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The diabetes pandemic: the latest figures from across the world

The diabetes pandemic: the latest figures from across the world. Gojka Roglic. Number of persons with diabetes in the world. 346 million in 2008 (WHO, 2011) 366 million in 2011 (IDF, 2011). Predicted number of persons with diabetes in the world (IDF Atlas, 5th ed).

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The diabetes pandemic: the latest figures from across the world

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  1. The diabetes pandemic: the latest figures from across the world Gojka Roglic

  2. Number of persons with diabetes in the world 346 million in 2008 (WHO, 2011) 366 million in 2011 (IDF, 2011)

  3. Predicted number of persons with diabetes in the world (IDF Atlas, 5th ed) 552 million in 2030

  4. The Top 10s (number of people with diabetes)

  5. The Top 10s (prevalence %)

  6. Regional overview

  7. Prevalence (%) by region

  8. Prevalence (%) by age and sex

  9. Proportion undiagnosed The International Diabetes Federation diabetes atlas methodology for estimating global and national prevalence of diabetes in adults. Guariguata L, Whiting D, Weil C, Unwin N. Diabetes Res Clin Pract. 2011 Nov 17. [PMID: 22100977]

  10. Undiagnosed diabetes

  11. Type 1 diabetes in the young

  12. Healthcare expenditures USD 465 billion spent on healthcare for diabetes 11% of all healthcare spending is for diabetes USD 1,274 is spent on diabetes care per person with diabetes in 2011

  13. A population-based cost of illness study Prof. m. viswanathan Diabetes RESEARCH CENTRE AND M.V. HoSpital for Diabetes Chennai

  14. Key findings The median annual direct cost was $525. The median annual indirect cost was $ 102. Extrapolating the direct and indirect cost to the total prevalence of India, the annual cost for diabetes would be $ 31.9 billion. A two way sensitivity analysis estimation showed a range of $25.5 billion - $38 billion with 10% variation either in the prevalence or in the cost of diabetes care.

  15. How do patients pay for Diabetes care in India? 100% 6.2 Borrowing loan and mortgaging / selling property Savings plus other methods Insurance and company reimbursement Personal savings 11.7 10.4 15.2 2 80% 60 60% 72 40% 81.2 11.1 20% 28.8 0% <10000 INR 10001 – 30000 INR >30000 INR (>620.86 US$) (206.95 – 620.86 US$) Shabana Tharkar, Arut Selvi Devarajan, Satyavani Kumpatla, Vijay Viswanathan DRCP 89 2010 334-340

  16. The global burden • The number of people with type 2 diabetes is increasing in every country • 80% of people with diabetes live in low-and middle-income countries • 183 million people (50%) with diabetes are undiagnosed

  17. The global burden • The greatest number of people with diabetes are between 40 to 59 years of age • 78,000 children develop type 1 diabetes every year

  18. The global burden • Diabetes caused 4.6 million deaths in 2011 • Diabetes caused at least USD 465 billion dollars in healthcare expenditures in 2011; 11% of total healthcare expenditures in adults (20-79 years)

  19. Regional highlights Africa: 78% of people with diabetes are undiagnosed Europe: the highest prevalence of type 1 diabetes in children Middle East and North Africa: 6 of the top 10 countries by diabetes prevalence North America and Caribbean: 1 adult in 10 has diabetes

  20. Regional highlights South and Central America: 12.3% of all deaths were due to diabetes South-East Asia: almost one-fifth of the world’s people with diabetes live in just seven countries Western Pacific: 132 million adults have diabetes, the largest number of any region

  21. The rising global prevalence of diabetes (millions)

  22. Diabetes prevalence trend 1980-2008(Danaei et al, 2011)

  23. Is there a diabetes epidemic?

  24. Possible causes of increasing diabetes prevalence (from Colagiuri et al, Diabetologia 2005) • Ageing of the population • Younger age at onset • Decreasing mortality • Increasing incidence (risk)

