Researchers from the Global Burden of Disease Collaboration systematically assessed and modelled diabetes diagnosis and treatment in 204 countries and territories from 2000 to 2023. They found that just over half of people with diabetes aged 15 years and over are aware of their condition, and of these people, only about one fifth have adequate blood glucose control. The findings are published in The Lancet Diabetes & Endocrinology.
Diabetes mellitus is one of the most serious global health problems with a significant impact on disability and mortality, and its prevalence is increasing. Recently, various highly effective methods of glycemic control have been developed, but the system of diagnosis, treatment and monitoring of its effectiveness is far from perfect. To improve this situation, complete and up-to-date data on the current state of affairs are needed.
Lauryn Stafford of the University of Washington in Seattle and colleagues conducted a systematic analysis of data from the Global Burden of Disease (GBD) study, which included cross-sectional population-representative surveys, scientific publications, and grey literature. They used this to estimate the proportion of people with diabetes who were undiagnosed, diagnosed but not treated, and receiving treatment (insulin or any other glucose-lowering drug) with poor or fair glycemic control. Using a hierarchical Bayesian meta-regression tool, these parameters were modeled by location, year, age, and sex, and scaled to all people with diabetes in a given population.
The authors estimate that in 2023, only 55.8 percent of people with diabetes were diagnosed with the disease. Of those diagnosed, 91.4 percent were receiving some kind of treatment, but only 41.6 percent had adequate glycemic control. Of all people with diabetes, 21.2 percent had adequate glycemic control. The highest proportion of people diagnosed were in high-income countries in North America, those receiving treatment were in high-income countries in the Asia-Pacific region, and those with adequate glycemic control were in southern Latin America. The situation was worst in central sub-Saharan Africa. Compared with 2000, the proportion of people diagnosed increased by 8.3 percentage points, those receiving treatment among those diagnosed increased by 7.2 percentage points, and those with optimal glycemic control among those being treated increased by 1.3 percentage points.
Thus, despite some progress achieved over the past two decades, underdiagnosis of diabetes and suboptimal glycaemic control remain a major global problem, particularly in low- and middle-income countries.
Previous estimates have shown that the number of people with diabetes has quadrupled in 30 years, and children by 40 percent. The number of people with the disease is projected to increase from 529 million in 2021 to 1.3 billion in 2050.
