New estimates published in The Lancet indicate that more than 1·31 billion people could be living with diabetes by 2050 worldwide. That’s 1·31 billion people living with a disease that causes life-altering morbidity, high rates of mortality, and interacts with and exacerbates many other diseases.
The increase in prevalence (up from 529 million in 2021) is expected to be driven by increases in type 2 diabetes, which in turn will be caused by a rise in the prevalence of obesity and by demographic shifts. In 2021, type 2 diabetes accounted for 90% of all diabetes prevalence. Most of this burden is attributable to social risk factors—such as high BMI, dietary risks, environmental and occupational risks, tobacco use, alcohol use, and low physical activity—that thrive on the obesogenic way our environments are designed and the inequitable way we organise our resources and societies.
Currently, only 10% of people with diabetes living in these countries receive guideline-based diabetes care.The Lancet and The Lancet Diabetes and Endocrinology
Timed to coincide with the American Diabetes Association’s 83rd Scientific Session, The Lancet and The Lancet Diabetes and Endocrinology publish a Series on Global Inequity in Diabetes. Two papers—one global and one focused on the USA—together tell the unhappy and inequitable story of diabetes. By 2045, as many as three in four adults with diabetes will be living in low-income and middle-income countries.
Currently, only 10% of people with diabetes living in these countries receive guideline-based diabetes care. Regardless of economic category, in every country, those who are discriminated against and marginalised suffer the most and worst consequences of diabetes. In the USA, where the burden of type 2 diabetes in young people has nearly doubled in the past 20 years, the highest burden is seen among Black or Indigenous American populations.
Photo by Polina Tankilevitch