The number of adults with diabetes worldwide will more than double by 2050, according to research that blames rapidly rising obesity levels and widening health inequalities for the trend, with experts saying no country is likely to see a decline in statistics over the next three decades.
The new estimates predict cases will rise from 529m in 2021 to more than 1.3bn in 2050, reports The Guardian. The findings were published in The Lancet and The Lancet Diabetes & Endocrinology journals.
Experts described the data as alarming, saying diabetes was outpacing most diseases globally, presenting a significant threat to people and health systems.
“Diabetes remains one of the biggest public health threats of our time and is set to grow aggressively over the coming three decades in every country, age group and sex, posing a serious challenge to healthcare systems worldwide,” said Dr Shivani Agarwal of the Montefiore Health System and the Albert Einstein College of Medicine in New York.
Separately, the UN has predicted that by 2050 the world’s population will be about 9.8bn. That suggests that by then, between one in seven and one in eight people will be living with diabetes.
The research authors wrote: “Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors.”
Structural racism experienced by minority ethnic groups and “geographic inequity” were accelerating rates of diabetes, disease, illness and death around the world, the authors said.
People from marginalised communities are less likely to have access to essential medicines such as insulin, and have worse blood sugar control, a lower quality of life and reduced life expectancy.
The pandemic has amplified diabetes inequity globally. People with diabetes were twice as likely to develop severe infection with Covid-19 and to die, compared with those without diabetes, especially among minority ethnic groups, the authors said.
The research outlines how the large-scale and deep-rooted effects of racism and inequity lead to unequal impacts on global diabetes prevalence, care and outcomes.
The negative impacts of public awareness and policy, economic development, access to high-quality care, innovations in management, and sociocultural norms were felt widely by marginalised populations and will be for generations to come, it found.
The structural conditions in the places people live and work have far-reaching, transgenerational negative effects on diabetes outcomes worldwide, according to the research.
Dr Alisha Wade, a co-author and an associate professor at the University of the Witwatersrand, said: “It is vital that the impact of social and economic factors on diabetes is acknowledged, understood and incorporated into efforts to curb the global diabetes crisis.”
The charity Diabetes UK has previously said that the high number of overweight or obese people – about 64% of adults in England – is translating into an increase in cases of type 2 cases.
The condition is becoming increasingly common among those under 40 and in areas where there are higher levels of deprivation, and risk factors, which were “multiple and complex”, included age, family history, ethnicity and weight.
Study details
Global inequity in diabetes
Published in The Lancet on 22 June 2023
Executive Summary
Diabetes has become a global crisis that is increasing exponentially and will have lasting effects on global health for generations to come. Inequity in diabetes is accelerating this global crisis, exacting outsized impacts on outcomes. Structural inequity, comprised of structural racism and geographical inequity, is deeply rooted within geopolitical, economic, health care, and social structures, and creates major differences in upstream social determinants of health, such as socioeconomic position and availability of resources. These differences differentially and negatively influence downstream social determinants of health, such as access to high-quality care and education, as well as diabetes prevalence, morbidity, and mortality. In this Series, we use a health equity perspective to review the large body of work on diabetes and its consequences, and discuss the complex and intersecting ways in which structural inequity impacts social determinants of health and diabetes outcomes on a global scale. We present new conceptual frameworks, offer real-world regional perspectives, and provide strategic action plans.
The Lancet article – Global inequity in diabetes (Open access)
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