The number of people with diabetes worldwide is estimated to have risen by about 133% to approximately 350 million, researchers from Imperial College London and Harvard School of Public Health report in the medical journal The Lancet. The authors explain that the main reason for this rise has been longer life spans – people today live longer and diabetes risk increases with age. However, obesity and overweight are also factors that have contributed considerably.

Authors, Professor Majid Ezzati and Dr Goodarz Danaei wrote that diabetes rates have risen in virtually every corner of the globe since 1980 – in a very small number of places where incidences have not gone up, they have remained stable.

People with diabetes cannot control their blood sugar levels properly. If somebody has diabetes type 1 it is because their insulin-producing beta cells in the pancreas have been destroyed – they produce no insulin. Patients with diabetes type 2 are either not producing insulin properly, or their bodies (cells) are not responding to insulin in the way they should (insulin sensitivity). Inadequate blood sugar control can lead to stroke, heart disease, and damage to retinae, nerves and kidneys.

Diabetes and elevated glucose cause about 3 million deaths worldwide annually – experts say this number will increase.

The authors evaluated FPG (fasting plasma glucose) records from 2.7 million individuals aged 25+ years worldwide, and estimated prevalence using advanced statistical methods. They worked out that worldwide there were approximately 153 million people with diabetes in 1980, and 347 in 2008. This is a much higher figure than a 2009 estimate of 285 million.

They believe 70% of this increase is due to longer life-spans – people are living longer. The older you are, the higher your risk is of developing diabetes. Other risk factors, including obesity are probably responsible for the remaining 30%, the authors added.

Between 1980 and 2008:

  • Adult male diabetes prevalence rose by 18%, from 8.3% to 9.8%
  • Adult female diabetes prevalence rose by 23%, from 7.5% to 9.2%

The reason the total number more than doubled while the percentage prevalence increase rose at a different rate is simply because over the last 30 years the world’s population has grown considerably.

Diagnosing diabetes – doctors test a patient’s blood glucose levels after he/she has fasted for between 12 and 14 hours. Any readings below 5.6 millimoles per litre (mmol/L) are considered normal, while from 5.6 to 7 are considered pre-diabetes, and above 7 are diagnosed as diabetes. Mean global FPG (fasting plasma glucose) has gone up over the last 30 years in both sexes.

FPG rises have not been the same in high-income nations. In the USA, for example, rates have increased at twice that seen in Western Europe. Industrialized countries with the highest FPG rates are the USA, Spain, New Zealand, Malta and Greenland, while France, Austria and the Netherlands have the lowest.

The UK is an enigma. It has a high obesity rate compared to other rich nations, but diabetes prevalence among men are the 5th lowest while among women are the 8th lowest.

Pacific Island countries have experienced the highest increase in diabetes rates, including the Marshall Islands, where one-third of adult females and one-quarter of adult males have diabetes. Diabetes rates in Saudi Arabia have risen markedly, as have rates in the rest of the Middle East, North Africa, Central Asia and the Caribbean. Prevalence in Eastern Europe changed little over the thirty-year period.

The researchers identified a close parallel between BMI (body mass index) and diabetes rates globally. The link was closer among males than females.

They added:

“However, genetic factors associated with ethnic origin, fetal and early life nutritional status, diet quality, and physical activity might also affect glycemic values and trends (and therefore diabetes prevalence_.”

Professor Ezzati wrote:

“Diabetes is one of the biggest causes of morbidity and mortality worldwide. Our study has shown that diabetes is becoming more common almost everywhere in the world. This is in contrast to blood pressure and cholesterol, which have both fallen in many regions. Diabetes is much harder to prevent and treat than these other conditions.”

Dr. Danaei added:

“Unless we develop better programmes for detecting people with elevated blood sugar and helping them to improve their diet and physical activity and control their weight, diabetes will inevitably continue to impose a major burden on health systems around the world.”

Dr Martin Tobias, Health and Disability Intelligence, Ministry of Health, Wellington, New Zealand, wrote, in conclusion:

“Worldwide..the urgent need is to strengthen basic surveillance of dysglycaemia and diabetes, including standardised frameworks, case definitions, survey methods, tools, and reporting protocols. The forthcoming high-level meeting of the UN General Assembly on the Prevention and Control of Non-communicable Diseases (New York, Sept 19-20, 2011), provides a welcome opportunity to strengthen global commitment to non-communicable disease surveillance.”

“National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2•7 million participants”
Goodarz Danaei MD, Mariel M Finucane PhD, Yuan Lu MSc, Gitanjali M Singh PhD, Melanie J Cowan MPH, Christopher J Paciorek PhD, John K Lin AB, Farshad Farzadfar MD, Prof Young-Ho Khang MD, Gretchen A Stevens DSc, Mayuree Rao BA, Mohammed K Ali MBChB, Leanne M Riley MSc, Carolyn A Robinson MSc, Prof Majid Ezzati PhD
The Lancet, Early Online Publication, 25 June 2011 doi:10.1016/S0140-6736(11)60679-X

Written by Christian Nordqvist