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St Vincent Declaration

Diabetes mellitus in Europe: A problem at all ages in all countries

"Representatives of Government Health Departments and patients organisations from all European countries met with diabetes experts under the aegis of the Regional Offices of the World Health Organisation and the International Diabetes Federation in St.Vincent, Italy on October 10-12, 1989. They unanimously agreed upon the following recommendations and urged that they should be presented in all countries throughout Europe for implementation.

Diabetes mellitus is a major and growing European health problem, a problem at all ages and in all countries. It causes prolonged ill-health and early death. It threatens at least ten million European citizens.

It is within the power of national Governments and Health Departments to create conditions in which a major reduction in this heavy burden of disease and death can be achieved. Countries should give formal recognition to the diabetes problem and deploy resources for its solution. Plans for the prevention, identification and treatment of diabetes and particularly its complications - blindness, renal failure, gangrene and amputation, aggravated coronary heart disease and stroke - should be formulated at local, national and European regional levels. Investment now will earn great dividends in reduction of human misery and in massive savings of human and material resources.

General goals and five-year targets listed below can be achieved by the organised activities of the medical services in active partnership with diabetic citizens, their families, friends and workmates and their organisations; in the management of their own diabetes and the education for it; in the planning, provision and quality audit of health care; in national, regional and international organisations for disseminating information about health maintenance; in promoting and applying research.

General goals for people - children and adults - with diabetes:

• Sustained improvement in health experience and a life approaching normal expectation in quality and quantity.
• Prevention and cure of diabetes and of its complications by intensifying research effort.

• Elaborate, initiate and evaluate comprehensive programmes for detection and control of diabetes and of its complications with self-care and community support as major components.
• Raise awareness in the population and among health care professionals of the present opportunities and the future needs for prevention of the complications of diabetes and of diabetes itself.
• Organise training and teaching in diabetes management and care for people of all ages with diabetes, for their families, friends and working associates and for the health care team.
• Ensure that care for children with diabetes is provided by individuals and teams specialised both in the management of diabetes and of children, and that families with a diabetic child get the necessary social, economic and emotional support.
• Reinforce existing centres of excellence in diabetes care, education and research. Create new centres where the need and potential exist.
• Promote independence, equity and self-sufficiency for all people with diabetes children, adolescents, those in the working years of life and the elderly.
• Remove hindrances to the fullest possible integration of the diabetic citizen into society.

• Reduce new blindness due to diabetes by one third or more.
• Reduce numbers of people entering end-stage diabetic renal failure by at least one third.
• Reduce by one half the rate of limb amputations for diabetic gangrene.
• Cut morbidity and mortality from coronary heart disease in the diabetic by vigorous programmes of risk factor reduction.
• Achieve pregnancy outcome in the diabetic woman that approximates that of the non-diabetic woman.
• Establish monitoring and control systems using state of the art information technology for quality assurance of diabetes health care provision and for laboratory and technical procedures in diabetes diagnosis, treatment and self-management.
• Promote European and international collaboration in programmes of diabetes research and development through national, regional and WHO agencies and in active partnership with diabetes patients organisations.
• Take urgent action in the spirit of the WHO programme, "Health for All" to establish joint machinery between WHO and IDF, European Region, to initiate, accelerate and facilitate the implementation of these recommendations.

At the conclusion of the St. Vincent meeting, all those attending formally pledged themselves to strong and decisive action in seeking implementation of the recommendations on their return home."

References:

1. . A Model for Prevention and Self Care; Saint Vincent (ITALY), 10-12 October 1989 (A Meeting Organized by WHO and IDF in Europe )

Last issued 05 Jul 2006