Diabetes study reveals undiagnosed cases pose higher risk
In 2023, 44% of diabetics were undiagnosed, despite improved detection since 2000; urgent need for better care, especially in low-income areas, persists.
Nearly half, or 44%, of people over the age of 15 living with diabetes remained undiagnosed in 2023, leaving them at an increased risk of complications due to lack of early intervention, according to a new study published in The Lancet Diabetes & Endocrinology on Monday.
This, however, is an improvement from 2000, when around 53% people were diagnosed, suggesting the detection of diabetes has improved over time, according to the Global Burden of Diseases, Injuries, and Risk Factors (GBD-2023) study.
The study — titled ‘Global, regional, and national cascades of diabetes care, 2000-23: a systematic review and modelling analysis using findings from the Global Burden of Disease Study’ — also found that at least 90% of diagnosed individuals received some form of treatment, and at least 40% of those treated for diabetes had their blood sugar levels under control, compared to 21% control rate observed among all people with diabetes.
Diabetes is a serious global health challenge, with a rising prevalence and substantial effect on disability and mortality worldwide. Approximately one out of every seven adults with diabetes globally lives in India, a country with over 1.4 billion population.
The authors of the study said they aimed to comprehensively assess the state of the diabetes cascade of care —comprising diagnosis, treatment, and glycaemic management— globally, identifying areas of strength and needs for improvement in diabetes management.
Despite improvements in the diagnosis, treatment, and control of blood sugar levels in people living with diabetes, the authors pointed out that significant gaps still exist, which is concerning as it hinders effective management of the disease on a global scale. Up-to-date global estimates of diabetes diagnosis, care, and management are vital for assessing progress and identifying areas for improvement, they said in the paper.
Using GBD data and methods, researchers assessed the state of diabetes care globally from 2000 to 2023, covering 204 countries and territories.
“We systematically reviewed cross-sectional surveys that are representative of the general population and the published and grey literature to estimate the proportion of people with diabetes who are undiagnosed, diagnosed but untreated, receiving treatment with suboptimal glycaemic concentrations, and receiving treatment with optimal glycaemic concentrations. Treatment was defined as current use of insulin or other hypoglycaemic medication,” the authors said in the paper.
The study found major regional differences in diagnosis, treatment, and management of diabetes globally. In 2023, the highest rates of diabetes diagnosis were observed in high-income North America (around 83%), southern Latin America (around 80%), and western Europe (around 78%), while the lowest rates were found in central sub-Saharan Africa, where only about 16% of people with diabetes were diagnosed.
Among people diagnosed with diabetes, treatment rates ranged from about 97% in the high-income Asia Pacific region to about 69% in central sub-Saharan Africa. The study also found that younger people (aged 15-39 years) were least likely to be diagnosed with diabetes globally, with only 26% receiving a diagnosis in 2023. Yet, this group faces a higher risk of lifetime complications compared to those diagnosed later in life, partly because they live with diabetes for longer.
Between 2000 and 2023, the proportion of people diagnosed globally with diabetes increased by 8·3 percentage points, and the proportion of people receiving treatment among those diagnosed increased by 7·2 percentage points. The proportion of people receiving treatment who had optimal glycaemic concentrations increased by 1·3 percentage points.
The authors said that despite progress over the past two decades, diabetes remains widely underdiagnosed and poorly managed, especially in low- and middle-income countries and for younger adults. “There is an urgent need to strengthen health systems to improve detection, treatment, and ongoing care,” the authors said in the paper. They also highlighted that expanding healthcare access, targeted screening, and higher quality of care could significantly reduce the global burden of diabetes.
