascular,
frequently diagnosed too late and the complications are
frequently detected only at the time of diagnosis.

foot-related)

renal,

and

16. RECOGNISES that, in order to address and reduce suffering
from diabetes, a long-term approach incorporating actions
aimed at the healthy population as well as at individuals at
high risk or living with diabetes is necessary.

17. ACKNOWLEDGES that health promotion requires an inte-
grated approach and needs to be comprehensive, trans-
parent, multi-sectoral, multidisciplinary, participatory and
based on the best available research and evidence. In par-
ticular,
to target people
throughout the life cycle, especially those who are most at
risk of diabetes, taking account of social, cultural, gender-
related and age differences. Efforts should be made to
address appropriate evaluation, including monitoring and
surveillance of actions and programmes.

disease prevention needs

9. STATES that preventive measures, early detection and diag-
nosis and effective management of the disease can result in
reduced mortality from diabetes and increasing life expec-
tancy and quality of life of European populations.

18. WELCOMES that the Commission has set up the Platform

for Action on Diet, Physical Activity and Health.

10. IS CONCERNED by the negative consequences for health,
and the incidence of diabetes in particular, of the increase
in overweight and obesity among the population of all
ages in the European Union, especially among children
and young people. The impact of Type 2 diabetes on
women in their early reproductive years is of particular
concern.

11. STATES that urgent targeted action on diabetes and the
underlying health determinants is needed to address the
growing incidence and prevalence of disease as well as the
rise in the direct and indirect costs thereof.

12. RECOGNISES that it is possible to prevent or delay the
onset of Type 2 diabetes and to reduce associated compli-
cations by addressing the underlying health determinants,
particularly poor diet and physical inactivity, even in early
childhood.

13. RECOGNISES that preventing diabetes has a direct positive
benefit on other non-communicable diseases, e.g. cardio-
vascular diseases, which are also major health risks for the
citizens of the European Union, and on burdens for health
systems and economies.

19. ACKNOWLEDGES the important role that civil society can

play in preventing diabetes and its consequences.

20. INVITES the Member States to consider, within the context
of the adoption or review of national public health strate-
gies and their efforts to focus on health determinants and
promotion of healthy lifestyles, and with regard to avail-
able resources:

— Collection, registration, monitoring and reporting at
national
level of comprehensive diabetes epidemiolo-
gical and economic data as well as data on the under-
lying factors;

— Development and implementation of framework plans,
as appropriate, addressing diabetes and/or its determi-
nants, of evidence-based disease prevention, screening
and management
founded on best practices and
comprising an evaluation system with measurable
targets to track health outcomes and cost-effectiveness,
taking into account Member States' organisation and
delivery of
respective health services, ethical,
legal, cultural and other relevant issues and available
resources;

their

14. ACKNOWLEDGES the need for diabetes monitoring and
surveillance,
information on
including the exchange of
diabetes mortality, morbidity and risk factor data, and for
a greater understanding of lifestyles, knowledge, attitudes
and behaviours in populations across the EU.

— Development of evidence-based, sustainable and cost-
effective public awareness and primary prevention
measures that are accessible and affordable to meet the
needs of those most at risk of developing diabetes as
well as the population as a whole;

15. ACKNOWLEDGES that further research in Europe on the
health determinants for combating the risk factors for
diabetes could make a positive contribution to addressing
the disease in the future.

— Development of affordable and accessible secondary
prevention measures based on national evidence-based
guidelines and aimed at detecting and preventing the
development of diabetes complications;

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— Adoption of a holistic, multi-sectoral, multidisciplinary
approach to people with diabetes
management
including
involving
an emphasis on prevention,
primary, secondary and community care, social services
and education services;

— Further

development

of

comprehensive

diabetes

training for healthcare professionals.

21. INVITES the European Commission to support, as appro-
priate, Member States in their efforts to prevent diabetes,
and to promote a healthy lifestyle by:

— Identifying diabetes as a public health challenge in
Europe and encouraging networking and the exchange
of information between Member States with a view to
promoting best practices, to enhancing the co-ordina-
tion of health promotion and prevention policies and
programmes for the whole population and high-risk
groups and to reducing inequalities and optimising
healthcare resources;

— Facilitating and supporting European diabetes research
in basic and clinical science and ensuring the wide
dissemination of
this research across
Europe;

the results of

— Examining and strengthening the comparability of
diabetes epidemiological evidence by considering the
establishment of standardised outputs for monitoring,

surveillance
morbidity and risk factor data across Member States;

and reporting of diabetes mortality,

— Reporting on Member States' actions in order

to
emphasise health determinants, promote healthy life-
styles, national diabetes plans and prevention measures,
information provided by Member
on the basis of
States, assessing the extent
to which the proposed
measures are working effectively, and considering the
need for further action;

