In this stream, you will learn all aspects of cardiovascular disease related to diabetes, both prevention and treatment of people with diabetes and existing cardiovascular disease or heart failure. Additional topics include epidemiology, screening processes and organisation of such care, diagnosis and latest management. The data presented during this session derives from high-, middle- and low-income countries. Therapy areas will focus on lifestyle factors, established cardiovascular risk reduction therapies and anti-diabetic medicines.

Learning objectives

After attending sessions in the Cardiovascular Disease & Hypertension stream, you will:

• Understand the main risk factors for cardiovascular risk in diabetes and how to determine cardiovascular risk with simple risk scores.
• Understand that early treatment of lipids and blood pressure has substantial benefits in diabetes and, where relevant, discuss appropriate treatment targets.
• Understand the evidence base for lifestyle interventions to lower cardiovascular risk in diabetes.
• Understand drivers of heart failure in diabetes and how to assess such risks.
• Understand the evidence base for treatments designed to lower glucose but now available for lessening cardiovascular or cardiorenal risks and when to use them.
• Gain an appreciation of trends in cardiovascular risks in people with diabetes over time and across different regions.
• Apply evidence-based research to the management of cardiovascular disease and heart failure in diabetes.

This stream focuses on clinically important aspects of the devastating late complications of diabetic retinopathy and diabetic kidney disease. Diabetic retinopathy is the most common reason for blindness in working-age adults. Meanwhile, diabetic kidney disease affects more than one in two people living with diabetes. It is associated with serious consequences such as the increased risk of dying early, cardiovascular events, hospitalisation for heart failure and end-stage kidney disease. Sessions will highlight the commonality of eye and kidney disease and the importance of screening for them.

In this stream, you will also learn early-stage identification of individuals with these complications to prevent the progression and improve the prognosis of people living with diabetes. Additional topics include how to treat eye and kidney disease with “standard-of-care” tools and how to implement novel organ-protective treatment options; how eye and kidney disease impacts adherence to treatment and the psychological well-being of the individuals affected, not only from the “care provider’s” but also from the “patient’s” perspective.

Learning objectives

After the sessions in the Eye & Kidney stream, you will understand:

• How to screen for diabetic eye and kidney disease with currently available tools, and what new tools are emerging.
• That eye and kidney disease are common complications, and that they carry grim consequences for the individual affected by these complications.
• That screening for these complications is suboptimal, and one needs to ensure regular screening of every individual living with diabetes.
• Why some people living with diabetes develop eye and kidney disease while others do not.
• That there is an urgent and unmet need to provide balanced standard of care to people living with diabetes.
• How to treat eye and kidney disease according to standard of care but also to become familiar with the novel organ-protective medications that have shown a dramatic improvement in the prognosis of people living with diabetes.

In this stream, you will learn all aspects of diabetic neuropathy, including somatic and autonomic. There will also be a focus on lower limb problems in diabetes, particularly neuropathy, peripheral arterial disease, and diabetic foot disease. The latter will include a section on Charcot neuroarthropathy. All aspects of the neuropathies and diabetic foot problems will be covered, including epidemiology, screening, diagnosis and the latest management.

In the area of the diabetic foot, a major section will cover the prevention of amputation and early management of diabetic foot infections, together with an update on evidence-based management of complex diabetic foot lesions. Finally, the 2023 American Diabetes Association’s guidelines on foot care, with  update to the International Working Group on the Diabetic Foot guidelines (2023), will be covered. 

Learning objectives

After attending sessions in the Foot & Neuropathy stream, you will :

• Understand the multiple manifestations of neuropathy, both somatic and autonomic.
• Understand that the early diagnosis of neuropathy by screening is advocated in the prevention of later complications.
• Understand the pathophysiology of diabetic neuropathies and that, to date, there are no pathogenetic treatments but many proposed symptomatic treatments for painful neuropathy which will be outlined in this stream.
• Achieve a broad understanding of the pathogenesis and prevention of diabetic foot problems.
• Understand the evidence-based treatments available for managing diabetic foot problems and foot infections.
• Understand the updated guidelines from the American Diabetes Association and International Working Group on the Diabetic Foot for all aspects of diabetic foot care
• Apply evidence-based research in the management of neuropathy and foot problems in day-to-day clinical practice.

