This year‘s German Diabetes Congress took place in Berlin on May 28-31, 2025 and had about 6,000 participants. The conference programme comprised a broad range of aspects related to diabetes and its complications with a particular focus on the current state of therapies and available diabetes technologies, on novel developments in these fields, on challenges to the healthcare system and on the specific needs and requirements that are linked to the different stages throughout the lifecourse.
One of the symposia was again organised by CEDA and highlighted the “Practical significance of the new diabetes subtypes for prevention and therapy“. Session chairs were Professor Péter Kempler (Budapest, Hungary; CEDA President) and Professor Julia Szendroedi (Heidelberg, Germany).
Professor Christian Herder (Düsseldorf, Germany) started the session with an update on approaches to diabetes reclassification. He emphasised that the five new diabetes subtypes differ not only in the risk of somatic complications, but also in patient-reported outcomes. Current studies are ongoing to optimise the reclassification of diabetes to increase its practical value. Even before the diagnosis of diabetes, there is considerable heterogeneity with regard to the risk of type 2 diabetes and associated complications. The clusters identified based on cohorts from Tübingen could be replicated in the German KORA F4/FF4 cohort and differed in their inflammatory burden which could be useful for more targeted prevention approaches.
Dr. Katharina Weber (Kiel, Germany) discussed the role of nutrition in precision prevention and therapy of diabetes. She explained that the concept of metabotyping groups people with similar metabolism (e.g. diabetes subtypes) to provide precision-based dietary recommendations. Analyses in the German Diabetes Study did not reveal clinically relevant differences in the adherence to dietary patterns and carbohydrate quality between the diabetes subtypes. However, there were associations of these dietary factors with cardiometabolic risk factors and a cardiovascular risk score that differed between the diabetes subtypes. The reclassification of diabetes could be suitable for identifying groups of people who benefit from specific nutritional therapy.
Dr. Nina Trinks (Düsseldorf, Germany) continued with individualised exercise recommendations for people with diabetes. Exercise serves as cornerstone in the prevention and therapy for diabetes. Specific exercise recommendations apply for people on insulin therapy. Exercise programs for people with type 2 diabetes include a combination of endurance training, strength training, coordination and flexibility training as well as activities integrated into daily life. Diabetes subtypes differ in terms of physical fitness, muscle mass, body fat percentage and risk of cardiovascular disease but further studies are needed before specific, evidence-based exercise recommendations can be given for the different diabetes subtypes.
In the final talk, Professor Alba Sulaj (Heidelberg, Germany) discussed the relevance of diabetes subtypes for pharmacological therapy. Their identification could improve the medical care of people with diabetes through stratified therapy concepts and provide new insights into the underlying pathomechanisms. The available evidence on treatment consequences and practicability in implementation is currently still insufficient for the inclusion of new subtypes in guideline recommendations. Of note, there are many factors that are underutilised for risk prediction, such as social factors, gender aspects and markers for steatotic liver disease.
CEDA thanks the German Diabetes Association (DDG) for the opportunity to organise CEDA symposia at the Diabetes Congress, and we are looking forward to future joint scientific discussions.
Prof. Dr. Christian Herder