The number of diabetes cases worldwide will exceed one billion by 2050

Jhe number of people with diabetes worldwide is expected to more than double to 1.3 billion by 2050, according to a new study, a trend accelerated by worsening inequalities between and within countries.

By 2050, around 1 in 10 people worldwide are predicted to have the disease, representing a 60% increase in the prevalence of diabetes, according to the study published Thursday in The Lancet as part of a large-scale study. series on global inequalities in diabetes.

“Diabetes will be a defining disease of this century,” the Lancet editors wrote in an op-ed for the series. “How the healthcare community treats diabetes over 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 has underestimated the true magnitude and threat the disease poses.

Rising rates will be driven by type 2 diabetes, which accounted for 96% of global diabetes cases in 2021, and type 2 diabetes cases will largely be driven by obesity, a primary risk factor of the disease. While the authors attribute about half of the increase in diabetes over the next three decades to demographic changes such as an aging population, they attribute the other half to soaring obesity rates.

Diabetes has always been considered a disease that occurs in high-income countries, but with obesity, it is also increasingly affecting low- and middle-income countries. These regions are rapidly shifting to industrialized lifestyles consisting of diets of processed foods and reduced physical activity, while experiencing limited health expenditures and inadequate treatment, the authors said.

Although very effective new drugs against obesity and diabetes have emerged – like the GLP-1 class of drugs that includes Ozempic, Wegovy and Mounjaro – treating diabetes around the world requires not only medical interventions, but also sweeping changes to the environments people live in, the Lancet editors wrote. .

“The excitement and utility surrounding GLP-1 agonists and new drug combinations that help control blood sugar levels as well as reduce body weight is understandable,” they said. But, “the solution to unhealthy and unjust societies is not more pills but to reassess and reimagine our lives to provide opportunities to challenge racism and injustice, and prevent key social drivers of disease.” .

“Addressing structural racism must become a central part of prevention and health promotion strategies – areas that invariably receive too little investment,” they added.

Previous studies have shown that more than three quarters of people with diabetes are supposed to live in low- and middle-income countries by 2045, but less than 10% of people with diabetes in these countries received comprehensive diabetes care. This new study digs deeper into specific regions around the world.

In every country and territory in three regions – North Africa and the Middle East, Central Latin America and Oceania – the rate of diabetes is expected to exceed 10% by 2050, according to the study. And in 10 of 21 countries in North Africa and the Middle East and 13 of 18 countries in Oceania, the prevalence of diabetes is expected to exceed 20%.

Overall, across the world, there are no countries where diabetes rates are expected to decline, the authors said.

“For a disease where there is a significant amount of financial investment – ​​some countries are spending a lot of money and there are certainly industries that are spending a lot of effort and energy – it seems something is wrong” , said Liane Ong, first author of the study and principal investigator at the Institute for Health Metrics and Evaluation. “The way we have tried to tackle this condition perhaps needs to be rethought and reframed.”

The Lancet series examined not only inequalities between countries but also within countries. In Australia, for example, the authors note that Indigenous peoples experienced diabetes-related death and hospitalization rates more than four times higher than non-Indigenous Australians. The authors attribute these differences in results to long-standing issues faced by Indigenous groups, such as food insecurity and inadequate housing.

In the United States, the authors note that Native Americans and black Americans are more affected by diabetes and attribute the disparities to the consequences of historical events such as the displacement of native communities and redlining which discriminates against black populations.

“Structural inequalities are really at the heart of the global diabetes crisis we are experiencing and for generations to come,” said Shivani Agarwal, senior author of the Lancet series and associate professor of medicine at Albert Einstein College of Medicine. If people are not careful now, “we will be in a very difficult situation for ourselves and for our children and their children”.

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