Diabetes was defined as a fasting blood glucose of 7.0 mmol/L or greater, glycated hemoglobin (HbA1c) of 6.5% or greater (2 commonly used diagnostic criteria for diabetes according to current guidelines), or by taking medication for diabetes.
Most previous research on diabetes rates relied on high fasting blood sugar as the only measure and did not account for people with high HbA1c, which likely led to underestimates.
The new study analyzes blood sugar and HbA1c data from more than 140 million people aged 18 or over from more than 1,000 studies conducted in populations from different countries:
- The global rate of diabetes (type 1 diabetes and type 2 diabetes combined) among adults doubled from about 7% to about 14% between 1990 and 2022, with the greatest increase in low-income countries and intermediate;
- during this same period, diabetes treatment rates have stagnated at low levels in many of the same countries where rates of the disease have increased significantly;
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thus, nearly 450 million adults aged 30 and over with diabetes worldwide (i.e. 59% of people with diabetes) did not have access to treatment in 2022;
- however, in some regions of the world, treatment rates have improved somewhat (North America, Australasia, Central and Western Europe, parts of Latin America, East Asia and the Pacific): global inequalities in terms of diabetes treatment are gradually being resolved, but not quickly enough.
In other words, it is an urgent call for funding for diabetes drugs and programs that enable early detection and effective treatment of diabetes in low- and middle-income countries.
Prevalence of the disease worldwide:
- 828 million adults will have diabetes in 2022;
- 212 million live in India and 148 million in China, 42 in the United States, 36 in Pakistan, 25 in Indonesia and 22 in Brazil.
Lead author Professor Majid Ezzati of Imperial College London emphasizes “the persistence of global inequalities in diabetes, with stagnant treatment rates in many low- and middle-income countries where the number of adults with diabetes is increasing dramatically at the same time. “Particularly worrying trends are that increasingly younger people with diabetes are at risk of suffering lifelong complications, including amputation, heart disease, kidney disease or vision loss, and in some cases, premature death.”
A worrying trend
- Indeed, global rates of diabetes have doubled over the past 30 years;
- from 1990 to 2022, these global rates have doubled for men: 14.3% in 2022 vs. 6.8% in 1990 and for women: 13.9% vs. 6.9%;
- taking into account the additional impact of population growth and aging, this explains the prevalence of around 828 million adults with diabetes in 2022, an increase of around 630 million people vs. 1990;
- These growths in diabetes rates vary considerably between countries, with poorer countries experiencing the strongest growth, some high-income countries, such as Japan, Canada and some Western European countries (including France) not noticing no change or even a slight decrease in the rate of diabetes during these 30 years.
What major factors? Obesity and poor diet are the most obvious and important factors in increasing rates of type 2 diabetes.
“Given the disabling and life-threatening consequences of diabetes, its prevention through healthy diet and exercise is essential for better global public health. Our findings highlight the need to see more ambitious policies, particularly in low-income areas that expand access to healthy foods and exercise.”
What access to treatment?
59% of diabetic adults aged 30 and over, or a total of 445 million, do not have access to antidiabetics,
this is 129 million more than in 1990. In many low- and middle-income countries, coverage of diabetes treatment has remained low and insufficient, and has changed little over the last 30 years. In the poorest countries, up to 30% of people with diabetes receive no treatment.
And the diagnosis? Part of the lack of access to treatment is also linked to the lack of diagnosis for many patients: “Most people with untreated diabetes have not been diagnosed, so improving diabetes detection must be a priority, particularly in countries where treatment levels are modest.”
Health
