The number of adults with diabetes worldwide has quadrupled from 108 million in 1980 to 422 million in 2014, according to a study published in The Lancet.
By 2025, the global target is to halt the increase in age-standardized adult prevalence of diabetes to its 2010 levels. The results of this study put the probability of meeting this goal at less than 1% for men and 1% for women if post-2000 trends continue.
“Diabetes has become a defining issue for global public health. An aging population and rising levels of obesity mean that the number of people with diabetes has increased dramatically over the past 35 years,” said Majid Ezzati, PhD, from Imperial College London in the United Kingdom. “Rates of diabetes are rising quickly in China, India, and many other low and middle income countries, and if current trends continue, the probability of meeting the 2025 UN global target is virtually non-existent.”
The researchers used data from 751 studies that included 4,372,000 adults from 146 countries. The study estimates the diabetes prevalence for 200 countries, adjusted to account for the increased risk of diabetes in aging people and for countries with older populations.
In 1980, global age-standardized diabetes prevalence among men was 4.3%, increasing to 9.0% in 2014. For women, the prevalence increased from 5.0% to 7.9%. During the study period, the number of people with diabetes globally increased from 108 million to 422 million; the researchers attribute 28.5% of the growth to an increase in prevalence, 39.7% to population growth/aging, and 31.8% to an interaction of these factors.
In 2014, diabetes prevalence was lowest in northwestern Europe and highest in Polynesia and Micronesia, at approximately 25%. The areas with the next-highest diabetes rates were Melanesia, the Middle East, and North Africa.
The individual country with the highest diabetes rate in 2014 was American Samoa, with rates exceeding 30% for men and women. Many low- and middle-income countries had significant increases in diabetes rates, including China, India, Indonesia, Pakistan, Egypt, and Mexico. No country had a significant decrease in diabetes prevalence.
If post-2000 trends continue, 9 countries for men and 29 for women have a 50% or greater chance of meeting the global target for diabetes prevalence in 2025.
“Obesity is the most important risk factor for type 2 diabetes, and our attempts to control rising rates of obesity have so far not proved successful,” added Dr Ezzati. “Identifying people who are at high risk of diabetes should be a particular priority since the onset can be prevented or delayed through lifestyle changes, diet, or medication.”
The study was released to coincide with the World Health Organization’s (WHO) World Health Day on April 7, 2016, which focuses on diabetes this year.
“The prevalence estimates provided by [the NCD Risk Factor Collaboration] sound the alarm for large-scale, effective action to reduce the health and economic impact of diabetes,” said Etienne G. Krug, MD, MPH, director of the WHO’s Department for Management of Noncommunicable Diseases, Disability, Violence, and Injury Prevention, in a related commentary. “Improvements in prevention and management, together with better surveillance, should be prioritized in response to this call.”
- NCD Risk Factor Collaboration. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. The Lancet. Published online April 6, 2016. doi:10.106/S0140-6736(16)00618-8.
- Krug EG. Trends in diabetes: sounding the alarm. The Lancet. Published online April 6, 2016. doi: 10.106/S0140-6736(16)30163-5.