Lancet study: 1.3 billion people will be living with diabetes by 2050

A new study published in The Lancet shows that the population living with diabetes worldwide is projected to double to 1.3 billion people in the coming 30 years. The current global burden of diabetes is half a billion, with India accounting for 77 million cases alone worldwide.

According to a peer-reviewed paper, 'Epidemiology of type 2 diabetes in India' published in the National Library of Medicine, a 2019 estimate showed around 77 million Indians were already suffering from diabetes. This was expected to rise over 134 million by 2045. Alarmingly, the paper approximated that 57 per cent of diabetic individuals still remained undiagnosed.

Another peer-reviewed paper, 'Current scenario of diabetes in India' published in the Wiley Online Library, had estimated in 2009 that India's diabetes burden would increase to 70 million by 2025 — which implies either diagnosis improved or the disease has increased more rapidly than anticipated in 2009. This paper said that the cause for the rise of diabetes is hyper-urbanisation in India.

The data presented by Statista shows, India (74.2 million) is the second worst country in 2021 with highest number of diabetes cases, China (140.9 million) maintains the top most position. Pakistan (33 million), United States (32.2 million), Indonesia (19.5 million) are third, fourth, and fifth in their database, respectively.

The lead author of the Lancet paper, Liane Ong is lead research scientist at the Institute for Health Metrics and Evaluation (IHME), University of Washington's School of Medicine, US. Ong said, "The rapid rate at which diabetes is growing is not only alarming but also challenging for every health system in the world, especially given how the disease also increases the risk for ischaemic heart disease and stroke."

This is naturally of concern for India, which is known as the global capital of diabetes.

Of all diabetes patients globally, 96 per cent are sufferers of Type-2 (which is preventable), the researchers said. They used the Global Burden of Disease (GBD) 2021 study and examined the prevalence, morbidity, and mortality of diabetes for 204 countries and territories by age and sex between 1990 and 2021 to forecast diabetes prevalence until 2050.

The University of Warwick professor, Stephen Lawrance, a diabetes primary expert says, "The new study presents a sobering fact that global figures for type two diabetes will increase. These new figures surpass many of the predictions we had before."

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Lawrance said, "They've used very accurate modelling studies, so it isn't just someone putting their finger in the wind and making a guess."

The latest and most comprehensive calculations showed the current global prevalence rate to be 6.1 per cent, making diabetes one of the top 10 leading causes of death and disability, the analysis said.

At the regional level, the study found the rate to be the highest in North Africa and the Middle East at 9.3 per cent, which is expected to rise to 16.8 per cent by 2050 and to 11.3 per cent in Latin America and the Caribbean.

The researchers also found diabetes to be especially evident in people 65 and older in every country, registering a global prevalence rate of more than 20 per cent for that demographic. Regionally, North Africa and the Middle East had the highest rate at 39.4 per cent in this age group, while Central Europe, Eastern Europe and Central Asia had the lowest rate at 19.8 per cent.

All 16 risk factors associated with Type-2 diabetes were studied, the researchers said, with high BMI being the primary risk factor and accounting for 52.2 per cent of Type-2 diabetes-related disability and mortality. Dietary risks, environmental/occupational risks, tobacco use, low physical activity and alcohol use were other important risk factors.

However, Ong warned against a simplistic risk-avoidance strategy. "While the general public might believe that Type-2 diabetes is simply associated with obesity, lack of exercise, and a poor diet," she said, "preventing and controlling diabetes is quite complex due to a number of factors. That includes someone's genetics, as well as logistical, social, and financial barriers within a country's structural system, especially in low- and middle-income countries."

Lauryn Stafford, second author and post-bachelor fellow at IHME, added, "Some people might be quick to focus on one or a few risk factors, but that approach doesn't take into account the conditions in which people are born and live that create disparities worldwide."

"Those inequities ultimately impact people's access to screening and treatment and the availability of health services. That's precisely why we need a more complete picture of how diabetes has been impacting populations at a granular level," Stafford noted. 

Inputs from PTI and DW