— Continuing the work on the development of a compre-
hensive approach to health determinants at European
including a coherent and comprehensive nutri-
level,
tion and physical activity policy, and addressing the
impact on public health of the promotion, marketing
and presentation, in particular to children, of energy
dense foods and sugar-sweetened drinks;

— Building on the work of the EU Platform for Action on
Diet, Physical Activity and Health and encouraging the
development and implementation of national diabetes
prevention programmes and measures;

— Taking the health determinants and risk factors of

diabetes into account across EU policies.

22. INVITES the Commission to continue to cooperate with
the relevant international and inter-governmental organisa-
tions, in particular the World Health Organisation and the
OECD, to ensure effective coordination of activities.

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Official Journal of the European Union

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ANNEX

Summary of the conclusions of the Austrian Presidency conference ‘Prevention of Type 2 diabetes’ held on 15-
16 February 2006 in Vienna, Austria

Each of the working groups agreed on a set of recommendations described in this chapter. There are various overlaps
between the results of the groups which have not been removed as they underline the importance of specific recommen-
dations. In our concluding remarks we would like to highlight some aspects again as they do not only refer to a specific
topic, but have a wider scope:

1. It is important to differentiate between different types of prevention of diabetes and its complications according to

the target groups and the objectives of the intervention:

— Prevention of Type 2 diabetes at general population level, focusing on the promotion of healthy lifestyles and

on the creation of environments that make healthy choices easy and socially preferred;

— Identification of individuals at high risk of developing Type 2 diabetes and implementation of evidence-based

measures in order to prevent or delay the onset of diabetes;

— Early detection of as yet undiagnosed Type 2 diabetes in order to ensure timely, professional care and self-care

to control and to reduce/prevent complications;

— Provision of comprehensive, high quality, multidisciplinary, multifactorial and multisectoral diabetes care
programmes in order to reduce/prevent complications in persons with diagnosed Type 2 diabetes and ensure
good quality of life, equal opportunities and access to care for people with diabetes. With regard to reducing
diabetes morbidity and mortality these aspects are equally important and need to be addressed simultaneously
and systematically.

2. Socio-economically disadvantaged groups, persons with lower education and minority groups, including women in
their reproductive years, need particular attention, acknowledging the fact that they are more often affected by Type
2 diabetes and with regard to bridging inequalities in health.

3. The combined impact of diabetes and its complications on the individual patient, health services and the economy
needs to be recognised and addressed. The EU and the member states need to raise public and professional aware-
ness of the negative effects of Type 2 diabetes. Targeted and systematic awareness programmes need to be devel-
oped.

4. There is a need for an EU strategy including an EU Council Recommendation on diabetes prevention, early detection
and management and a permanent EU forum for the exchange and dissemination of best practice by networking.

5. In order to have a sound basis for policy planning and evaluation, the occurrence of Type 2 diabetes and its risk
factors as well as the immediate and long term outcomes of improved programmes of care need to be systematically
monitored and reported both in the member states and at EU level using a valid methodology and comparative
data.

6. Standards of prevention and care need to be developed at EU level to be reflected by national guidelines. Patient

care needs to be monitored according to these guidelines.

7. The timely implementation of the national diabetes plans should be a priority. These plans should include preven-
tion and early detection programmes. Special focus should be given to lifestyle interventions since they have shown
to be effective and, if broadly implemented, can have a health impact on future generations.

8. There is a need to develop new techniques for client centred education and empowerment as well as for appropriate
training of health care professionals. The effectiveness of educational programmes should be subjected to research.

9. Effective diabetes prevention requires multidisciplinary cooperation. The collaboration between general practitioners,
diabetologists, diabetes specialist nurses, nutrition experts, exercise experts and other health care providers needs to
be improved.

10. There is also a need for multisectoral cooperation as the creation of healthy environments requires action in
different policy fields. Both at national and at EU level, relevant policies outside the health sector should be systema-
tically assessed for their health consequences, with a particular view to their consequences for preventive efforts.

11. Additional research on diabetes is required both in the member states and at EU level. The EU and the member
states should facilitate and support research in basic, clinical and social sciences and humanities on all aspects of
prevention of diabetes and its complications with increased funding. The results of EU funded research should be
made easily accessible to the public, relevant health professionals and the national authorities of the member states.