Copenhagen Declaration: A New Start in Diabetes Prevention

“We are at a turning point,” explains Prof. Dr. med. Andreas Birkenfeld, co-author of the declaration. He is head of the Institute for Diabetes Research and Metabolic Diseases (IDM) of Helmholtz Munich at the Tübingen site of the German Center for Diabetes Research (DZD) e.V. and Director of Medical Clinic IV at the Tübingen University Hospital. Birkenfeld: “If we want to stop the momentum of the global diabetes epidemic, we need to start much earlier – with precise prediction, personalized strategies and new prevention concepts, such as prediabetes remission.” 
 

Recognize Earlier, Act more Purposefully 

Background: More than 800 million people worldwide live with diabetes – most of them in low- and middle-income countries. There is often a lack of resources, access to modern therapies and research data. The Copenhagen Declaration aims at improving this situation. It calls for the development of precise early detection and prevention measures and the implementation of culturally and economically appropriate programs. 

Intention: The long-term effects of remission strategies, such as lifestyle changes or new, innovative drugs, are to be systematically investigated. According to the authors, it is crucial to focus not only on achieving normoglycemic values in the short term, but also on preventing disease progression in the long term. 

“We have to understand how stable a diabetes remission is, which groups particularly benefit from it and how we can also achieve these effects under real conditions,” explains Birkenfeld. “The potential is huge, but we need evidence-based concepts and international cooperation.” 
 

Precision Medicine: Phenotyping of Prediabetes is the Key

Another central focus of the declaration is precision medicine. The experts recommend differentiating between prediabetes phenotypes in order to develop risk-based, personalized prevention strategies. Genetic, epigenetic, behavioral and environmental factors should be taken into account. “The idea of a uniform prediabetes stage is outdated,” says Birkenfeld. “Only if we understand the biological diversity of the early stages can we really specifically prevent prediabetes from becoming type 2 diabetes.” 
 

Seven Fields of Action, one Global Mission 

The Copenhagen Declaration defines seven fields of action: 

1. Prevention, early detection and remission: development of low-threshold programs and assessment of the long-term effectiveness of intervention strategies. 
2. Precision medicine: subtyping of forms of diabetes by using AI-assisted decision-making aids. 
3. Equitable access to care: development of infrastructure, especially in regions with few resources. 
4. Innovative treatment models: integration of real-time data, digital tools and biomarker-based decision-making aids. 
5. Integrated care for comorbidities: focus on cardiovascular, renal and oncological concomitant diseases, among others. 
6. Psychosocial support: digital peer-to-peer programs and AI-assisted psychological tools. 
7. Global cooperation and research: focus on LMICs (low- and middle-income countries). 

Particular attention is paid to cost-effective solutions: Artificial intelligence, mobile health applications and telemedicine are to be made accessible to people worldwide. 

Appeal to Politics and Society 

The declaration is not merely a vision, but a concrete call to action – to governments, health organizations, research institutions and industry. It calls for targeted investments, standardized monitoring systems and the development of global data platforms. 
 
“The Copenhagen Declaration is a roadmap for fairer, more effective and smarter care for people with type 2 diabetes,” says Birkenfeld. “If we set the right course now, we can prevent millions of illnesses – and improve the lives of hundreds of millions of people.”