Spotlight on diabetes around the world

Some recent studies offered a global perspective on diabetes care.

An analysis of diabetes prevalence and burden in 204 countries and territories, published by The Lancet on June 22, calculated that there are 529 million people with diabetes worldwide, for an age-standardized prevalence of 6.1%. The highest age-standardized rates were found in northern Africa and the Middle East (9.3%) and Oceania (12.3%). Qatar had the world's highest age-specific prevalence of diabetes: 76.1% of residents ages 75 to 79 years had diabetes there. Type 2 accounted for 96.0% of cases, and 52.2% of the disability-adjusted life-years lost to type 2 diabetes were attributable to high body mass index (BMI). The study authors calculated that by 2050, more than 1.31 billion people in the world will have diabetes, with 43.6% of the studied countries and territories having an age-standardized rate greater than 10%. The study's results should be useful for policymakers, said the authors. “Our estimates should also serve as a rallying call to galvanise increased research funding to identify and develop more effective measures to prevent diabetes that are economically and behaviourally sustainable at a population level across the world,” they wrote. “Diabetes was already a substantial concern in 2021 and is set to become an even greater public health issue over the coming three decades, with no effective mitigation strategy currently in place.”

Diabetes control in China was the focus of a study published by Annals of Internal Medicine on Aug. 1. It used a sample of 8,401 adults with self-reported diabetes in 2015 to 2017, including a subset of 3,531 with dietary data to assess achievement of ABC targets (individualized HbA1c level, blood pressure <130/80 mm Hg, and low-density lipoprotein cholesterol level <2.6 or <1.8 mmol/L [<100 or <70 mg/dL] depending on cardiovascular disease status), BMI below 24 kg/m², and lifestyle and dietary targets. The proportion of participants who achieved the three ABC targets was 64.1%, 22.2%, and 23.9%, respectively. The BMI target was met by 32.2%, and achievement of lifestyle targets ranged from 75.8% to 52.0%. Only 4.4% of participants achieved all three ABC targets, 5.1% achieved all four lifestyle targets, and a total of four participants achieved all five dietary targets. “National programs aimed at providing evidence-based, affordable, and accessible diabetes care and improving skills for self-management of diabetes are urgently needed for all Chinese people with diabetes,” concluded the study authors.

Another study, published by JAMA Internal Medicine on July 31, used India's Fifth National Family Health Survey to assess prevalence and treatment of diabetes among more than 1.6 million adults with available blood glucose measures. The rate of diabetes was 6.5%, and 74.2% of patients with diabetes reported having been diagnosed. Medications were used by 59.4% of diagnosed patients, and 65.5% had achieved control (defined as fasting blood glucose ≤126 mg/dL [3.99 mmol/L] and nonfasting ≤180 mg/dL [9.99 mmol/L]). Those in urban areas, older age groups, and wealthier households were more likely to be diagnosed and treated. Overall, 34.8% of studied districts met the World Health Organization Global Diabetes Compact targets of 80% of diabetes patients being diagnosed, and only 10.7% met the target of 80% controlled among those diagnosed. The results show “considerable district-level variation, age-related disparities, and rural-urban differences” in diabetes diagnosis and control, the study authors observed. “India's rising diabetes burden across all sociodemographic groups presents a challenge for public health and health care,” they said.