According to recent projections, the prevalence of type 2 diabetes is expected to more than double within the next three decades, rising from 529 million individuals in 2021 to at least 1.3 billion by 2050.
A study published in The Lancet reveals that the global number of people living with diabetes is projected to more than double by 2050. The estimates indicate an increase from 529 million individuals living with diabetes in 2021 to at least 1.3 billion by 2050. The researchers anticipate no decline in age-adjusted diabetes rates across any countries in the next 30 years.
The researchers commented that diabetes was already a significant concern in 2021 and is expected to become an even more pressing public health issue in the next three decades, as there is currently no effective strategy in place to mitigate its impact.
To arrive at these findings, the researchers utilized the latest methodological framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to estimate the overall prevalence and burden of total diabetes, type 1 diabetes (T1D), and type 2 diabetes (T2D) between 1990 and 2021. The study’s results were published alongside a collaborative series on the global burden of diabetes by GBD 2021.
The researchers computed estimates for 204 countries and territories, employing the Cause of Death Ensemble model and data from vital registration records and verbal autopsy reports spanning 25,666 location-years to assess the prevalence of diabetes-related deaths.
In 2021, around 529 million people worldwide were living with diabetes. This means that about 6.1% of the global population had diabetes. The highest rates of diabetes were found in North Africa, the Middle East, and Oceania. In Qatar, among individuals aged 75 to 79 years, an alarming 76.1% had diabetes.
Type 2 diabetes (T2D) is the most common form, accounting for 96% of all diabetes cases and causing significant health problems. Among older adults, T2D is a major concern. One of the leading causes of T2D is having a high body mass index (BMI), which is a measure of weight and height. In fact, 52.2% of the burden of T2D can be attributed to a high BMI.
Over the past three decades, the contribution of high BMI to the burden of T2D has increased worldwide. This rise in obesity-related diabetes varied among different countries, with Czechia experiencing a small increase and Vietnam observing a substantial increase. Factors such as the global increase in obesity rates have likely contributed to this concerning trend.
The researchers emphasized that T2D is preventable and, in some cases, reversible if diagnosed and treated early. Preventing and controlling T2D remains an ongoing challenge, they stated. It is crucial to gain a better understanding of disparities in risk factor profiles and the burden of diabetes across populations. This will inform strategies to successfully control diabetes risk factors within the context of complex and multiple drivers.
The number of people with diabetes is expected to reach over 1.31 billion by 2050, more than doubling the 2021 figure. In certain regions like North Africa, the Middle East, Latin America, and the Caribbean, more than 10% of the population is projected to have diabetes. By 2050, almost half of the countries analyzed are expected to have diabetes rates higher than 10%.
The authors of the series emphasized that structural racism and geographic inequality contribute to the rising rates of diabetes, its associated health problems, and mortality.
According to The Lancet’s press release, the series highlights that individuals from marginalized communities face barriers in accessing essential medications like insulin and new treatments. They also experience poorer blood sugar control, reduced quality of life, and shorter life expectancy. The COVID-19 pandemic has worsened global diabetes disparities, with people with diabetes being 50% more likely to develop severe infections and twice as likely to die, particularly among ethnic minority groups.
The GBD 2021 collaborators intend to use this series to showcase practical interventions that can reduce inequities in diabetes care, improve outcomes for racially and geographically marginalized individuals, and call for more high-quality research in real-world settings.
Dr. Shivani Agarwal, leader of the series and an expert in diabetes, stated in the press release that addressing diabetes inequity is crucial for achieving the UN’s Sustainable Development Goal of reducing non-communicable diseases by 30% within seven years. It is also essential to mitigate the adverse impact on the health of marginalized populations and the long-term strength of national economies. The series presents an important opportunity for collaborative action to transform diabetes care and enhance outcomes for marginalized populations worldwide.
Implications for global health systems:
Diabetes significantly impacts cardiovascular health by increasing the risk of heart disease, stroke, and peripheral artery disease. It accelerates the buildup of plaque in arteries, narrowing blood vessels and raising the risk of heart attacks and strokes. Hypertension is closely associated with diabetes and further raises the risk of cardiovascular complications. Integrating diabetes care into cardiovascular disease prevention is crucial for reducing complications.
The projected increase in diabetes prevalence and the burden of non-communicable diseases (NCDs) have significant implications for health systems. Some key implications for fighting diabetes and managing other NCDs are:
- Increased healthcare demand: The rise in diabetes cases will lead to a substantial increase in the demand for healthcare services, including primary care, specialized diabetes clinics, and management of complications, which will require additional resources and capacity-building within health systems.
- Strain on budgets: The escalating prevalence of diabetes and other NCDs will put a strain on healthcare budgets, as the cost of treating and managing diabetes, including medications, regular check-ups, and potential complications, can be substantial, necessitating careful allocation of funding and resource optimization.
- Health workforce capacity: The rising diabetes prevalence will require an expanded and adequately trained healthcare workforce, including physicians, nurses, and other allied health personnel, to effectively manage diabetes, provide patient education on lifestyle modifications and self-care practices, and ensure optimal patient outcomes and quality of care.
- Need for integrated care models: Managing NCDs like diabetes requires a comprehensive and coordinated approach, involving collaboration between primary care providers, specialists, pharmacists, and other healthcare professionals, to ensure continuity of care, personalized treatment plans, and ongoing support for individuals with diabetes, emphasizing the importance of interdisciplinary teamwork and care coordination.
- Robust health information systems: Health information systems are essential for monitoring diabetes prevalence, tracking risk factors, and evaluating the impact of interventions, necessitating investments in electronic health records, data analytics, and surveillance systems to gather accurate and timely information on diabetes trends, risk factors, and outcomes, enabling evidence-based decision-making and resource allocation.
- Health promotion and prevention: To effectively combat diabetes and other NCDs, health systems should prioritize health promotion and prevention strategies, implementing population-wide interventions that promote healthy lifestyles, such as initiatives to encourage physical activity, improve nutrition, reduce tobacco and alcohol consumption, and raise awareness about diabetes risk factors, ensuring a comprehensive approach that addresses modifiable risk factors and reduces the burden of disease.
- Policy and governance: Health systems need supportive policies and governance structures to effectively address the NCD burden, including implementing regulations to promote healthy environments, such as taxation on sugary beverages and restrictions on unhealthy food marketing, prioritizing NCDs in national health plans, fostering multisectoral collaborations, and advocating for increased political commitment and funding to effectively combat NCDs, emphasizing the importance of an enabling policy environment to drive positive health outcomes.
References:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01301-6/fulltext
https://www.ajmc.com/view/diabetes-prevalence-expected-to-double-globally-by-2050