828 Million Adults Worldwide Have Diabetes: 59% of Those Aged 30 and Older Go Untreated

An analysis estimating that about 828 million adults aged 18 and older worldwide have diabetes was published in The Lancet. The NCD Risk Factor Collaboration (NCD-RisC), a network of researchers around the world, estimated trends in prevalence and treatment rates in 200 countries and territories all at once.

1,108 population-representative surveys, 141 million people

The researchers pooled data from 1,108 population-representative surveys with 141 million participants in which fasting blood glucose and glycated hemoglobin (HbA1c) were actually measured. Diabetes was defined as any of the following: fasting blood glucose of 7.0 mmol/L or higher, HbA1c of 6.5% or higher, or taking diabetes medication. Trends by country were calculated using a Bayesian hierarchical meta-regression model.

Over the roughly 30-year analysis period, the number of adults with diabetes rose by about 630 million. Age-standardized prevalence rose in 131 countries for women and 155 countries for men, with the largest increases in low- and middle-income countries in Southeast Asia, South Asia, the Middle East and North Africa, and Latin America. Of people aged 30 and older with diabetes, 445 million (59%) were not receiving drug treatment, which is 3.5 times the number at the start of the analysis. Korea's treatment rate rose substantially, placing it in the group of countries with treatment rates of 55% or higher.

Prevalence is rising, but treatment is standing still

In some countries in sub-Saharan Africa and South Asia, the treatment rate was under 10%. The researchers proposed that expanding health insurance and primary care must be accompanied by early detection and treatment programs. However, countries with little survey data rely heavily on model estimates, and because treatment was defined only as taking medication, the analysis does not reflect whether blood glucose is actually well controlled.