The Lancet declared a global diabetes emergency in its latest study. Things cannot go on like this; we must change something.
Here is the German translation of the study, with a link to the original study in the appendix.
Global, regional, and national cascades of diabetes care, 2000–2023: a systematic review and modelling analysis based on the results of the Global Burden of Disease study
Summary
Background
Diabetes is a serious global health challenge with increasing prevalence and significant impacts on disability and mortality worldwide. Despite medical advances, gaps persist in the so-called diabetes care cascade – consisting of diagnosis, treatment, and glycaemic management – and hinder effective care. This study aimed to comprehensively assess the status of the global diabetes care cascade and identify areas of strength as well as areas in need of improvement.
Methods
Using data and methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), this modelling analysis covered the years 2000 to 2023 and 204 countries and territories. We conducted a systematic review of population-representative cross-sectional surveys as well as published and grey literature to estimate the proportion of people with diabetes who are undiagnosed, diagnosed but remain untreated, treated with suboptimal glycaemic levels, or treated with optimal glycaemic levels. Treatment was defined as the current use of insulin or other glucose-lowering medications. These measures were modelled separately by location, year, age, and sex using DisMod-MR 2.1 – a hierarchical Bayesian meta-regression modelling tool – and then scaled so that they sum to 100% of people with diabetes in each stratum. Using the GBD-2023 estimates of the number of people with diabetes, we calculated the diabetes care cascade: the proportion of diagnosed individuals among all people with diabetes, the proportion of treated individuals among those diagnosed, and the proportion with optimal glycaemic levels among those treated.
Results
In 2023, an estimated 55.8% (95% uncertainty interval 49.3–62.3) of people aged 15 years and older with diabetes were diagnosed worldwide. Among those diagnosed, 91.4% (88.0–94.2) received treatment, and 41.6% (35.7–48.5) of those treated achieved optimal glycaemic levels. Relative to all people with diabetes, 21.2% (17.4–25.6) had treatment with optimal glycaemic control globally in 2023. Clear regional differences were observed: the highest diagnosis rates in high-income North America, the highest treatment rates among those diagnosed in the high-income Asia-Pacific region, and the highest rates of optimal glycaemic levels among those treated in South Latin America. Between 2000 and 2023, the proportion of diagnosed individuals increased worldwide by 8.3 (6.6–10.0) percentage points, the proportion of treated individuals among those diagnosed by 7.2 (5.7–8.8) percentage points, and the proportion of treated individuals with optimal glycaemic levels by 1.3 (0.8–1.8) percentage points.
Interpretation
Despite improvements over the past two decades, underdiagnosis and inadequate glycaemic management of diabetes remain major challenges worldwide – particularly in low- and middle-income countries. These results highlight the urgent need for expanded strategies and capacity building to improve the early detection, treatment, and management of diabetes. Targeted measures to strengthen health systems could lead to better health outcomes and reduce the burden of this growing disease.
The link to the original study here
0 comments