In 2024, more than 50 diabetes experts from around the world came together as the Global Diabetes Forum. They had a bold ambition – to develop a blueprint for transforming diabetes prevention and care, globally. 

The result was the Copenhagen Declaration. It calls for the world to leverage advances in precision medicine, new therapeutics, and technologies such as mobile health and artificial intelligence (AI) to improve the lives of people with, or at risk of, diabetes.  

It calls for more investment in research, education, and health infrastructure, particularly in low- and middle-income countries, innovative prevention strategies, and equitable access to healthcare.  

And it calls for global collaboration – the sharing of knowledge, strategies, tools, and resources between regions and for mutual benefit. 

With 828 million people diagnosed with diabetes worldwide – 80% of them in low- and middle-income countries – and that number set to rise, there is no time to waste.  

Marie-Louise Hartoft-Nielsen is a member of the Global Diabetes Forum and Vice President for Clinical Medicine and Endocrinology here at the Novo Nordisk Foundation, which provides funding and logistical support to the forum. 

We spoke to her about the Copenhagen Declaration – why this, why now, and what is needed to turn it from blueprint to reality. 

There are lots of guidelines and recommendations on diabetes already. What makes the declaration different?

It is a true collaboration between Global North and South, both in terms of the people involved and the principles within it. There’s a recognition that you can’t just take knowledge from high-income countries and apply it elsewhere. However, there are significant research gaps when it comes to lower income settings. We need new knowledge and new ways of thinking, and we need to develop technologies, treatments and so on that are relevant, affordable and accessible where the burden is greatest.  

Back in 1989, we had the St. Vincent Declaration – a vision for diabetes care and research in Europe. The goals were fully achieved, which is fantastic, but now we need a new vision, one that is ambitious on behalf of the whole world. 

What excites you about it?

Firstly, it’s ambitious but not unachievable. Secondly, the excellent collaboration that got us there. It was amazing to be among so many goal-oriented, curious people who believed in what we were doing and that it could be done.  

Why is now the right time for this?

The world is at a crossroads, where changes in demographics, disease patterns and climate are hitting us. We also have a lot of technology available – for treatment and monitoring, but also AI capabilities – and new treatments too. There are many things we didn’t have just five or ten years ago, and now we need to figure out how we can use these things smartly to ensure we can face the future. 

The number of people with diabetes is growing rapidly in most parts of the world. How can we reverse that trend? 

A lot of the knowledge that’s needed is already out there, but we need to be better at ensuring that knowledge, data, research that could help improve diabetes care and prevention in different regions is available and implementable. For example, India has had great recent success with using telemedicine technology in diabetes care and screening. Their approaches could be adapted for use in other parts of the world where remote care is needed. 

Secondly, whenever new knowledge or data is generated, there should be a plan for how it will be used. Closer links between researchers and policy makers would help here. 

Thirdly, we need to build awareness of the scale and nature of the problem – among policymakers, industry, physicians, health workers and the general public. The treatment of diabetes has advanced hugely in the last decades, partly due to the development of new drugs – but this only happens if there’s an understanding of the burden for individuals and societies and an appetite for new and better treatments. Awareness is key here. 

Finally, we need to focus on prevention. The trajectories for cardiometabolic disease, including diabetes, in Africa and elsewhere are tsumani-like – we need to flatten the curve. 

The Copenhagen Declaration sets out clear recommendations in all these areas – and more – listing clear goals, knowledge gaps, and opportunities for utilising current knowledge. There are also metrics to measure success.  

What’s next for the declaration? 

We want to see the recommendations implemented, of course. That requires engagement from governments, healthcare systems, health workers and broader society. 

But the declaration is also a living document. We hope that others – not least people living with diabetes – will engage in the dialogue started by the forum and the declaration, to ensure we stay focused on the most important gaps and how to close them.  

You can read the Copenhagen Declaration here. Comments and feedback are welcome at [email protected]. 

Read a commentary on the Declaration, published in The Lancet, here. 

Learn more about the global challenge of diabetes and the Declaration in this video: