Global challenges in diabetes research and care: which way forward? An appraisal from the EASD Global Council

Francesco Giorgino¹, Fawaz Alzaid^{2

3}, Anca Pantea Stoian⁴, Juliana C N Chan^{5

6

7}, Linong Ji⁸, William Lumu⁹, Helard Manrique¹⁰, Didac Mauricio¹¹, Banshi Saboo¹², Peter A Senior¹³, Daisuke Yabe¹⁴, Sophia Zoungas¹⁵, Manuela Meireles¹⁶, Chantal Mathieu¹⁷, Leszek Czupryniak¹⁸

Affiliations

¹ Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy. francesco.giorgino@uniba.it.
² Dasman Diabetes Institute, Kuwait City, Kuwait.
³ Institut Necker-Enfants Malades, Inserm U1151, CNRS UMR 8253, IMMEDIAB Laboratory, Paris, France.
⁴ Diabetes, Nutrition and Metabolic Diseases Department, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.
⁵ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, HKSAR, China.
⁶ Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, HKSAR, China.
⁷ Li Ka Shing Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, HKSAR, China.
⁸ Peking University Diabetes Center, Peking University People's Hospital, Beijing, China.
⁹ Department of Endocrinology and Non-Communicable Diseases, Mengo Hospital, Kampala, Uganda.
¹⁰ Department of Diabetes, Endocrinology and Nutrition, Delgado Clinic and Diabetes, Obesity Nutrition Research, Lima, Perú.
¹¹ Department of Endocrinology & Nutrition, CIBERDEM - IR Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
¹² Diacare - Diabetes Care and Hormone Clinic, Ahmedabad, India.
¹³ Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada.
¹⁴ Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
¹⁵ School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
¹⁶ European Association for the Study of Diabetes Office, Düsseldorf, Germany.
¹⁷ Endocrinology UZ Gasthuisberg, KU Leuven, Leuven, Belgium.
¹⁸ Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.

PMID: 40928674
DOI: 10.1007/s00125-025-06504-5

Review

Global challenges in diabetes research and care: which way forward? An appraisal from the EASD Global Council

Francesco Giorgino et al. Diabetologia. 2025.

. 2025 Sep 10.

doi: 10.1007/s00125-025-06504-5. Online ahead of print.

Authors

Affiliations

¹ Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy. francesco.giorgino@uniba.it.
² Dasman Diabetes Institute, Kuwait City, Kuwait.
³ Institut Necker-Enfants Malades, Inserm U1151, CNRS UMR 8253, IMMEDIAB Laboratory, Paris, France.
⁴ Diabetes, Nutrition and Metabolic Diseases Department, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.
⁵ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, HKSAR, China.
⁶ Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, HKSAR, China.
⁷ Li Ka Shing Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, HKSAR, China.
⁸ Peking University Diabetes Center, Peking University People's Hospital, Beijing, China.
⁹ Department of Endocrinology and Non-Communicable Diseases, Mengo Hospital, Kampala, Uganda.
¹⁰ Department of Diabetes, Endocrinology and Nutrition, Delgado Clinic and Diabetes, Obesity Nutrition Research, Lima, Perú.
¹¹ Department of Endocrinology & Nutrition, CIBERDEM - IR Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
¹² Diacare - Diabetes Care and Hormone Clinic, Ahmedabad, India.
¹³ Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada.
¹⁴ Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
¹⁵ School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
¹⁶ European Association for the Study of Diabetes Office, Düsseldorf, Germany.
¹⁷ Endocrinology UZ Gasthuisberg, KU Leuven, Leuven, Belgium.
¹⁸ Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.

PMID: 40928674
DOI: 10.1007/s00125-025-06504-5

Abstract

This review article, developed by the EASD Global Council, addresses the growing global challenges in diabetes research and care, highlighting the rising prevalence of diabetes, the increasing complexity of its management and the need for a coordinated international response. With regard to research, disparities in funding and infrastructure between high-income countries and low- and middle-income countries (LMICs) are discussed. The under-representation of LMIC populations in clinical trials, challenges in conducting large-scale research projects, and the ethical and legal complexities of artificial intelligence integration are also considered as specific issues. The development of global research networks and strategies for improved training, standardisation of data and enhanced accessibility to big data analytics to drive innovation and personalised medicine are recommended. With regard to diabetes care, inequalities in access to essential medications, particularly insulin and novel therapies, and disparities in healthcare infrastructure are discussed. Proposed initiatives include international support programmes, improved healthcare provider training and the inclusion of newer diabetes medications in essential drug lists. The importance of global screening programmes, a universal diabetes education curriculum and standardised healthcare checklists is also emphasised. Regarding healthcare organisation, the development of national diabetes registers, benchmarking performance across regions and strengthening international collaborations are highly advised. The role of diabetes specialists as care coordinators and the need for structured assessments to improve early intervention and long-term outcomes are also discussed. Ultimately, the EASD Global Council urges action for a unified, global approach to diabetes research and care to bridge the gap between scientific innovation and clinical practice, ensuring equitable healthcare worldwide.

Keywords: Artificial intelligence; Big data; Clinical trials; Diabetes; Diabetes registers; Digital health; Education and training; Equity, diversity and inclusion; Health systems; Low- and middle-income countries; Personalised medicine; Review.

