India continues to be home to the second-largest number of adults with diabetes worldwide, with the latest data from the International Diabetes Federation (IDF) putting the incidence at 77 million in the 20-79 years age group. This follows China, which has 116 million adults with diabetes in the same age profile.

In its 2017 report, the IDF had estimated the incidence in the two countries in the same age profile at 73 million and 114 million, respectively.

The worldwide prevalence of diabetes was estimated at 463 million in this age group, or in other words, one in 11 adults. This shows an alarming increase in the prevalence of diabetes around the world, as 38 million more adults are now estimated to be living with diabetes compared with the results published in 2017, the IDF said. The federation launched the latest edition of the IDF Diabetes Atlas in Brussels to mark World Diabetes Day.

China, India and the United States had the largest number of adults with diabetes and are expected to remain so in 2030, says the IDF. “It is projected that the number of adults with diabetes in Pakistan will exceed that in the United States of America, and it will move to third place by 2045. The countries that have the highest number of people with diabetes do not, of course, necessarily have the highest prevalence,” it added.

India was the largest contributor to diabetes mortality with more than 1 million estimated deaths attributable to diabetes and related complications, in the larger South East Asian region, the report said.

Low health expenditure

In fact, diabetes-related health expenditure in the South East Asia, at $8.1 billion in 2019, was the lowest total of all IDF regions, the report said. “However, it is projected that the Region will experience growth in health expenditure on diabetes in the next decades, reaching $10.1 billion in 2030 and $ 12.3 billion in 2045,”it added.

In the SEA Region, 8.4 percent of total health expenditure was allocated to diabetes. The highest percentage was in Mauritius (16.9 per cent), and the lowest was in Nepal (4.2 per cent). The highest estimate in 2019 for mean annual expenditure per person with diabetes in the region was $1,794 in the Maldives, while the lowest was $64 in Bangladesh. “In India, which accounts for 87.9 per cent of adults with diabetes in the Region, $92 was spent per person.”

While experts are still slicing and dicing the details from the latest IDF report, diabetologist Rajiv Kovil told BusinessLine that India’s health expenditure and that on non-communicable diseases such as diabetes needed a massive increase to tackle the increase in incidence. The mortality from diabetes, for example, has to do with the low expenditure on the illness, he said, which, in turn, would translate into inadequate treatment and management of diabetes.

International landscape

The worldwide prevalence of diabetes had reached 9.3 percent with more than half (50.1 per cent) of adults undiagnosed. Type 2 diabetes accounted for around 90 percent of all people with diabetes.

The rise in the number of people with type 2 diabetes was driven by a complex interplay of factors, the IDF said, including urbanisation, an ageing population, decreasing levels of physical activity and increasing levels of overweight people and obesity. For reasons which are unknown, type 1 diabetes is also on the rise, it added.

“More than 1.1 million children and adolescents younger than 20 years are living with type 1 diabetes, while three in every four people with diabetes (352 million) are of working age (20-64 years). One in five people over 65 has diabetes,” the IDF said, pointing to the strain on countries, as the prevalence increased.

Undetected or inadequately supported diabetes puts people at risk of serious and life-threatening complications, such as heart attack, stroke, kidney failure, blindness and lower-limb amputation. These result in reduced quality of life and higher healthcare costs, and place undue stress on families, the IDF said

    • The number of people with diabetes is predicted to rise to 578 million by 2030 and to 700 million by 2045
    • 374 million adults have impaired glucose tolerance, placing them at high risk of developing type 2 diabetes
    • Diabetes was responsible for an estimated $760 billion in health expenditure in 2019
    • Diabetes is among the top 10 causes of death, with people under the age of 60 accounting for almost half the deaths
    • One in six live births is affected by hyperglycaemia in pregnancy
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