After a two-year break due to the pandemic, this year’s Diabetes Congress from the German Diabetes Association (DDG) took place in a hybrid format on May 25-28, 2022 with many of the 6600 participants coming to Berlin for a highly comprehensive congress programme. The congress again included a CEDA session, this time on prediabetes and its clinical implications chaired by Professor Thomas Stulnig, current CEDA president, and Professor Péter Kempler, CEDA president-elect (Budapest, Hungary).
Professor Thomas Stulnig (Vienna, Austria) started the session with an introduction to CEDA and invited all participants to the next CEDA Congress in Vienna (June 23-25, 2022). With about 40 plenary lectures from speakers from 16 CEDA countries and new symposium formats the congress will offer an exciting programme for clinicians and also many opportunities for networking and discussions.
Professor Christian Herder (Düsseldorf, Germany) started the scientific part of the symposium with an overview of new data on prediabetes and the risk of diabetes-related complications. He presented findings from a recent umbrella review that included 95 separate meta-analyses and pointed towards an increased risk (1.1-1.5-fold) for mortality, cardiovascular endpoints, nephropathy, several types of cancer and dementia among people with prediabetes compared to people with normal glucose metabolism. In particular the association with mortality was strongest when prediabetes was defined as impaired glucose tolerance, whereas associations were weakest for HbA1c-defined prediabetes. Overall, the findings emphasise that a diagnosis of prediabetes should be used for intervention measures although long-term data on their efficacy are still scarce.
In the second scientific talk Dr. Katharina Weber (Kiel, Germany) provided an overview of the current evidence on the benefits of dietary supplements and formula diet for people with prediabetes. Vitamin D supplementation may decrease the risk to progress to type 2 diabetes. However, it is still not clear which subgroups of people with prediabetes benefit most from such a supplementation. In contrast, there is insufficient evidence to recommend magnesium or zinc supplements to prevent type 2 diabetes. Several intervention trials found that the combination of lifestyle changes and meal replacement with formula diets led to better improvements of cardiometabolic risk factors and a higher probability to achieve normoglycaemia compared with lifestyle changes alone.
Professor Bernhard Schwaab (Timmendorfer Strand, Germany) discussed the options for personalised intervention based on physical activity in people with prediabetes. There are still insufficient data on the optimal training intensity to prevent or treat type 2 diabetes. It is important to consider the individual exercise capacity and to combine endurance and strength training to achieve the best cardiometabolic improvements.
In the final scientific presentation, Professor Thomas Stulnig focused on the potential pharmacological prevention of diabetes. Weight loss of 5-10% is often sufficient for the prevention of type 2 diabetes but only few people with overweight or obesity can achieve this goal in the long run. Therefore, oral glucose-lowering drugs such as metformin or weight-loss support particularly by incretin analogues have shown to reduce the risk of type 2 diabetes. However, obstacles with respect to reimbursement in the context of diabetes prevention often preclude their use in clinical practice.
The scientific talks led to lively discussions and the symposium was very well received. CEDA thanks DDG for the opportunity to organise CEDA symposia at the Diabetes Congress, and we are looking forward to future joint symposia.
Prof. Dr. Christian Herder