  25. Incidence of (diagnosed) diabetes • UK population 25-79yrs 4.7/1000 p-y (Hippisley-Cox, 2009) • Finnish population 40-69yrs 4.5/1000 p-y (Montonen, 2005) • Chinese women 25+ yrs 5.4/1000 p-y (Villegas, 2008) • US female nurses 38-63yrs 3.8/1000 p-y (Bazzano, 2008)

  26. Possible causes of increasing type 2 diabetes prevalence (Colagiuri et al, 2005) • Ageing of the population • Younger age at onset • Decreasing mortality Explain only 20-25% increase in prevalence

  27. Possible causes of increasing type 2 diabetes prevalence (from Colagiuri et al, 2005) • Ageing of the population • Younger age at onset • Decreasing mortality • Increasing incidence! Explain only 20-25% increase in prevalence

  28. RISING PREVALENCE OF DIABETES IN URBAN INDIA (Mohan, 2006) 1989 - 2005 Within a span of 14 years, the prevalence of diabetes increased by 72.3%

  29. Prevalence of overweight and obesity in population aged over 15 years (WHO STEPS Surveys)

  30. BMI trends 1980-2008 ( Finucane et al, 2011)

  31. Obesity/overweight trends 1980-2008 ( Finucane et al, 2011)

  32. Obesity Increases Risk of Co-morbid States Type 2 diabetes Cholelithiasis Hypertension Coronary heart disease Women Men 6 6 5 5 4 4 Relative Risk 3 3 2 2 1 1 0 0 27 22 23 29 30 <21 27 24 25 26 28 22 23 29 30 <21 24 25 26 28 BMI (kg/m2) BMI (kg/m2) Willett WC et al. N Engl J Med. 1999;341:427-434.

  33. Relationship between BMI and diabetes prevalence in Asia (Boffetta, 2011)

  34. Estimated projected urban and rural populations in the world, 1950-2030

  35. Possible causes of increasing diabetes prevalence (from Colagiuri et al, 2005) • Ageing of the population • Younger age at onset • Decreasing mortality • Increasing incidence (risk) Explain only 20-25% increase in prevalence

  36. Diabetes and the risk of tuberculosis: a neglected threat to public health? (Stevenson et al, 2007)

  37. The link of India’s diabetes epidemic to rising tuberculosis Stevenson et al. Diabetes and tuberculosis: the impact of the diabetes epidemic on tuberculosis incidence. BMC Public Health 2007, 7:234 In India • 18.4% of adults with pulmonary TB have diabetes, rising to 23.5% among those with infectious TB • Diabetes accounts for 14.8% of adult pulmonary TB incidence, 20.2% of infectious TB incidence • Diabetes makes a substantial contribution to the burden of incident tuberculosis in India, and the association is particularly strong for the infectious form of tuberculosis

  38. IDF Atlas 2011: Diabetes and Tuberculosis Focus on the linkages between the two diseases and a review of the evidence Calculated the attributable cases of tuberculosis to diabetes Highlights areas where there is a high double burden

  39. Prevalence of diabetes and Prediabetes among TB patients in Tamil Nadu, India Prof. m. viswanathan Diabetes RESEARCH CENTRE AND M.V. HoSpital for Diabetes

  40. Objective • To estimate the prevalence of diagnosed and undiagnosed diabetes among a cohort of tuberculosis patients registered under RNTCP in selected Tuberculosis Units in Tamil Nadu, India. • To study the current diabetes care of TB patients with diabetes.

  41. Deaths due to diabetes 4.6 million deaths due to diabetes in 2011 8.2% of all-cause mortality 48% in people under 60

  42. Deaths attributable to diabetes in India, 2011 (IDF Atlas 2011) 547,000 women 436,200 men

  43. Diabetes deaths as % of all deaths in India, 2011 (IDF Diabetes Atlas, 2011)

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