IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045

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Abstract

Aims

To provide global, regional, and country-level estimates of diabetes prevalence and health expenditures for 2021 and projections for 2045.

Methods

A total of 219 data sources meeting pre-established quality criteria reporting research conducted between 2005 and 2020 and representing 215 countries and territories were identified. For countries without data meeting quality criteria, estimates were extrapolated from countries with similar economies, ethnicity, geography and language. Logistic regression was used to generate smoothed age-specific diabetes prevalence estimates. Diabetes-related health expenditures were estimated using an attributable fraction method. The 2021 diabetes prevalence estimates were applied to population estimates for 2045 to project future prevalence.

Results

The global diabetes prevalence in 20–79 year olds in 2021 was estimated to be 10.5% (536.6 million people), rising to 12.2% (783.2 million) in 2045. Diabetes prevalence was similar in men and women and was highest in those aged 75–79 years. Prevalence (in 2021) was estimated to be higher in urban (12.1%) than rural (8.3%) areas, and in high-income (11.1%) compared to low-income countries (5.5%). The greatest relative increase in the prevalence of diabetes between 2021 and 2045 is expected to occur in middle-income countries (21.1%) compared to high- (12.2%) and low-income (11.9%) countries. Global diabetes-related health expenditures were estimated at 966 billion USD in 2021, and are projected to reach 1,054 billion USD by 2045.

Conclusions

Just over half a billion people are living with diabetes worldwide which means that over 10.5% of the world’s adult population now have this condition.

Introduction

Diabetes has emerged as one of the most serious and common chronic diseases of our times, causing life threatening, disabling and costly complications, and reducing life expectancy. [1] The global prevalence of diabetes had reached pandemic proportions with the 9th edition of the IDF reporting a prevalence of 9% (463 million adults) in 2019. The rising prevalence of diabetes has been attributed principally to the ageing of populations. However, decreasing mortality among those with diabetes due to improving medical care as well as increases in diabetes incidence in some countries resulting from increasing prevalence of diabetes risk factors, especially obesity, are also important drivers of higher prevalence. [2], [3]

The aim of the 10th edition of the IDF Diabetes Atlas is to provide updated estimates and projections of diabetes prevalence as well as health expenditure due to diabetes at national, regional, and global levels.

Section snippets

Methods

The IDF Diabetes Atlas methods have been previously described in detail. [4] This study complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) recommendations (see Supplementary material for checklist). [5] The following sections provide a brief summary, and includes any changes introduced by the 10th edition.

For the 10th edition of the IDF Diabetes Atlas, the list of countries and territories was re-evaluated based on the UN list of countries [6] (United

Study sources

The 2019–2020 literature review identified 13,570 articles of which 153 met the pre-defined inclusion criteria (Fig. 1) and proceeded to data extraction. After contacting authors or organisations from 94 studies to obtain detailed age- and sex-stratified data and further details about methods, a total of 106 new studies met our inclusion criteria and were added into the IDF Diabetes Atlas database. The grey literature search (including data from the IDF Regional offices and WHO STEPwise approach

Discussion

The 10th edition IDF Diabetes Atlas estimates that in 2021 there are 537 million people living with diabetes worldwide. Overall, the global prevalence of diabetes is now estimated to be over 10%. Among income groups, the highest prevalence was observed in middle-income countries. Compared to the previous 9th IDF Diabetes Atlas edition, we report an overall 12.9% increase in diabetes prevalence, with prevalence increasing in many world regions

Future projections suggest that by 2045 the absolute

Conclusion

The 10th edition of the IDF Diabetes Atlas suggests that in 2021 more than 1 in 10 adults now have diabetes globally and that the number of people with diabetes will continue to expand rapidly in the future. As our projections only consider demographic changes in populations relating to ageing and urbanisation, and not changes in risk factor prevalence or in survival, it is likely that our projected increases over time are conservative. Prevalence is predicted to increase the most among

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

We would like to thank all those who have supported the production of the IDF Diabetes Atlas, 10th edition, by providing additional diabetes data, where needed. We would like to thank Prof Agus Salim, Baker Heart and Diabetes Institute Australia for reviewing the statistical methodology employed in this edition.

Funding

The 10th edition of the IDF Diabetes Atlas was supported by an educational grant from the Pfizer-MSD Alliance, with the additional support of Sanofi and Novo Nordisk.

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