More than half of the estimated 800 million adults who have diabetes are not receiving treatment for their condition, research shows. The World Health Organisation had previously estimated that about 422 million people have diabetes, a chronic disease involving blood sugar levels, which can damage the heart, blood vessels, nerves and other organs if untreated. The rise of the condition has seen a corresponding treatment gap as proportionally fewer people seek medical help.
The study was carried out by the NCD Risk Factor Collaboration and the WHO, and is the first global analysis to include rates and treatment estimates for all countries, the authors said. It is based on more than 1,000 studies involving more than 140 million people. Three out of five (59%) of adults aged 30 years and older with diabetes. A total of 445 million, were not receiving medication for diabetes in 2022, three and half times the number in 1990 (129 million).
About 14% of people now have the condition globally, rising to 7% in the past three decades, with much of the burden falling on low and middle-income countries. The rate of diabetes stayed the same or even fell in some wealthier countries, such as Japan, Canada or Western European nations such as France and Denmark, the study said.
WHO Director-General Dr Tedros Adhanom Ghebreyesus said in a statement that the rise documented in the study was alarming. “To bring the global diabetes epidemic under control, countries must urgently take action,” he said, including with policies supporting healthy diets and physical activity, as well as health systems that can prevent, detect and treat the condition.
East Asia and the Pacific, as well as Canada and South Korea, have seen vast improvements in treatment rates for diabetes resulting in more than 55% of people with diabetes in these countries receiving treatment in 2022. The highest treatment rates were estimated in Belgium, at 86% for women and 77% for men.
However, for many low and middle-income countries diabetes treatment coverage has stayed low and changed little over the previous three decades, with over 90% of people with diabetes not receiving treatment in some countries in both 1990 and 2022. In sub-Saharan Africa, only five to 10% of adults with diabetes received treatment in 2022. In addition, just 10% of people with diabetes in the Middle East and North African region received treatment, according to the study.
In 2022, about 133 million people with untreated diabetes lived in India, more than 50% greater than the next largest number which was in China with 78 million. Similarly, Pakistan had 24 million cases and Indonesia had 18 million cases, the next two countries with the largest number of untreated diabetes surpassed the USA with 13 million untreated cases.
“Our study highlights widening global inequalities in diabetes, with treatment rates stagnating in many low- and middle-income countries where numbers of adults with diabetes are drastically increasing,” said senior study author Majid Ezzati of Imperial College London. “This is especially concerning as people with diabetes tend to be younger in low-income countries and, in the absence of effective treatment, are at risk of lifelong complications.”
Those complications include “amputation, heart disease, kidney damage or vision loss – or in some cases, premature death,” he said.
