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Article 32 forms part of the final clauses. Even before a multilateral treaty has entered into force, some final clauses are immediately applicable. The Convention enters into force 3 months after the date of the deposit of the 30 instrument of ratification, acceptance, approval or accession (Art. 29 para. 1).

Treaties of international law follow the fundamental principle of pacta sunt servanda — they need to be obeyed. Sovereign States, as masters of their commitment, express their will to be bound by the respective treaty with the ratification or any other form of national approval process. But State interests that lead to the negotiations and ratification of the treaty are in no way static. Over time, such interests can change. There can be a shift in the preferences of domestic constituencies or a change of obligations arising out of the treaty.

Purpose Epidemiological investigations revealed an inverse correlation between the dietary intake of flavanols, the mortality of cardiovascular disease, and the incidence of diabetes. Controlled trials evaluating longer-term effects of flavanol-containing cocoa on endothelial function in diabetic patients are missing. This study was designed to test feasibility and efficacy of a dietary intervention based on daily intake of flavanol-containing cocoa for improving vascular function of medicated diabetic patients. Methods In a feasibility study with 10 diabetic patients, we assessed vascular function as flow-mediated dilation (FMD) of the brachial artery, plasma levels of flavanol metabolites, and tolerability following an acute, single-dose ingestion of cocoa, containing increasing concentrations of flavanols (75,371,963mg). In a subsequent efficacy study, changes in vascular function in 41 medicated diabetics were assessed following a 30-day, thrice-daily dietary intervention with either flavanol-rich cocoa (321mg flavanols per dose) or a nutrient-matched control (25mg flavanols per dose). Both studies were undertaken in a randomized, double-masked fashion. Results A single ingestion of flavanol-containing cocoa was dose-dependently associated with significant acute increases in circulating flavanols and FMD (at 2h: from 3.7±0.2% to 5.5±0.4%, p Conclusions Our study clearly establishes improvements of endothelial function after regular consumption of flavanol-containing cocoa in patients with type 2 diabetes, highlighting the potential of flavanol-containing diets, and underscoring the potential health care benefit for reducing the risk of cardiovascular events in diabetic patients.