A recent analysis published in The Lancet ahead of World Diabetes Day reveals a staggering increase in global diabetes rates. The total number of adults with diabetes has surpassed 800 million—over four times the figure in 1990. Among these, 445 million adults (59%) received no treatment in 2022, highlighting a critical gap in care.
Between 1990 and 2022, global diabetes prevalence (type 1 and 2 combined) in adults increased from 7% to 14%, with the sharpest increases in low- and middle-income countries (LMICs). In 2022, 445 million adults aged 30 and older with diabetes (59%) did not receive treatment—a threefold increase since 1990.
India leads with 212 million adults with diabetes, followed by China (148 million), the USA (42 million), Pakistan (36 million), Indonesia (25 million), and Brazil (22 million). The study could not differentiate between type 1 and type 2 diabetes in adults, but existing evidence suggests that type 2 accounts for most cases.
From 1990 to 2022, diabetes rates doubled globally, with increases from 6.8% to 14.3% in men and from 6.9% to 13.9% in women. This rise was particularly pronounced in LMICs, such as Pakistan, where diabetes rates among women increased from 9.0% in 1990 to 30.9% in 2022. In contrast, some high-income countries, including Japan, Canada, and parts of Western Europe, saw little to no change or even slight declines.
Diabetes prevalence in 2022 varied significantly across regions. The lowest rates were observed in Western Europe and East Africa (2-5% in women and 3-5% in men in countries like France, Denmark, Uganda, and Kenya). The highest rates were observed in the Pacific Islands, the Caribbean, the Middle East, and LMICs like Pakistan and Malaysia, where over 25% of the population had diabetes.
Rising obesity and poor diets were key drivers of the diabetes surge, particularly in regions where unhealthy lifestyles have become more common between 1990 and 2022.
Although treatment rates improved in some regions, 59% of adults with diabetes worldwide were untreated in 2022. Many LMICs saw little progress over three decades, leaving over 90% of people with diabetes without treatment in some countries.
While diabetes treatment rates improved in North America, Europe, parts of Latin America, and East Asia, many LMICs saw little progress, exacerbating global inequities.
The gap between countries with the highest and lowest treatment coverage widened from 1990 to 2022 - among women from 56 to 78% and among men from 43 to 71%.
India had the largest number of untreated cases (133 million), followed by China (78 million), Pakistan (24 million), and Indonesia (18 million). Higher treatment rates in China (45% for women, 41% for men) contrasted with India’s lower rates (28% for women, 29% for men).
Researchers emphasise the urgent need to address the global diabetes crisis through policy interventions to restrict unhealthy foods, subsidising healthy options, and promoting active lifestyles; innovative diagnosis by expanding workplace and community screenings, extending clinic hours, and integrating diabetes care with established programmes for diseases like HIV/AIDS; and ensuring affordable treatment, particularly in LMICs.
Without effective interventions, the growing diabetes epidemic will lead to life-long complications such as heart disease, kidney damage, and premature death in millions of people, particularly in low-income countries, the researchers warn.
This study underscores the urgent need for global and regional strategies to combat diabetes. By prioritising prevention, early detection, and equitable treatment, particularly in LMICs, policymakers can mitigate the devastating health and economic consequences of this growing epidemic.
Source: The Lancet
Image Credit: iStock
