Diabetes Cases Exceed 800 Million Worldwide – and 11 Million in Turkey

Why Is the Global Diabetes Burden Rising?

Diabetes has become one of the most important chronic diseases threatening public health worldwide. As of 2022, approximately 828 million adults worldwide were living with diabetes. This represents a striking increase of 630 million since 1990. Rising prevalence, particularly in low- and middle-income countries, highlights inequalities in global health systems.

Prevalence refers to the total number of existing cases of a disease or condition in a population during a specified period.

• Related topic: What Are Diabetes, Prediabetes, and Insulin Resistance? Symptoms and Treatment

Study Scope and Key Data

On 13 November 2024, The Lancet published this extensive study, which analyzed 1108 population-representative studies and data from 141 million adult participants. The main findings were as follows:

• Global Diabetes Prevalence (2022): 13.9% in women and 14.3% in men.
• Regional Distribution: India (212 million) and China (148 million) account for the largest shares of diabetes cases, followed by the United States, Pakistan, Indonesia, and Brazil.
• Untreated Diabetes: In 2022, 445 million adults were not receiving diabetes treatment with oral glucose-lowering medicines or insulin. Compared with 129 million in 1990, this represents an approximately 3.5-fold increase in the number without treatment.

Figure 1: The image shows the global situation and regional trends in diabetes prevalence and treatment access. It covers four main areas:

1. Diabetes Prevalence (2022)

• Women and Men (Over Age 18):
  • High Prevalence: Prevalence exceeds 20% to 30% in regions such as South Asia, the Middle East and North Africa, and the Pacific islands.
  • Low Prevalence: Prevalence is below 10% in regions such as Western Europe and sub-Saharan Africa.
  • Turkey is not specifically marked on the map. However, given its location between Southern Europe and Western Asia, prevalence may be assumed to be in the middle-to-high range (10-20%).

2. Change in Diabetes Prevalence (1990-2022)

• Regions with Increases:
  • Increases of up to 15-20% are seen in South and Central Asia, particularly in countries such as India and Pakistan.
  • Latin America and the Middle East also have high rates of increase.
• Stable or Declining Prevalence:
  • Prevalence has remained stable or declined in Western Europe and some East Asian countries, such as Japan.

3. Access to Treatment (2022)

• Women and Men (Over Age 30):
  • High Access: Treatment access exceeds 60% in Western Europe, North America, and Australia, approaching 80% in some regions.
  • Low Access: Treatment access is below 20% in sub-Saharan Africa, South Asia, and Southeast Asia. This is a particularly serious problem in India, Bangladesh, and some African countries.

4. Change in Treatment Access (1990-2022)

• Largest Improvements:
  • Increases of 20-30% are seen in Latin America, including Mexico, Colombia, and Chile, and in Western Europe.
  • Marked improvements are also seen in South Korea, Canada, and some Middle Eastern countries, such as Jordan.
• Regions with Little or No Improvement:
  • No significant improvement in treatment access has been recorded in sub-Saharan Africa, South Asia, and the Pacific islands.

Assessment of Turkey

• Turkey appears to lie in a region with diabetes prevalence of 10-20% and moderate treatment access (40-60%).
• Changes in prevalence and improvements in treatment access may resemble those in the Middle East and Eastern Europe, depending on Turkey's economic and health-system dynamics.

Inequalities in Diabetes Treatment Access

The study shows that, despite improvements in treatment access in high-income countries, access remains inadequate in low- and middle-income countries. For example:

• 2022 Statistics: Treatment access was reported as 59% in women and 49% in men. However, rates are below 10% in many countries in sub-Saharan Africa and South Asia.
• Highest Treatment Access: High-income countries such as South Korea and Belgium achieved treatment access above 55%.

Figure 2: The charts show the distribution of diabetes and untreated diabetes by country and region. Circle sizes are proportional to the number of people with diabetes or untreated diabetes in each country. Only the 20 countries with the largest numbers of cases are shown.

A) People with Diabetes (Age 18 and Older, 2022)

• Overview: The estimated number of people aged 18 and older living with diabetes worldwide is 828 million according to the analysis.
• Largest Burden:
  • India (212 million, 26%) and China (148 million, 18%) account for the largest shares of the population with diabetes. Together, they represent 44% of the global burden.
  • The United States (42 million, 5%), Pakistan (36 million, 4%), and Indonesia (25 million, 3%) also have large populations with diabetes.
• Turkey's Position:
  • Turkey, with 11 million people with diabetes, accounts for 1% of the global diabetes burden and ranks 12. Located in the Middle East and Central Asia region, it is in an area with a growing diabetes burden.

B) People with Untreated Diabetes (Age 30 and Older, 2022)

• Overview: The estimated number of people with untreated diabetes worldwide is 445 million according to the analysis.
• Largest Burden:
  • India (133 million, 30%) accounts for the largest share of untreated diabetes. This points to limitations in its health system and treatment access.
  • China (78 million, 17%) and Pakistan (24 million, 5%) also have large numbers of untreated diabetes cases.
• Turkey's Position:
  • Turkey, with 5 million untreated diabetes cases, occupies rank 12. This highlights the need to improve treatment access in diabetes management.

Overall Assessment and Implications

• Diabetes Burden: Highly populated countries such as India and China carry a substantial share of the global diabetes burden, placing serious pressure on global health systems.
• Unequal Treatment Access: Access to treatment remains very low for people with diabetes in low- and middle-income countries. India, China, and Pakistan have particularly large numbers of untreated cases.
• Turkey's Situation: Turkey ranks in the middle range for diabetes prevalence and the number of untreated cases. Addressing this situation requires stronger health infrastructure for diabetes care and management and expanded early diagnosis and treatment programs.

Diabetes and Social Determinants

One of the main reasons for rising diabetes numbers is the global increase in obesity rates. Limited access to healthy food, greater consumption of processed food, and inadequate access to healthcare in low-income countries are also important factors. The study emphasizes the contribution of genetics and childhood undernutrition to the high prevalence of diabetes in South Asia.

Effective Strategies for Diabetes Management

The study highlights the following strategies for addressing diabetes:

1. Early Diagnosis and Prevention: Expand screening programs for early diagnosis, particularly where young adults have less contact with healthcare services.
2. Health Insurance: Universal health insurance is a fundamental step toward better treatment access, but coverage must be expanded to include diabetes medicines.
3. Diet and Lifestyle Changes: Preventing and managing diabetes requires greater access to healthy food, reduced processed-food consumption, and promotion of physical activity.
4. Medicine Supply Chains: Develop national or multinational strategies to make medicines available at low cost.

The Future of Diabetes: What Should Be Done?

The burden of diabetes strains not only individuals but also entire health systems. Therefore:

• Global Health Policies: Develop dedicated programs to expand diabetes treatment in low- and middle-income countries.
• Comprehensive Prevention Strategies: Expand population-wide efforts against obesity and diabetes screening programs.
• An Equity-Focused Approach: Address regional inequalities in treatment access.

Conclusion: Diabetes Is an Equity Issue as Well as a Health Issue

The study shows that diabetes is no longer only a health problem but also an issue of social inequality. Health systems must develop more effective responses and raise public awareness. Effective policies and innovative treatment approaches are vital to reducing the burden of diabetes.