Nearly 1.5 billion people will be living with diabetes by mid-century

WHO experts have calculated that in 2021, 529 million people in the world had diabetes, and by 2050 the number of such patients will increase to almost one and a half billion. These studies are published in the journal Lancet. 49.6% of this growth, according to experts, is due to the problem of obesity, and the remaining 50.4% is explained by demographic changes. About 5 million people officially live with diabetes in Russia, and the same number of citizens probably simply do not know about their diagnosis.

Almost 460 million people were living with diabetes in 2019, according to experts from the Global Burden of Disease Research (GBD), making the disease the eighth leading cause of death and disability in the world. The International Diabetes Federation (IDF) estimates that 537 million people have been diagnosed in 2021. In 98% of cases it is type 2 diabetes. Russia, according to the report, is among the countries where the prevalence of this disease is up to 4%. This is consistent with official data from the Ministry of Health: according to the register, diabetes has been diagnosed in about 5 million people. However, in September 2022, the Ministry of Health stated that in fact every 15th Russian, or 10.5 million people, lives with him.

Global health care costs due to diabetes amounted to $966 billion, according to a report published in the Lancet. By 2045, they are projected to grow by another $100 billion. At the same time, the efforts of public health authorities around the world are hardly justified: the probability of meeting the global goals to stop the increase in the prevalence of diabetes by 2025 is less than 1% for women and even lower for men.

Between 1990 and 2021, the global age-standardized prevalence of diabetes increased by an average of 90.5%. Six regions (North Africa and the Middle East, high-income North America, Central Asia, Oceania, the Andes of Latin America, and southern Latin America) showed over 100% increases in prevalence.

More than doubled in 97 (47.5%) of 204 countries and territories and more than 200% in three countries and one territory: Egypt (284.3%), Greenland (263.6%) , Timor-Leste (225.3%) and Seychelles (211.5%). The prevalence of diabetes has increased by less than 30% only in two countries – Mexico (19.7%) and the Philippines (29.1%).

To calculate how many years of healthy life a person with a chronic disease loses, the DALY indicator (Disability-adjusted life year) was developed. It gives an idea of ​​the years of life that can be lost due to loss of health or disability, and if this figure is increasing, then the number of chronic diseases is increasing. WHO experts have calculated that the average number of likely years of life lost due to diabetes worldwide by 2021 has reached 79.2 million years. 94% of DALYs are associated with type 2 diabetes. Moreover, the contribution of a high body mass index (BMI) to DALYs in type 2 diabetes increased by 24.3%. The authors of the report provided a table showing how this indicator changed from 1990 to 2021 in different countries. In Russia, according to their data, over 30 years the total probable “burden of the disease” has increased by 206% and amounted to 671 deaths per 100,000 population.

Between 2021 and 2050, global prevalence of diabetes is expected to increase by 59.7%, meaning 1.31 billion people will be living with the disease. 49.6% of this growth, according to experts, is due to the problem of obesity, and the remaining 50.4% is explained by demographic changes.

In Russia, there is a continuous increase in the prevalence of diabetes, says the CEO of Geropharm (manufacturer of insulin) Petr Rodionov. He notes that in 2016 the total number of registered patients per 100 thousand of the population was 2878.1, and in 2020 it is already 3203. “According to some experts, both in Russia and in the world, about half of the cases are not diagnosed. For example, in 2020, experts recorded a decrease in the number of new patients in Russia. But this does not mean a decrease in the incidence – most likely, the pandemic affected the diagnosis. At the same time, patients who have not been diagnosed with diabetes in a timely manner have an increased risk of developing complications due to the lack of proper control and management of the disease,” says Mr. Rodionov. He emphasizes that there are different types of diabetes. The first type is an autoimmune disease, and medicine does not yet know how to prevent its development. The second type of diabetes develops due to the lifestyle of patients: unhealthy diet and low level of activity. “It is the incidence of type 2 diabetes that is growing rapidly. Therefore, it is important to pay more attention to prevention: to instill healthy eating habits, work with eating disorders and promote physical activity,” says Petr Rodionov.

Leading endocrinologist at one of the clinics of the Nearmedic network, Yulia Khruleva, believes that diabetes mellitus is currently classified as a non-infectious pandemic of the 21st century. She cites data from the 2022 federal registry, according to which 11,848 people were first diagnosed with type 1 diabetes and 277,573 people with type 2 diabetes. Thus, the increase in prevalence for 2010–2022 was 30% for type 1 diabetes and 55.1% for type 2 diabetes. “Diabetes mellitus, in turn, contributes to the development of diseases of the cardiovascular system and microvascular complications (damage to the eyes, kidneys, nerve endings,” continues Ms. Khruleva. “The leading cause of death in patients with diabetes mellitus is diseases of the circulatory system. They kill 38.6% of patients with type 1 diabetes and 50.9% of patients with type 2 diabetes. At the same time, the number of patients who died due to diabetic causes associated with acute and chronic complications of diabetes mellitus occupies a much smaller proportion: 7.3% in type 1 diabetes and only 2.5% in type 2 diabetes. Early diagnosis and timely effective hypoglycemic therapy can not only improve the quality of life of patients, but also prolong life, Yulia Khruleva is convinced.

Natalia Kostarnova