Number of adults with diabetes reaches 422 million
worldwide and the global cost is now 825 billion
dollars per year, according to the largest ever
study of diabetes levels across the world.
The research, which was led by scientists from
Imperial College London, and involved Harvard T.H.
Chan School of Public Health, the World Health
Organization, and nearly 500 researchers across the
globe, incorporated data from 4.4 million adults in
most of the world’s countries. The research team has
also created interactive maps and other visuals that
show the data for each country, and how they compare
to each other.
The study, published in the journal The Lancet,
compared diabetes levels among adult men and women
from 1980 to 2014. Diabetes results in a person
being unable to regulate levels of sugar in their
blood, and increases the risk of heart and kidney
disease, vision loss, and amputations.
The team adjusted their results to account for
diabetes becoming more common as a person ages and
for some countries having older populations. Using
age-adjusted figures, they found that in the last 35
years, global diabetes among men has more than
doubled—from 4.3% in 1980 to 9% in 2014—after
adjusting for the effect of aging. Meanwhile
diabetes among women has risen from 5% in 1980 to
7.9% in 2014. This rise translates as 422 million
adults in the world with diabetes in 2014—which has
nearly quadrupled since 1980 (108 million).
The study follows previous work by the same Wellcome
Trust-funded team that studied global obesity levels
and published in The Lancet last week.
The data also revealed that the age-adjusted levels
of diabetes in 2014 were lowest in some countries in
northwestern Europe, where around 4% of women and 6%
of men have diabetes. The prevalence of diabetes was
highest in Polynesia and Micronesia, where more than
one in five adults has the condition. Overall, low-
and middle-income countries had the largest rise in
diabetes levels over the 35-year period.
The team also calculated the annual cost of
diabetes—which included the cost of treating and
managing the disease and its complications, such as
limb amputations. This was calculated in
International Dollars. The global cost was 825
billion dollars per year, with the largest cost to
individual countries being in China ($170 billion),
the US ($105 billion), and India ($73 billion). The
authors added that the calculation did not include
work days lost due to diabetes, which would make the
costs far greater if incorporated.
The study also found that:
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Diabetes has increased most dramatically in
Pacific island nations and in the Middle East
and North Africa region, which now have the
highest diabetes levels in the world. In
Polynesia and Micronesia, where prevalence is
highest, more than one in five adults have
diabetes. In Nauru and American Samoa, the
number is nearly one in every three men and
women.
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In the US in 2014, 8.2% of men and 6.4% of women
had diabetes, making the US’ rank 114th for men
and 146th for women in the world. The number of
US men with diabetes has increased by more than
two thirds since 1980, when 4.7% had the
disease. Among women in 1980, 4.3% had diabetes.
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Among high-income countries, the rise in
diabetes was relatively small in western Europe,
especially among women. Diabetes was lowest in
Switzerland, Austria, Denmark, Belgium, and the
Netherlands.
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After age-adjustment, 6.6% of men and 4.9% of
women in the UK had diabetes in 2014. UK men
were 169th in the world (out of 200) in terms of
diabetes prevalence, and 33rd in Europe (out of
43 nations). In comparison, UK women were 181st
in the world, and 29th in Europe.
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One half of the 422 million adults with diabetes
in 2014 lived in five countries: China, India,
the US, Brazil, and Indonesia.
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If current trends continue, over 700 million
adults worldwide would be affected with diabetes
by 2025.
The
study did not differentiate between type 1 and type
2 diabetes, as this wasn’t included in most of the
raw data. At least 85-90% of diabetes cases are type
2.
Professor Majid Ezzati, senior author of the study,
from the School of Public Health at Imperial College
London and an adjunct professor of global health at
Harvard Chan School, said: “This is the first time
we have had such a complete global picture about
diabetes—and the data reveals the disease has
reached levels that can bankrupt some countries’
health systems. The enormous cost of this disease—to
both governments and individuals—could otherwise go
towards life essentials such as food and education.”
He
added that until we find effective ways of
addressing the global obesity epidemic, the key to
tackling the diabetes crisis is focusing on
individuals who are at high risk of the condition.
“We
need financially accessible and effective health
systems that can highlight those at high risk of
diabetes or at pre-diabetes stage. Healthcare staff
can then deliver medication and lifestyle advice to
delay or even prevent the onset of the condition, as
has been done in some countries in western Europe,”
Ezzati said.
Professor Goodarz Danaei, co-lead author of the
study and an assistant professor of global health at
Harvard Chan School, said: “The most important risk
factor for diabetes is obesity. Yet global obesity
levels are soaring out of control.”
He
also added that genetics and fetal and early life
conditions may play a role in why some countries
seem to have much higher rates of diabetes: “There
is increasing evidence that the interaction of genes
and the environment plays a role in diabetes. For
example, certain genotypes may increase the risk of
diabetes especially in people with unhealthy
lifestyles. In addition, inadequate nutrition during
pregnancy and in early life may increase the risk of
diabetes later in life. Therefore, long-term
diabetes prevention should address nutrition in
every stage of life.”
For
more information
The Lancet
Worldwide trends in diabetes since 1980: a pooled
analysis of 751 population-based studies with 4·4
million participants
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