As of 2014, 422 million adults globally had diabetes, nearly four times as many as in 1980, according to findings of the largest ever worldwide study of the condition, published in The Lancet. Treatment costs now stand at $825 billion a year.

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Experts call for interventions to prevent diabetes among high-risk groups.

If the trend continues, over 700 million adults globally will have diabetes by 2025.

Diabetes renders an individual unable to regulate their blood sugar levels, potentially leading to heart and kidney disease, vision loss and amputations.

Nearly 500 researchers worldwide participated in the study, which was led by a team from Imperial College London in the UK and involved the Harvard T.H. Chan School of Public Health in Boston, MA, as well as the World Health Organization (WHO).

It reviewed data for 4.4 million adults, representing most countries in the world.

The study did not differentiate between type 1 and type 2 diabetes, as this information was largely unavailable from the raw data. Type 2 diabetes accounts for at least 85-90% of cases.

The teams compared levels of diabetes in adult men and women from 1980-2014.

After adjusting figures for age, and taking into account those countries with a larger aging population, results showed that globally, the rate of diabetes in men more than doubled, from 4.3% in 1980 to 9% in 2014. Among women, rates rose from 5% in 1980 to 7.9% in 2014.

Fast facts about diabetes
  • In the US, 21 million people were living with diagnosed diabetes in 2014
  • Including undiagnosed cases, the Centers for Disease Control and Prevention (CDC) put the total figure at 29.1 million
  • That is equivalent to 9.3% of the population.

Learn more about diabetes

In the US, the rate of diabetes among men rose from 4.7% in 1980 to 8.2% in 2014. In 1980, 4.3% of American women had diabetes, rising to 6.4% in 2014. The US currently ranks 114th for men and 146th for women in the world.

Countries with the lowest age-adjusted rates of diabetes in 2014 were in northwestern Europe, specifically in Switzerland, Austria, Denmark, Belgium and the Netherlands, with a prevalence of around 4% for women and 6% for men.

Polynesia and Micronesia had the highest rates, with more than 1 in 5 adults affected.

Overall, low- and middle-income countries saw the largest rise.

The financial burden of diabetes, including the cost of treating and managing the disease and its complications, such as limb amputations, calculated in International Dollars, stood at $825 billion per year.

The cost of working days lost would increase the sum dramatically, were it included.

Individual countries with the highest costs were China ($170 billion), the US ($105 billion) and India ($73 billion).

Other highlights of the survey show:

  • The highest increase was in the Pacific Island nations and in the Middle East and North Africa, which now have the highest diabetes levels worldwide
  • After age-adjustment, 6.6% of men and 4.9% of women in the UK had diabetes in 2014
  • Around 50% of the 422 million adults with diabetes in 2014 lived in five countries: China, India, US, Brazil and Indonesia.

Senior author Prof. Majid Ezzati, from the School of Public Health at Imperial College, says:

“This is the first time we have had such a complete global picture about diabetes, and the data reveals the disease has reached levels that can bankrupt some countries’ health systems. The enormous cost of this disease, to both governments and individuals, could otherwise go towards life essentials such as food and education.”

Prof. Ezzati believes that the key to tackling the crisis is to focus on helping individuals who are at risk of developing the condition.

He calls for “financially accessible and effective health systems that can highlight those at high risk of diabetes or at pre-diabetes stage.”

This, he says, will enable health care staff to provide medication and lifestyle advice that can slow or prevent the development of diabetes. This has already been done in some European countries.

Prof. Goodarz Danaei, co-lead author of the study from Harvard T.H. Chan School of Public Health, focuses on the need to control obesity, the most important risk factor for diabetes.

Prof. Danaei suggests that genetics and environmental factors, fetal and early life conditions may contribute to the high rates of diabetes in some countries.

An unhealthy lifestyle, he says, can exacerbate the risk of diabetes among people with certain genotypes, as can inadequate nutrition during pregnancy and in early life.

Prof. Danaei recommends addressing nutrition throughout the lifespan in order to prevent diabetes.

Interactive maps and data for individual countries are also available.

Medical News Today reported last week on work by the same team, revealing an equally dramatic rise in global obesity levels.