Diabetes is influenced by a complex interaction of behavioural, genetic and socioeconomic factors, many of which are outside our individual control.
Three in four people living with diabetes (352 million people) are of working age (i.e. between 20 and 64 years old). This number is expected to increase to 417 million by 2030 and to 486 million by 2045.
This generates a growing human impact and will also drive a serious and expanding strain on productivity and economic growth in the coming decades.
In 2019, the estimated number of people over 65 years of age with diabetes is 111 million. One in five adults in this age group is estimated to have diabetes
It is projected that by 2030 the number of people over 65 with diabetes will further increase to 195 million. By 2045, it will reach 276 million. These data point to substantial increases in the diabetes population of ageing societies in the next 25 years, as well as the inevitable public health and economic challenges this will bring.
An estimated 1.1 million children and adolescents (aged under 20) have type 1 diabetes. There is some evidence that type 2 diabetes among children and adolescents is increasing in some counties, but it is not currently possible to estimate the numbers due to a lack of data.Read more
The IDF Middle East and North Africa (MENA) Region has the highest age-adjusted prevalence of diabetes in adults in 2019, 2030 and 2045 (12.2%, 13.3% and 13.9% respectively).
The IDF Africa (AFR) Region has the lowest age-adjusted prevalence in 2019, 2030 and 2045 (4.7%, 5.1% and 5.2%), which can be partly attributed to lower levels of urbanisation, under-nutrition and lower levels of overweight and obesity. However, the number of people with diabetes in this Region is expected to increase in 143% by 2045 – the largest percentage increase of all regions over that period.
In 2019, the countries with the largest numbers of adults with diabetes are China, India and the United States of America, and are anticipated to remain so until 2030.
It is projected that the number of people with diabetes in Pakistan will exceed that in the United States of America by 2045, moving the country to third place.
The Region with the highest estimated number of diabetes-related adult deaths is the IDF Western Pacific (WP) Region, where 1.3 million deaths are due to diabetes each year. This is followed by the IDF South-East Asia (SEA) Region, with 1.2 million deaths. The Region with the lowest number of diabetes-related deaths is the IDF South and Central America (SACA) Region (0.2 million).Read more
Inequalities in access to quality healthcare persist, particularly in low- and -middle-income countries. Diabetes is often undiagnosed or inadequately treated, with people unable to access the essential medicines and devices they need.
While found everywhere, low-income countries have the highest proportion of undiagnosed diabetes, at 66.8% (two in three people with diabetes). This is due to a combination of limited access to healthcare services, inadequate training among healthcare professionals and lack of awareness of the symptoms among the general population.
In many less-resourced countries, health worker awareness about type 1 diabetes is low and glucose testing facilities are limited, meaning the disease is often mistaken for malaria, pneumonia or various other conditions.
If the diagnosis of type 1 diabetes is delayed or missed, the risk of serious complications and mortality rises. If missed entirely, the person will likely die. This may be the most common reason for the death for children with type 1 diabetes globally.
In countries with limited access to insulin and inadequate health service provision, children and adolescents with type 1 diabetes, even when correctly diagnosed, face serious complications and often premature death.
Nine out of 10 live births affected by hyperglycaemia in pregnancy are seen in low- and middle-income countries, where access to antenatal care may be limited.
Worldwide, many people with type 1 diabetes cannot access the insulin they need to survive. Additionally, it is estimated that one in two people with type 2 diabetes do not have access to the insulin they have been prescribed. Populations from low-income settings suffer the most from lack of availability to diabetes medicines. For example, 86% (four in five) of people with type 2 diabetes in Africa do not have access to the insulin they need.
Ninety percent of all diabetes-related premature deaths and 87% of all diabetes-related deaths happen in low- and middle-income countries. This can be attributed to the lowest rates of diabetes diagnosis and the difficulties in accessing diabetes care in these settings, when compared to high-income countries.
Diabetes did not attract much political attention in the past, but this has improved in the last 15 years with the adoption of several international commitments.
As a diabetes advocate, you need to bring the international commitments to the national sphere, by using them to underpin your requests to governments. If you see that your country's progress towards the objectives is insufficient, hold your government accountable by requesting stronger and more effective actions to address the existing gaps.