Diabetes Cases Have Doubled Globally, With Health Disparities Soaring.

A woman with diabetes monitors her glycemia in Paris on March 24, 2020. (Photo by FRANCK FIFE / … [+] AFP) (Photo by FRANCK FIFE/AFP via Getty Images)

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More than 800 million individuals have diabetes globally, doubling in the last three decades according to research recently published in The Lancet.

This represents an increase of 630 million individuals since 1990, with 14% of the global population with the disease. More than half of global cases were concentrated in four countries- the most in India, followed by China, the United States and Pakistan.

The largest increase in diabetes cases occurred in low and middle-income countries, such as Malaysia, Pakistan and Egypt.

These health disparities are amplified by the lack of treatment for many diabetics around the world. In 2022, more than half of diabetics, or 445 million adults aged 30 and over did not receive treatment for diabetes, which represents 3.5 times the number in 1990. Treatment coverage was lowest in many middle and low-income countries, particularly countries in sub-Saharan Africa and south Asia.

The study sheds light on the growing inequities in the prevalence and treatment of a chronic debilitating disease that can decrease the quality of life for millions of individuals around the world. Diabetes occurs when blood sugar levels are too high. It can be genetic whereby the body does not produce enough insulin (type I diabetes), which is a hormone that decreases blood sugar levels, or when the body cannot use insulin properly (type II diabetes). The vast majority (90-95%) of diabetics are type II, which is largely preventable with a healthy diet and regular exercise. The rise of obesity, ultra-processed foods and lack of physical activity have perpetuated an epidemic in type II diabetes.

Diabetes can take a significant toll on one’s health. Too much sugar in the blood can damage blood vessel and ultimately lead to heart disease, kidney failure and vision loss. In fact, diabetes is the eighth leading cause of death and the number one cause of kidney failure, lower leg amputations and adult blindness in America.

Major systemic changes that involve health policy and healthcare access must be implemented in order to narrow the global gap in diabetes prevalence and treatment, which has resulted in an increasing number of people with both diabetes and untreated diabetes living in middle and low-income countries.

The study underscores the importance of tackling the obesity epidemic, with one billion individuals projected to be living with obesity by 2030, according to the World Obesity Federation. A proactive approach should be adopted globally to screen as many patients as possible at health visits to identify those with diabetes early, so early intervention can be performed along with education to prevent detrimental complications of the disease.

In addition, widespread access to healthier food options that are cheaper and readily available, particularly among underserved poorer communities will help keep people healthy and mitigate obesity and ultimately a diagnosis of type II diabetes. Investments in parks and fitness centers that can serve the entire population, not just the wealthy, will be crucial in decreasing the burden of disease globally.

A major bottleneck in addressing the scope of diabetes is also the lack of treatment among low and middle-income countries for diabetes. Universal healthcare insurance that is affordable or subsidized by the government needs to be considered in these countries, coupled with an infrastructure that supports preventive doctor visits to treat and address diabetes throughout the population. These barriers must all be addressed in order to move the needle for a healthier global environment.

The vast majority of diabetes cases can be entirely prevented. The world must take notice of the enormous inequities that are plaguing diabetics globally. Without intervention, millions upon millions of individuals will continue to suffer.

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