The Policy Puzzle: the diabetes maze in Europe

Abstract

Introduction The Policy Puzzle is an Europe-wide audit of diabetes policies originally conducted under the auspices of the IDF and FEND. The first edition of the Policy Puzzle (2005) provided a benchmark in the area of diabetes policy.1 The concept of a European diabetes audit was initially mooted in 1989 when representatives of European government health departments, patient organisations and diabetes experts met under the aegis of the World Health Organisation Regional Office for Europe and the IDF European Region to provide a framework to improve systems provisions to reduce the burdens of diabetes at individual and societal levels.2 The resultant consensus document, the St Vincent Declaration, called for creation of conditions to improve diabetes-related outcomes and tackle the diabetes epidemic by implementing a series of agreed actions which included realisable 5-year targets.2,3 Most of the countries surveyed in the Policy Puzzle1,4 signed the St Vincent Declaration which has influenced policy, notably in Britain5 and nearly half the countries of the EU, but several countries have failed to fulfil a key requirement of the Declaration to introduce plans to combat diabetes. The third edition of the Policy Puzzle, launched on World Diabetes Day 2011, has been more ambitious and moved beyond the EU to include countries which comprise the IDF European region (figure 1).6