Recent estimates published in The Lancet this week project a grim picture for the global diabetes landscape. By the year 2050, it is anticipated that over 1.31 billion individuals worldwide will grapple with diabetes—a debilitating ailment notorious for inflicting life-altering health complications, a heightened risk of mortality, and intricate interplay with various other diseases. This disconcerting surge in diabetes prevalence, surpassing the 2021 figure of 529 million cases, is chiefly attributed to the escalating incidence of type 2 diabetes. This, in turn, is largely driven by the mounting prevalence of obesity and shifting demographics.

In 2021, type 2 diabetes constituted a staggering 90% of all diabetes cases worldwide. Most of this burden can be traced back to social determinants of health, including but not limited to elevated body mass index (BMI), dietary patterns, environmental and occupational hazards, tobacco and alcohol consumption, and sedentary lifestyles. These risk factors flourish within obesogenic environments and reflect the systemic disparities in resource allocation and societal organization.

Coinciding with the American Diabetes Association’s 83rd Scientific Session, The Lancet and The Lancet Diabetes and Endocrinology have unveiled a comprehensive series on Global Inequity in Diabetes. Comprising two seminal papers, one with a global focus and another centered on the United States, this series unveils a disheartening narrative of diabetes characterized by stark inequities. An alarming projection indicates that by 2045, up to 75% of adults grappling with diabetes will reside in low- and middle-income nations. Shockingly, merely 10% of individuals with diabetes in these regions currently receive care that aligns with established clinical guidelines.

Regardless of economic strata, a common thread emerges: individuals who are subjected to discrimination and marginalization bear the brunt of diabetes’ most severe and devastating consequences. In the United States, where the incidence of type 2 diabetes in young populations has nearly doubled over the past two decades, the burden is most pronounced among Black and Indigenous American communities.1

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References

  1. Lancet. (2023). Diabetes: a defining disease of the 21st century. The Lancet, 401(10394), 2087. https://doi.org/10.1016/s0140-6736(23)01296-5

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