According to a modelling study in the journal Lancet Diabetes and Endocrinology, by 2030, out of 79 million adults with type 2 diabetes, only half the number will have access to insulin if the current issue is not addressed. The study found 79 million people worldwide will require insulin to treat the disease, but only 38 million will have access.
The team of researchers from Stanford University developed a microsimulation of type 2 diabetes burden from 2018 to 2030 across 221 countries using data from the International Diabetes Federation, Diabetes Atlas (2017) for prevalence projections and from 14 cohort studies representing more than 60% of the global type 2 diabetes population for HbA1c, treatment, and bodyweight data. The study estimated the number of people with type 2 diabetes expected to use insulin, international units (IU) required, and DALYs averted per year under alternative treatment algorithms targeting HbA1c from 6·5% to 8%, lower microvascular risk, or higher HbA1c for those aged 75 years and older.
Without improved insulin access, 7·4% (95% CI 5·8–9·4) of people with type 2 diabetes in 2030 would use insulin, increasing to 15·5% (12·0–20·3) if insulin were widely accessible and prescribed to achieve an HbA1c of 7% (53 mmol/mol) or lower. The study model predicts type 2 diabetes prevalence will continue to increase invariably where 15.5% of all people with type 2 diabetes will use insulin in 2030, but supply will fall short if targets remain unchanged and are to be achieved.
Globally, 511 million adults are expected to have type 2 diabetes in 12 years, up from 406 million this year, the study found. More than half of those people come from China, India and the U.S.
In addition, the global rise in prevalence of type 2 diabetes and growing numbers of people living with the disease continue to drive up demand and prices for insulin. In 2016 an article in the Journal of the American Medical Association reported that the drug’s price almost tripled between 2002 and 2013.
“These estimates suggest that current levels of insulin access are highly inadequate compared to projected need, particularly in Africa and Asia, and more efforts should be devoted to overcoming this looming health challenge,” Sanjay Basu, lead author on the study and an assistant professor of medicine at Stanford, said in a statement. He added, “Despite the UN’s commitment to treat noncommunicable diseases and ensure universal access to drugs for diabetes, across much of the world insulin is scarce and unnecessarily difficult for patients to access. Unless governments begin initiatives to make insulin available and affordable, then its use is always going to be far from optimal.”