The total number of people living with diabetes worldwide is expected to more than double over the next 30 years.
New estimates published in the first week of July in The Lancet indicate that worldwide, more than 1.31 billion people could have diabetes by 2050. That's a heavy burden for a disease that causes life-altering morbidity, high rates of mortality, and interacts with and exacerbates many other diseases. The increase in prevalence (up from 529 million in 2021) is expected to be driven by increases in type 2 diabetes, and a rise in the prevalence of obesity and by demographic shifts. In 2021, type 2 diabetes accounted for 90% of all diabetes prevalence. Most of this burden is attributable to social risk factors, such as high BMI, dietary risks, environmental and occupational risks, tobacco use, alcohol use, and low physical activity, which thrive on the obesogenic way our environments are designed and the inequitable way we organise our resources and societies.
Type 2 diabetes also accounted for 95% of the diabetes disability-adjusted life-years (DALYs), the sum of years of life lost due to premature death plus the years lived with disability. The investigators cited structural inequalities, such as access to healthy food options, as well as shifts toward an industrialised diet among low- to middle-income populations as part of the cause for higher BMI.
Socio-economic determinants may also play a role in the rising diabetes prevalence, despite well-established strategies to reduce the disease burden (eg, increasing access to insulin, enhancing health system infrastructure).
As of 2021, the region with the highest age-standardised prevalence of diabetes was North Africa and the Middle East, at 9%, while the region with the highest age-standardised rate was Oceana, at 12%. Qatar had the highest country-level age-specific prevalence, at 76.1% in people ages 75 to 79 years.
An editorial published in The Lancet stated: “Diabetes will be a defining disease of this century. How the health community deals with diabetes in the next two decades will shape population health and life expectancy for the next 80 years. The world has failed to understand the social nature of diabetes and underestimated the true scale and threat the disease poses. The GBD 2021 estimates and the Lancet Global Inequity
in Diabetes Series are an urgent call to course correct.”
Sources: MedPage Today, The Lancet
