The number of people living with type 1 diabetes globally could increase to between 13.5 million to 17.4 million people by 2040.
A modeling study published in The Lancet Diabetes & Endocrinology projects that type 1 diabetes will increase in all countries by 2040, rising from the 8.7 million people now living with type 1 diabetes.
“Our results provide a warning for substantial negative implications for societies and healthcare systems. There is an opportunity to save millions of lives in the coming decades by raising the standard of care for T1D (including ensuring universal access to insulin and other essential supplies) and increasing awareness of the signs and symptoms of T1D to enable a 100 percent rate of diagnosis in all countries,” Dr. Graham Ogle, co-author of the study and adjunct professor at the University of Sydney in Australia, said in a statement.
The modeling suggests that the top 10 countries with the highest prevalence of type 1 diabetes are the United States, India, Brazil, China, Germany, the United Kingdom, Russia, Canada, Saudi Arabia, and Spain.
These countries account for 60% of global cases of type 1 diabetes, or slightly more than 5 million people.
The modeling also suggests that 21% of people who live with type 1 diabetes live in low-income countries and lower-middle-income countries.
Dr. Marilyn Tan, a clinical associate professor of medicine in endocrinology at Stanford University in California, says the projected increase in people living with diabetes could be due to improvements in testing as well as diabetes management.
“The modeling showed a significant number of individuals diagnosed were in low-income and lower-middle-income countries. Some of this may be due to increased access to care, increased awareness of type 1 diabetes in adults [and] non-adolescents, and increased diagnostic testing,” she told Healthline.
“The higher number of people living with type 1 diabetes may also reflect that we are doing a better job at managing diabetes and its complications,” Tan added. “Before insulin was readily available, people died soon after a diagnosis of type 1 diabetes. With modern insulins, glucose monitoring tools and delivery systems, education, and adjunctive therapies, people with diabetes are living much longer, so the prevalence increases just by having more people with diabetes staying alive.”
Prevalence refers to the proportion of people living with a condition during a specific period of time. Incidence refers to the rate of new cases that occurred during a given period of time.
Tan says while an increase in the prevalence of diabetes could be indicative of improved life expectancy for those with diabetes, an increase in incidence would be problematic.
“We don’t want an increase in the incidence of diabetes. Diabetes creates a real health burden. It’s cumbersome for patients/families to manage, it is an expensive disease to manage both for patients and the healthcare system, and importantly, it increases morbidity and mortality because diabetes (especially if poorly controlled) can increase the risk of many types of complications,” she said.
“Diabetes doubles the cardiovascular risk and increases the risk of other complications such as eye disease, kidney disease, neuropathy, and infections,” Tan also noted, “These can lead to increased healthcare utilization (clinic visits, testing, and procedures, medications), increased need for surgeries, and increased hospitalizations. Patients with poorly controlled diabetes frequently also fare less well than patients without diabetes. It takes longer for infections to improve and longer for wounds to heal. Insulin and diabetes medications, testing supplies, and diabetes technology are all very costly, as well.”
While historically type 1 diabetes was considered to be a disease beginning in childhood, the modeling suggests that in 2021 more adults than children were diagnosed with type 1 diabetes The mean age of diagnosis was 32.
Type 1 diabetes is believed to be caused by an autoimmune reaction in the body. The immune system attacks cells in the pancreas called beta cells that make insulin.
Researchers believe a number of factors could trigger this autoimmune response.
“There is some evidence that environmental factors trigger type 1 diabetes, especially among those that carry certain genes. These factors include the early introduction of cow’s milk, short duration of breastfeeding, and perhaps even pollution,” Dr. David Robbins, an endocrinologist and director of the Cray Diabetes Self-Management Center at the University of Kansas Health System, told Healthline.
“One fascinating speculation is that type 1 diabetes is entirely a modern disease. Scant descriptions of diabetes from ancient literature seem to only describe type 2 diabetes,” he added.
Studies suggest there is also an increased risk of new-onset diabetes due to COVID-19.
The researchers of the Lancet study say their modeling shows the overall scope of type 1 diabetes around the world is much higher than originally estimated.
They hope their work will help improve access to care for those living with type 1 diabetes.
“We hope that these country-level modeling results will be used by policymakers, researchers, and healthcare professionals alike to build initiatives that improve surveillance of T1D worldwide and encourage Universal health coverage programs, so that T1D care is available and affordable to all, addressing the substantial global burden of this disease,” Tom Robinson, a co-author of the study and a researcher at Juvenile Diabetes Research Foundation in Australia said, in a statement.
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Current Version
Oct 6, 2022
By
Elizabeth Pratt
Edited By
David Mills
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