Researchers say diabetes is growing exponentially in prevalence outpacing most diseases globally. Structural racism and geographic inequity are accelerating this global crisis of diabetes, with rates of diabetes among minority ethnic groups in high-income countries, like the USA, 1.5 times higher than among their white counterparts and diabetes death rates in low- and middle-income countries (LMIC) double that in high-income countries.
A new joint series published in The Lancet and The Lancet Diabetes & Endocrinology calls for more high-impact, high-quality, real-world research to reduce diabetes inequities. “Without an effective mitigation strategy, more than 1.3 billion people will be living with diabetes by 2050, one of the leading causes of death and disability worldwide,” it said.
The researchers say that no country is expected to witness a decline in age-standardised diabetes rates over the next three decades, with the worst affected regions of Oceania and north Africa and the Middle East expected to reach levels of diabetes that exceed 20% in many countries, along with Guyana in the Caribbean.
Estimates also indicate that more than three quarters of adults with diabetes will live in LMICs by 2045, of whom fewer than 1 in 10 will receive comprehensive diabetes care
In high-income countries (HICs) like the USA, rates of diabetes are almost 1.5 times higher among minority ethnic groups compared to white populations, fuelled by structural racism, the Lancet said. Dr Anoop Misra, chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, said the same was true of India too. “More diabetes in poor socio-economic groups from urban slums to suburban areas to even villages in these people because food is the prime pleasure of life. The more oily or sugary, the better it is,” he said.The series found that people from marginalised communities around the world are less likely to get access to essential medicines like insulin and new treatments, have worse blood sugar control, and have a lower quality of life and reduced life expectancy.According to the researchers the Covid-19 pandemic has amplified diabetes inequity globally, with people with diabetes 50% more likely to develop severe infection and twice as likely to die compared to those without diabetes, especially those from ethnic minority groups.
“Diabetes remains one of the biggest public health threats of our time and is set to grow aggressively over the coming three decades in every country, age group, and sex, posing a serious challenge to health-care systems worldwide,” says Series leader Dr Shivani Agarwal, Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine and Montefiore Health System, USA.
