• Diabetes is rising across the globe, killing 4.2 million people last year.
  • Middle- and low-income countries are seeing the biggest increases.
  • Over 460 million people already live with diabetes.
  • By 2045 over 700 million people will have the condition.
  • Changes to diet, exercise and quitting smoking can stop or even reverse the condition.

It’s the silent epidemic that claims 4.2 million lives around the world every yearalmost three times as many deaths as COVID-19. Diabetes is on the march, with experts predicting that one in 10 of us will be affected by 2045.

An estimated 463 million people already live with diabetes and that figure is set to rise to over 700 million by 2045, according to the latest data from the International Diabetes Federation (IDF). The condition is already one of the top 10 causes of death globally.

A world map showing differing rates of diabetes
Diabetes is on the rise in several major economies.
Image: Statista

China, the United States and India had the highest rates of diabetes last year, each with over 30 million cases, according to IDF’s latest Diabetes Atlas. The condition is rising fastest in sub-Saharan Africa with the number of cases forecast to increase by 143% by 2045.

The number of people with diabetes in the Middle East and North Africa is expected to grow by 96% in the same period with an increase of 74% forecast in South East Asia.

Diabetes is a serious, long-term condition that occurs when the body cannot produce any or enough insulin or cannot effectively use the insulin it produces. This results in a situation known as hyperglycemia where excessive blood sugar levels can cause a person to slip into a coma.

Which type?

There are two basic forms of diabetes. Type 1 diabetes cannot be prevented and is caused by an autoimmune reaction in which the body’s immune system attacks the insulin-producing cells of the pancreas. Genetic defects and viral infections are among its known causes.

Around 90% of diabetics worldwide have Type 2 diabetes, which has been linked to obesity and ageing and may have no early symptoms. Changes in diet, increased exercise, stopping smoking and maintaining a healthy body weight can manage and even reverse the condition.

The World Health Organization (WHO) says the number of cases has nearly quadrupled since 1980. When the IDF first published global data in 2000, there were an estimated 151 million people with the condition.

Part of the increase in the number of cases is the result of improved diagnosis, but the IDF says up to half of all Type 2 diabetes cases remain undiagnosed. Increasing wealth and access to unhealthy foods are also key factors in the rise in the number of people with the condition.

“Diabetes is a serious threat to global health that respects neither socioeconomic status nor national boundaries,” says IDF president Professor Nam H Cho. “If not well managed, it can lead to frequent hospital admissions and premature death.”

Global health expenditure on diabetes last year was $760 billion and is expected to reach $825 billion by 2030 and $845 billion by 2045. The WHO says most of the burden falls on middle- and low-income countries which are also seeing the greatest increase in cases.

Over 10,000 new cases are diagnosed each year among children and adolescents in sub-Saharan Africa, according to the IDF Diabetes Atlas, which says that in countries with limited access to insulin and inadequate health provision, young people “face serious complications and premature mortality”.

The United Nations Sustainable Development Goals include a pledge to ensure healthy lives for all people, listing diabetes alongside cancer and heart disease as one of the noncommunicable diseases responsible for one death every two seconds among 30-70 year olds.

A better way

But it doesn’t have to be like this. The WHO says that simple blood glucose tests could improve diagnosis and reduce the risk of long-term organ damage which often results from undiagnosed diabetes.

“A series of cost-effective interventions can improve patient outcomes, regardless of what type of diabetes they may have,” says the WHO. These interventions include controlling blood glucose levels and blood pressure and regular screening for damage to the eyes, kidneys and feet.

Last month, the World Economic Forum launched the Partnership for Health System Sustainability and Resilience in collaboration with the London School of Economics and AstraZeneca to help strengthen global healthcare in the wake of COVID-19.

The Forum said the pandemic had “exposed long-standing fault lines in health systems that were already straining to meet increasing population needs and bridge health inequalities”. Change is needed to build resilient health systems that are able to cope with long-term stresses.