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Conflict of interest statement

Acknowledgements: The EASD Global Council includes the following members: Francesco Giorgino (chair), Fawaz Alzaid, Juliana C. N. Chan, Anca Pantea Stoian, Linong Ji, William Lumu, Didac Mauricio, Helard Manrique, Banshi Saboo, Peter Senior, Daisuke Yabe, Sophia Zoungas, Manuela Meireles and Leszek Czupryniak (advisor). Funding: This work was supported by the EASD. PAS is supported by the Alberta Academic Medicine Health Services Program and the Charles A. Allard Chair in Diabetes Research. Authors’ relationships and activities: FG reports receiving grants from Eli Lilly and Roche Diabetes Care; consulting fees from Eli Lilly and Novo Nordisk and support for attending meetings or for travel from AstraZeneca, Boehringer Ingelheim, Eli Lilly, LifeScan, Merck Sharp & Dohme, Medtronic, Novo Nordisk, Roche Diabetes Care and Sanofi-Aventis. FG has participated on advisory boards for AstraZeneca, Biomea, Boehringer Ingelheim, Eli Lilly, LifeScan, Merck Sharp & Dohme, MedImmune, Medtronic, Novo Nordisk, Roche Diabetes Care and Sanofi-Aventis. FG is Senior Vice-President of the EASD/European Foundation for the Study of Diabetes (EFSD) (unpaid). APS reports participating on advisory boards for Amgen, AstraZeneca, Eli Lilly, Merck, Medtronic, MSD, Novo Nordisk, Roche Diabetes and Sanofi and in the CREDANCE, REIMAGINE 2 and ZEUS research/clinical studies. APS has received fees for meetings, travel or lectures from Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Egis, Coca-Cola, Medtronic, Medochemie, Novo Nordisk, Novartis, Merck, MSD, Servier and Sanofi. She is Vice-President of the Romanian Committee of Diabetes, Nutrition, and Metabolic Diseases (unpaid) and Vice-President of Central European Association of Diabetes (CEDA) (unpaid). JCNC reports receiving grants (through institutions) and/or honoraria for consultancy or giving lectures from Abbott, Applied Therapeutics, AstraZeneca, Bayer, Biomea, Boehringer Ingelheim, Eli Lilly, Hua Medicine, Merck, Novo Nordisk, Powder Pharmaceuticals, Roche, Sanofi, Servier and ZP Therapeutics. She is the Chief Executive Officer (pro bono) of the Asia Diabetes Foundation, which developed the web-based JADE platform for implementation of data-driven diabetes care. She is a co-inventor of patents owned by the Chinese University of Hong Kong on biomarkers and models for predicting diabetes and its complications. She is a co-founder of GemVCare, a technology company, with partial support from the Hong Kong Government, which uses biogenetic markers and information technology to implement precision diabetes care and prevention through partnerships. LJ reports receiving consulting or lecture fees from Eli Lilly, Novo Nordisk, Merck, Bayer, Sanofi-Aventis, MSD, AstraZeneca, Boehringer Ingelheim, Abbott, Fosun Pharma, Innovent Biologics, Gan & Lee Pharmaceuticals, Sinocare and Sibionics. HM reports receiving lecture fees from Novo Nordisk. DM has received advisory board and/or speaking fees from AB-Biotics, Abbott, Almirall, Amarna, Amgen, AstraZeneca, Ferrer, Gilead, Lilly, Medtronic, Menarini, MSD, Novo Nordisk and Sanofi. PAS has received speaker and consulting fees from Abbott, Bayer, Dexcom, GSK, Insulet, Novo Nordisk, Vertex and Yposmed. His institution has received grant support from Bayer, the Canadian Institutes of Health Research (CIHR), Brain Canada, Breakthrough T1D and Novo Nordisk. He is a past chair of Diabetes Canada. He serves in leadership roles in Diabetes Action Canada and CanScreen T1D. DY has received clinically commissioned/joint research grants from Novo Nordisk, Ono Pharmaceutical, Taisho Pharmaceutical, Terumo and Arkay. DY has also received consulting or speaker fees from Sumitomo Dainippon Pharma, Boehringer Ingelheim, Astellas Pharma, MSD, Novo Nordisk, Ono Pharmaceutical, Eli Lilly and Takeda Pharmaceuticals. SZ reports previous payments to her institution (Monash University) from AstraZeneca, Boehringer Ingelheim, CSL Seqirus, Eli Lilly Australia, Moderna, MSD Australia, Sanofi and Novo Nordisk for participation in advisory and educational meetings. CM serves or has served on the advisory panel for Novo Nordisk, Sanofi, Eli Lilly, Novartis, Dexcom, Boehringer Ingelheim, Bayer, Roche, Abbott, Medtronic, Insulet, Biomea Fusion, SAB Bio and Vertex. Financial compensation for these activities has been received by KU Leuven. KU Leuven has received research support for CM from Medtronic, Novo Nordisk and Sanofi. CM serves or has served on the speaker’s bureau for Novo Nordisk, Sanofi, Eli Lilly, Medtronic, Dexcom, Insulet, Abbott, Vertex and Boehringer Ingelheim. Financial compensation for these activities has been received by KU Leuven. CM is President of the EASD. All external support for EASD can be found at www.easd.org . The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work. Contribution statement: All authors were responsible for drafting the article and reviewing it critically for important intellectual content. All authors approved the version to be published.

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Global challenges in diabetes research and care: which way forward? An appraisal from the EASD Global Council

Affiliations

Global challenges in diabetes research and care: which way forward? An appraisal from the EASD Global Council

Authors

Affiliations

Abstract

Conflict of interest statement

References

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