By Sharon Atieno
Of the 800 million plus adults living with diabetes worldwide, more than half (about 450 million) are not receiving treatment, a study shows.
The study which used data from over 140 million people aged 18 years or older from more than 1,000 population studies of different countries, found that this number has increased by three and a half times between 1990 and 2022.
According to the findings, there are widening global inequalities in diabetes treatment with countries in the low-and middle-income countries (LMICs) being the most affected.
While the treatment coverage of people living with diabetes in many countries in central and western Europe, Latin America and East Asia and the Pacific as well as Canada and South Korea has risen to more than 55% in 2022, the coverage in LMICs remains low with more than 90% of them not receiving treatment.
The study notes that the countries with the highest and lowest treatment coverage for diabetes have expanded from 1990 to 2022; from 56% to 78% in women and 43% to 71% in men.
Senior author Professor Majid Ezzati, of Imperial College London, said: “Our study highlights widening global inequalities in diabetes, with treatment rates stagnating in many low- and middle-income countries where numbers of adults with diabetes are drastically increasing. This is especially concerning as people with diabetes tend to be younger in low-income countries and, in the absence of effective treatment, are at risk of life-long complications – including amputation, heart disease, kidney damage, or vision loss – or in some cases, premature death.”
According to Professor Jean Claude Mbanya, University of Yaoundé 1, Cameroon, only five to ten percent of adults with diabetes in some sub-Saharan African countries received diabetes treatment, leaving a huge number at risk of serious health complications.
He continues, “Most people with untreated diabetes will not have received a diagnosis, therefore increasing detection of diabetes must be an urgent priority in countries with low levels of treatment. Better diagnosis of diabetes requires innovations such as workplace and community screening programmes, extended or flexible healthcare hours to enable people to visit outside of standard working hours, integration with screening and care for diseases like HIV/AIDS and TB which have well-established programmes, and the use of trusted community healthcare providers.”
Notably, the study highlights that in 2022, almost one in three (about 133 million) adults with untreated diabetes lived in India, followed by China (78 million), then Pakistan (24 million) and Indonesia (18 million). The USA which follows them closely had 13 million despite having a high treatment coverage (65% for women and 67% for men).
The authors acknowledge some limitations to their study including that most survey data did not separate type 1 and type 2 diabetes in adults. Additionally, some countries where estimates were provided on diabetes rates and treatment had very little, or in some cases, no data. Their estimates were informed to a stronger degree by data from other countries.
The UK Medical Research Council, UK Research and Innovation, and the US Centers for Disease Control and Prevention funded this study. It was conducted by researchers from the Non-Communicable Disease Risk Factor Collaboration (NCD-RisC), a worldwide network of over 1,500 researchers and practitioners that provides rigorous and timely information on NCD risk factors for all countries.
