India among top 10 countries with highest Type 1 diabetes prevalence: Lancet

An estimated 8.4 million people were living with Type 1 diabetes across the globe in 2021, and India was among the top ten countries with highest prevalence of the disease, according to a modelling study published in The Lancet Diabetes & Endocrinology journal.

Illustration: Uttam Ghosh/Rediff.com

This number is predicted to increase to 13.5-17.4 million people living with Type 1 diabetes by 2040, the researchers said.

"Given that prevalence of people with T1D is projected to increase in all countries to up to 17.5 million cases in 2040, our results provide a warning for substantial negative implications for societies and healthcare systems," said Professor Graham Ogle, one of the authors of the study, from the University of Sydney, Australia.

"There is an opportunity to save millions of lives in the coming decades by raising the standard of care for T1D and increasing awareness of the signs and symptoms of T1D to enable a 100 per cent rate of diagnosis in all countries," Ogle said.

Researchers modelled data on childhood, adolescent and adult T1D prevalence in 97 countries, along with incidence over time data from 65 countries.

They also analysed mortality data from 37 countries to predict T1D incidence, prevalence, and mortality in 2021 for 201 countries, with projections of future prevalence through 2040.

The estimates were tested for accuracy against real world prevalence data from 15 countries.

In 2021, the model estimated that 8.4 million individuals worldwide were living with T1D.

Of these individuals, 18 per cent were under 20 years old, 64 per cent were between 20-59 years, and 19 per cent were over 60 years.

"These findings have important implications for diagnosis, models of care, and peer support programmes," said Professor Dianna Magliano, one of the authors of the study, from Monash University, Australia.

"Such programmes, in countries where they exist, are almost exclusively designed, and delivered for children and youth with T1D," Magliano said.

The ten countries with the highest estimated T1D prevalence US, India, Brazil, China, Germany, UK, Russia, Canada, Saudi Arabia, and Spain account for 5.08 million (60 per cent) of global cases of T1D, the researchers said.

Model estimates also suggest that 21 per cent of individuals with T1D live in low income countries and lower and middle income countries, they said.

Model estimates place global deaths due to T1D at 175,000 in 2021, the researchers said.

Of these, 35,000 or 20 per cent were attributed to non-diagnosis, of which 14,500 were in sub-Saharan Africa and 8,700 were in South Asia, they said.

The researchers estimate that an extra 3.1 million people would have been alive in 2021 if they hadn't died prematurely due to suboptimal care of T1D, and a further 700,000 people would still be alive if they hadn't died prematurely due to non-diagnosis.

"Our findings indicate that the overall footprint of T1D is much larger than previous estimates have indicated, when missing prevalence due to excess mortality is accounted for," said Professor Kim Donaghue, one of the authors of the study, from the University of Sydney, Australia.

"This is particularly true in low- and middle-income countries – for example in sub-Saharan Africa which accounts for 357,000 cases of T1D or 4 per cent of global prevalence but 23 per cent (40,000) of the lives lost each year – highlighting the urgent need to increase awareness of the signs and symptoms of T1D in LMICs," Donaghue said.

The projected T1D prevalence in 2040 given by the model was is 13.5-17.5 million people, with largest relative increases predicted to occur in LICs and LMICs, the researchers said.

Conservative estimates place the relative increase in the number of people living with T1D by 2040 compared to 2020 at 66 per cent, they added.