India among the countries with the highest estimated prevalence of Type 1 Diabetes
N.B. Nair
New Delhi (ISJ): An estimated 8.4 million people were living with Type 1 Diabetes (T1D) across the globe in 2021, according to the results of a new modelling study published in The Lancet Diabetes & Endocrinology. This number is predicted to increase to 13.5-17.4 million people living with T1D by 2040.
“Given that prevalence of people with T1D is projected to increase in all countries to up to 17.5 million cases in 2040, our results provide a warning for substantial negative implications for societies and healthcare systems,” said Prof. Graham Ogle, one of the authors of the study at Sydney Medical School, University of Sydney, Australia.
Prof. Ogle said, there is an opportunity to save millions of lives in the coming decades by raising the standard of care for T1D (including ensuring universal access to insulin and other essential supplies) and increasing awareness of the signs and symptoms of T1D to enable a 100 percent rate of diagnosis in all countries.
What is T1D?
Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition. In this condition, the pancreas makes little or no insulin. Insulin is a hormone the body uses to allow sugar (glucose) to enter cells to produce energy.
Data on T1D prevalence and mortality is rarely available in most countries – missing data usually relates to low- and middle-income countries and adult populations, with most previous studies calculating T1D incidence based on European and North American data. The 2017 Lancet Diabetes & Endocrinology Commission on Diabetes in sub-Saharan Africa, WHO, and World Health Assembly have all stated an urgent need for worldwide data on T1D. This new study aims to answer these calls, providing modeling estimates that are highly comparable to observed data and estimating missing prevalence for the first time, providing a more meaningful basis for change in T1D care and policy.
Researchers modelled data on childhood, adolescent and adult T1D prevalence in 97 countries, along with incidence over time data from 65 countries and mortality data from 37 countries to predict T1D incidence, prevalence, and mortality in 2021 for 201 countries, with projections of future prevalence through 2040. The estimates were tested for accuracy against real-world prevalence data from 15 countries.
In 2021, the model estimated that 8.4 million individuals worldwide were living with T1D. Of these individuals, 18 percent were under 20 years old, 64 percent between 20-59 years, and 19 percent were over 60 years. Although historically T1D has been a disease associated with onset in childhood, these results reveal that numerically more adults than children are diagnosed every year (316,000 vs 194,000 incident cases worldwide in 2021), with a mean diagnosis age of 32 years.
“These findings have important implications for diagnosis, models of care, and peer support programs. Such programs, in countries where they exist, are almost exclusively designed, and delivered for children and youth with T1D. In addition, our findings emphasize the urgent need for enhanced surveillance and data collection on T1D incidence, prevalence, and mortality in adult populations – an area where data are especially scarce,” says Prof. Dianna Magliano, one of the authors of the study at Monash University, School of Public Health and Preventive Medicine, Melbourne Australia.
The ten countries with the highest estimated T1D prevalence USA, India, Brazil, China, Germany, UK, Russia, Canada, Saudi Arabia, and Spain account for 5.08 million (60 percent) of global cases of T1D. Model estimates also suggest that 21 percent of individuals with T1D live in low-income countries and low and middle-income countries.
Model estimates place global deaths due to T1D at 175,000 in 2021. Of these, 35,000 or 20 percent were attributed to non-diagnosis, of which 14,500 were in sub-Saharan Africa and 8,700 in South Asia. The researchers estimate that an extra 3.1 million people would have been alive in 2021 if they hadn’t died prematurely due to suboptimal care of T1D, and a further 700,000 people would still be alive if they hadn’t died prematurely due to non-diagnosis.
The projected T1D prevalence in 2040 given by the model was is 13.5-17.5 million people, with highest relative increases, predicted to occur in low-income countries and low and middle-income countries. Conservative estimates place the relative increase in the number of people living with T1D by 2040 compared to 2020 at 66 percent.
Source: The Lancet
Image: Representational
