Diabetes worldwide will continue to increase at record levels

The number of people with diabetes worldwide will continue to increase at record levels through 2030, with the greatest relative increase in prevalence expected in the Middle Eastern Crescent, sub-Saharan Africa and India, according to a study published in the May issue of Diabetes Care.

Researchers predict the number of people with diabetes globally will actually double over the next three decades and that the United States will experience a far more rapid increase than previously expected.

“The human and economic costs of this epidemic are enormous,” concluded the researchers, from the World Health Organization and universities in Scotland, Denmark, Australia. “A concerted, global initiative is required to address the diabetes epidemic.”

The three countries with the highest prevalence are expected to remain India, China, and the United States -- as they are today. This new study projects an even higher increase for the United States than a 2001 study by the U.S. Centers for Disease Control and Prevention. That study projected the number of Americans with diagnosed diabetes would reach 29 million by 2050; this study estimates that there will be 30.3 million Americans with diabetes by as early as 2030. The most important explanation for the difference in these figures is that the CDC estimates were based on diagnosed diabetes (and therefore did not include the 33-50% of all people with diabetes whose diabetes is undiagnosed). The new study includes people with both diagnosed and undiagnosed diabetes.

Italy and the Russian Federation are expected to drop from the top ten countries with the highest prevalence; they will be replaced by Egypt and the Philippines, according to the study’s projections.

While diabetes is expected to increase in developing countries, mortality from communicable disease and infant and maternal mortality are expected to drop during the next 30 years. The authors predict this change will lead to higher proportions of deaths from cardiovascular disease as well as a great incidence of other diabetes-related complications, which will be particularly marked in developing countries.

What’s more, the authors conclude that their projections may be too low, because they are based upon the prevalence of obesity remaining stable worldwide. In fact, the prevalence of obesity has been climbing substantially in recent years, even among children. Obesity is the leading modifiable risk factor for type 2 diabetes and is associated with the increase of type 2 diabetes among children.

The researchers strongly urge a “wider introduction of preventive approaches” for diabetes, since studies over the past several years have found strong evidence that lifestyle changes (such as losing weight and increasing physical activity), along with improved pharmacological treatments, can help reduce the risk of developing diabetes by nearly 60 percent.