Number of people with diabetes has quadrupled over the last 35 years, study finds

Last week, researchers warned that the 2025 goal of the World Health Organization (WHO) for reining in the global obesity epidemic has “virtually zero” chance of being met.

On Wednesday, in advance of World Health Day today (April 7), WHO researchers released another study in The Lancet  that comes to the same conclusion about the agency’s 2025 diabetes target.

Well, almost the same conclusion. This time the researchers said the likelihood of meeting the diabetes target — which, like the obesity target, is to keep the rates of the disease no higher than 2010 levels — is “lower than 1 percent.”

Once again, the findings are startling. The number of adults worldwide with diabetes — primarily type 2 diabetes — has quadrupled in recent decades, from 108 million in 1980 to 422 million in 2014. According to the new study’s projections, it’s likely that 12.8 percent of men and 10.4 percent of women across the world will have diabetes in 2025, up from 9.0 percent of men and 7.9 percent in women of 2014.

That means the number of adults worldwide with diabetes will surpass 700 million by 2025.

“Diabetes has become a defining issue for global public health,” said Majid Ezzati, the study’s senior author and global health researcher at Imperial College London, in a released statement.

Diabetes rates are rising particularly quickly in China, India and many other low- and middle-income countries, he added.

Across the globe, these increases are almost entirely related to type 2 diabetes, the most common form of this chronic disease and the one associated with obesity. People who develop diabetes are at increased risk of disabling and life-threatening complications, including heart disease, kidney disease, vision loss and nerve damage, which can lead to amputation. (People with diabetes are 10 to 20 times more likely than those without the disease to have a lower limb amputated.) Diabetes can also cause complications during pregnancy.

All countries affected

For the study, an international team of researchers analyzed diabetes data from more than 750 studies conducted during the years 1980-2014 and involving 4.3 million adults in 146 of the world’s 200 countries and territories (that’s 90 percent of the world’s population).

During those 35 years, 120 countries saw their diabetes rates double in men across all age categories, and 87 countries saw a similar doubling of their rates in women. In no country did the diabetes rates significantly decline.

In 1980, women were more likely than men to have diabetes, but by 2014 those roles had reversed.

In 2014, half of adults with diabetes lived in five countries: China, India, the United States, Brazil and Indonesia. These countries also account for half of the world’s population.

Although the first three countries on that list have remained unchanged since 1980, the global share of people living with diabetes in China and India has increased, while the share of those living with diabetes in the U.S. has decreased.

In addition, higher-income European countries that were on the top-10 list for numbers of adults with diabetes in 1980, such as Germany, Italy, Ukraine and the United Kingdom, had fallen off the list by 2014. Their places have been taken by such low- and middle-income countries as Indonesia, Pakistan, Mexico and Egypt.

The rates of diabetes have become staggeringly high in some of those countries. Across many of the islands of Polynesia and Micronesia, for example, about 1 in 4 men and women have diabetes, including 1 in 3 adults in American Samoa — up 15 percentage points since 1980. And in countries in the Middle East and northern Africa, almost 1 in 6 adults have the disease.

Obesity key cause

As the study’s authors point out, much of the global rise in diabetes’ prevalence is driven by growth in the world’s population and to aging. But another key — indeed, essential — factor is obesity, which research has shown is the single biggest predictor of type 2 diabetes. Almost 90 percent of people with the disease are either overweight or obese.

Currently, about 11 percent of men and 15 percent of women across the globe are obese, according to WHO’s most recent estimates. Those rates are expected to keep climbing during the next decade.

“If we are to make any headway in halting the rise in diabetes, we need to rethink our daily lives: to eat healthily, be physically active, and avoid excessive weight gain,” said Dr. Margaret Chan, WHO’s director-general, in a released statement. “Even in the poorest settings, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes.”

But preventing type 2 diabetes is going to require more than simply telling people to eat less and exercise more.

“What’s happening in the low- and the middle-income countries quite quickly is very rapid urbanization,” Etienne Krug, director of the WHO Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, told the Washington Post. “People who used to work in the fields doing quite hard physical work, had access to vegetables and fruit very cheaply and did most of their transportation by walking or bicycle, are now living in cities where the type of work they do, the type of transportation modes they use and the type of food they eat is very different.”

Creating healthier environments in the face of that trend will require major changes from society as well as from individuals.

FMI: You can read The Lancet study on the journal’s website. WHO has also issued a “Global Report on Diabetes.”