The cost of diabetes hits 825 billion dollars a year

The cost of diabetes hits 825 billion dollars a year, according to new study, according to a team of scientists from Imperial College, London, in collaboration with Harvard T.H. Chan School of Public Health. The World Health Organisation and nearly 500 researchers across the globe, have estimated that the cost of diabetes has hit 825 billion dollars a year. The study, the largest ever study of diabetes levels across the world, incorporated data from 4.4 million adults in most of the world’s countries. It is the first time we have had such a complete global picture about diabetes – and the data reveals the disease has reached levels that can bankrupt some countries’ health systems. The enormous cost of this disease – to both governments and individuals – could otherwise go towards life essentials such as food and education. Until we find effective ways of addressing the global obesity epidemic, focusing on individuals who are at high risk of the condition is key to tackling the diabetes crisis. We need financially accessible and effective health systems that can highlight those at high risk of diabetes or at pre-diabetes stage. Healthcare staff can then deliver medication and lifestyle advice to delay or even prevent the onset of the condition, as has been done in some countries in Western Europe.

The study follows previous work by the same Wellcome Trust-funded team, which studied global obesity levels, and was published in The Lancet last week. The data published today also reveals the age-adjusted levels of diabetes in 2014 were lowest in some countries in northwestern Europe, where around 4 per cent of women and 6 per cent of men have diabetes. The prevalence of diabetes was highest in Polynesia and Micronesia, where more than one in five adults has the condition. Overall, low- and middle-income countries had the largest rise in diabetes levels over the 34-year period.

Diabetes results in a person being unable to regulate levels of sugar in their blood, and increases the risk of heart and kidney disease, vision loss, and amputations. The team adjusted their results to account for diabetes becoming more common as a person ages and that some countries have an older population. Using age-adjusted figures, they found the incidence of diabetes in men across the world has more than doubled – from 4.3 per cent in 1980 to 9 per cent in 2014 – after adjusting for the effect of ageing. Meanwhile diabetes among women has risen from 5 per cent in 1980 to 7.9 per cent in 2014. This rise translates as 422 million adults in the world with diabetes in 2014 – which has nearly quadrupled since 1980 (108 million). The enormous cost of this disease – to both governments and individuals – could otherwise go towards life essentials such as food and education.

The team also calculated the annual cost of diabetes – which included the cost of treating and managing the disease and its complications, such as limb amputations. This was calculated in International Dollars. The global cost was 825 billion dollars per year, with the largest cost to individual countries being in China ($170 billion), the USA ($105 billion) and India ($73 billion). This calculation did not include work days lost due to diabetes, which would make the costs far greater if incorporated.

There is increasing evidence that the interaction of genes and the environment plays a role in diabetes. For example, certain genotypes may increase the risk of diabetes especially in people with unhealthy lifestyles. In addition, inadequate nutrition during pregnancy and in early life may increase the risk of diabetes later in life. Therefore, long-term diabetes prevention should address nutrition in every stage of life. The study did not differentiate between type one and type two diabetes, as this wasn’t included in most of the raw data. At least 85-90 per cent of diabetes cases are type two.

Professor Majid Ezzati
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