Abstract
Background
There is an alerting increase in the population affected by type 2 diabetes mellitus (T2DM) in the European Union (EU) with significant socioeconomic burden. According to an estimation by the International Diabetes Federation, by 2030, the total number of diabetic patients will be 38 million in EU. The “screen and treat” strategies that predominantly applied in policies to prevent T2DM have not achieved significant success, as reported by a large systematic review and meta-analysis published in 2017. Although the member states of the EU have almost full responsibilities for actions in the field of health, the EU has to tackle non-communicable diseases by targeting health determinants and lifestyle mostly through non-binding policies. The goal of this work is to review the T2DM prevention policies in the EU and compare with tobacco policies, from a legal perspective.
Methods
Following the systematic search and screening of policies from EUR-lex, a content analysis was carried out by using MonQcle as publicly available legal text document analysis platform, by two coders. The search was limited for regulations, directives and white papers.
Results
Our data collection consisted of 19 documents including 10 regulations, 6 directives and 3 white papers with relevance to T2DM, covering the following topics: health infrastructure and services, informational policies, economic policies, environmental policies, command and control and social policies. The identified policies covered the time frame of 1972 to 2020. Diabetes was targeted as part of non-communicable diseases. None of the policies was legally binding addressing T2DM directly which is in sharp contrast to the tobacco control policies in the EU.
Conclusions
T2DM, in fact, is largely preventable. EU institutions should consider to reframe T2DM prevention strategies and consider applying a wide range of population-level legislative and innovative actions to prevent T2DM e.g. taxes on unhealthy food products.
Key messages
T2DM is a largely preventable disease, effective legal tools should be created and applied matching the scale of such public health problem. T2DM policies of the EU may be subject to change due to additional value of actions taken by the EU compared to that could have been achieved by member states alone.
General Practitioners’ Autonomy in the Management of Non-Communicable Diseases (NCDs) in the JKN Era: Is It Feasible?
