Global burden of type 1 diabetes likely to double by 2040, study predicts

An estimated 8.4 million people living with type 1 diabetes Worldwide in 2021, according to the results of a new modeling study published in (T1D) The Lancet Diabetes and EndocrinologyThis number is projected to rise to 13.5 million to 17.4 million T1D patients by 2040.

“Given that the prevalence of T1D patients is projected to increase to up to 17.5 million cases in all countries by 2040, our results have significant negative implications for society and health systems. The world has an opportunity to save millions of lives by improving the standard of care for type 1 diabetes (ensuring universal access to insulin and other needed supplies). ), aiming for decades to come by increasing awareness of the signs and symptoms of type 1 diabetes, enabling 100% diagnosis rates in all countries, now available in open source. , making data on the burden of T1D more widely accessible and serving as a platform for stakeholders to improve T1D care and outcomes,” said Graham Ogle, Sydney Medical School, one of the study’s authors. the professor said. , University of Sydney, Australia.

Data on the prevalence and mortality of T1D are rarely available in most countries. The missing data are usually related to LMICs and the adult population, and most previous studies have calculated the incidence of T1D based on European and North American data. The 2017 Lancet Diabetes and Endocrine Commission on Diabetes in Sub-Saharan Africa, WHO, and WHA all said there is an urgent need for global data on T1D. This new study aims to meet these demands, providing modeling estimates that are highly comparable to observed data, estimating defect prevalence for the first time, and providing guidance for T1D care and policy change. It provides a more meaningful foundation. Results will be published in an open source database as part of the T1D Index project. This project aims to help health planners, professionals and advocates improve care and health outcomes.

Researchers modeled data on childhood, adolescent, and adult T1D prevalence from 97 countries, together with longitudinal incidence data from 65 countries and mortality data from 37 countries, to We projected the country’s 2021 T1D incidence, prevalence, and mortality, and predicted future prevalence. Estimates were tested for accuracy against actual prevalence data from 15 countries.

By 2021, the model estimated that there will be 8.4 million people with T1D worldwide. Of these individuals, 18% were under the age of 20, 64% were between the ages of 20 and 59, and 19% were over the age of 60. While T1D has historically been a disease associated with childhood onset, these results reveal that, numerically, more adults are diagnosed each year than children (in 2021). 194,000 cases compared to 316,000 cases worldwide), with a mean age of diagnosis of 32 years.

“These findings have important implications for diagnosis, models of care, and peer support programs. Furthermore, our findings highlight the urgent need for enhanced surveillance and data collection on the incidence, prevalence, and mortality of T1D in the adult population. – areas where data are particularly scarce,” said one of the study’s authors, Professor Dianna Magliano of the School of Public Health and Prevention at Monash University. Medicine, Australia, Melbourne.

The 10 countries with the highest estimated T1D prevalence are the United States, India, Brazil, China, Germany, United Kingdom, Russia, Canada, Saudi Arabia, and Spain, accounting for 5.08 million (60%) of global T1D cases . Model estimates also suggest that 21% of T1D patients live in his LIC and LMIC.

Models estimate 175,000 global deaths in 2021 from T1D. Of these, 35,000 or 20% were attributable to undiagnosis, of which 14,500 were in sub-Saharan Africa and 8,700 in South Asia. Researchers estimate that 3.1 million more people would have survived in 2021, and an additional 700,000 would have survived had they not died prematurely from undertreated T1D. . .

“Our findings indicate that the overall footprint of T1D is much larger than previous estimates indicated, which is significant when the prevalence gap due to excess mortality is considered. This is especially true in low- and middle-income countries such as sub-Saharan Africa, which accounts for 357,000 cases of T1D, or 4% of the global prevalence, but 23% of the lives lost each year. (40,000), highlighting the urgent need to raise awareness of the signs and symptoms of T1D in low- and middle-income countries,” said Professor Kim Donaghue. One of the authors of this study, Sydney Medical School, University of Sydney, Australia.

The projected T1D prevalence in 2040 given by the model is 13.5 to 17.5 million, with the largest relative increases predicted for LIC and LMIC. Conservative estimates estimate that the number of people with type 1 diabetes will increase by 66% by 2040 compared to 2020.

The results of these country-level modeling will be used by policy makers, researchers, and health professionals alike to improve the surveillance of T1D worldwide, build initiatives to promote universal health coverage programs, and promote T1D. We want care to become available and affordable for all. The substantial global burden of this disease. ”

Tom Robinson, Study Author, Juvenile Diabetes Research Foundation, Australia

The authors acknowledge some limitations regarding this study, such as the lack of data to input into the model. Data for lower-middle income countries and his pre-1975 adult population are more limited. Information obtained based on extrapolation from nearby countries may be imprecise depending on genetic and environmental factors. In addition, estimates of undiagnosed mortality are based on clinician impressions and may be higher or lower than the actual situation. Prior to 1980, information on mortality in diagnosed cases is scarce.

In the linked comments, Hui Shao of the University of Florida, USA, who was not involved in this study, said: […] A global call for action to alleviate the issue of insulin access and affordability. Possible solutions are multifaceted and many depend on the country’s political and economic environment. In short, countries need to strengthen insulin price regulation and reimbursement policies while ensuring access to insulin and establishing subsidy programs to meet growing insulin demand. ”