To better understand diabetes and its complications, it is vital to understand and identify an individual’s experience of diabetes and the thoughts, emotions and contexts that can regulate diabetes self-management behaviours. In addition, it is the extent to which a person living with diabetes can engage with the demands of their diabetes that will significantly impact their risk of diabetes complications.

Complications of diabetes mainly result from uncontrolled diabetes. Therefore, the main focus should be on the importance of controlling glycemia. Furthermore, preventing complications is cost-effective and affects the quality of life of people with diabetes.

Diabetes complications are associated with multiple psychological and social factors, both as precipitants of risk and as a consequence of the physical impact of the complication. In addition, complications can be driven by and also lead to significant psychological morbidity, particularly in relation to depression, anxiety and eating disorders. Therefore, it is essential to consider the psychosocial drivers and consequences of diabetes complications to prevent and manage the physical impacts of the condition.

Therefore, this stream focuses on the experiences of people living with diabetes in the context of diabetes complications.

Learning objectives

After attending sessions in the Living with Diabetes stream, you will understand:

• How the experiences of people living with diabetes mediate the risks for, and experiences of diabetes complications and what they expect from the HCP.
• The importance of controlling glycemia because it is closely related to the risk of complications and how to convincingly communicate with people with diabetes.
• The interplay between psychological factors such as a person’s emotional relationship with diabetes and diabetes complications.
• How an individual’s social and cultural context can determine the risk of complications focusing on health inequalities, age and health literacy.
• The relationship between specific psychological morbidities (depression and eating disorders) and the risk and management of diabetes complications.
• How to improve the interaction of the multidisciplinary group within the team and with the patient for early diagnosis of complications.
• The lived experience of diabetes complications in relation to foot and kidney disease.

With an estimated 10% of adults and several million youths living with diabetes globally and the increasingly high rate of disasters, people living with diabetes will inevitably be affected. Adverse outcomes disproportionately affect those in low- and middle-income regions. Prevention, Preparation, Response and Recovery (PPRR) is a practical approach to improving disaster-related outcomes. There are many roles for individuals with diabetes, their carers, clinicians, the healthcare system, community, local and national governments, industry and NGOs. Sessions in this stream will share approaches, existing resources and diabetes-related experience with natural and manufactured disasters.

Learning objectives

After the sessions in the Natural Disasters and Conflict stream, you will :

• Understand the epidemiology of diabetes and disasters.
• Understand the potential effects of natural and man-made disasters on people living with diabetes.
• Have reviewed existing guidelines and resources for disaster prevention, preparation, response and recovery and related advocacy.
• Understand relevant human rights laws and who and how to ask for assistance.
• Learn from prior diabetes related experiences with natural and man-made disasters.

This stream focuses on the challenges of Post COVID-19 in people with diabetes for its clinical management and long-term impact. This will include updates on the global situation and the clinical management of Post COVID-19 and diabetes, with experiences from Asia, Africa, Europe, North and South America and the Western Pacific. Conditions such as existing cardiovascular disease and kidney disease will also be considered. Data from high and low-income countries in different ethnic populations will provide a unique opportunity to upgrade current knowledge and meet global experts in the COVID-19 and diabetes field. Lifestyle factors, good glycaemic control, management of metabolic state and anti-diabetes medicines will also be addressed.

Learning objectives

• Present the current state of affairs for diabetes and Post COVID-19 and the way forward.
• Hyperglycaemia in Post COVID-19: prognosis and management.
• Issues on cardiovascular risk management in people with diabetes with Post COVID-19.
• Review the impact of COVID-19 on diabetes incidence.
• Non-insulin anti-diabetes agents in people with type 2 diabetes and Post COVID-19.
• Discuss the management of diabetes and hyperglycemia in the post COVID-19 era.