Global type 1 diabetes cases projected to rise 29% by 2049

PREVALENCE:   New modelling forecasts that 12.1 million people will be living with type 1 diabetes worldwide by 2049, with low-income countries expected to experience the sharpest proportional increases as access to insulin and diagnosis improves…

By Own Correspondente

The number of people living with type 1 diabetes worldwide is projected to rise by 29% over the next quarter-century, increasing from 9.4 million in 2025 to 12.1 million in 2049.

New cases diagnosed annually are also expected to increase by 14%, from an estimated 530 024 in 2025 to 605 058 by 2049.

The projections come from research due to be presented at the annual meeting of the European Association for the Study of Diabetes in Milan, Italy, from September 28 to October 2.

The estimates were produced using the DIAMOND-T1D model, developed under the leadership of Professor Anders Green of the Steno Diabetes Centre Odense in Denmark.

The model forecasts substantial increases in the number of people living with type 1 diabetes in several high-income countries, even though their annual incidence—or rate of new cases—is expected to remain broadly stable.

In the United Kingdom, the number of people living with the condition is projected to increase by about a third, from 313 725 in 2025 to 420 551 in 2049.

The United States is expected to record an increase of more than half a million people, from nearly 1.5 million to just over 2.05 million during the same period.

Italy is forecast to experience a less pronounced increase of 16%, with its type 1 diabetes population rising from an estimated 205 499 in 2025 to 239 145 in 2049.

The researchers suggest that the comparatively high incidence and prevalence expected in countries such as Australia, the US and the UK could result from a combination of genetic susceptibility, environmental triggers and strong case-detection systems supported by well-developed healthcare infrastructure.

However, the greatest proportional increases are expected in low-income countries, where improved access to insulin, glucose monitoring and medical care is likely to enable more people with type 1 diabetes to survive for longer.

In Tanzania, for example, the annual number of new cases is projected to almost double, from 3,275 in 2025 to 6,177 in 2049. The number of people living with the condition is similarly expected to more than double, from 19 101 to 39 673.

Despite this rapid growth, the absolute number of people with type 1 diabetes in Tanzania will remain considerably lower than in many wealthier countries.The contrasting projections underline the unequal global experience of the disease. While high-income and middle-income countries currently account for most people living with type 1 diabetes, poorer countries face serious challenges in diagnosis, insulin availability and long-term treatment.

Type 1 diabetes is a chronic autoimmune condition in which the pancreas produces little or no insulin. People diagnosed with it require lifelong insulin treatment to control their blood glucose levels and prevent potentially fatal complications.

Reliable epidemiological data on the condition remain limited, particularly in low- and middle-income countries.

The researchers say accurate estimates of incidence, prevalence and mortality are essential for developing health policies, allocating resources and improving access to treatment.

The data could also support implementation of the World Health Organisation’s Global Diabetes Compact, which seeks to reduce diabetes risks and ensure that everyone diagnosed with the disease can obtain equitable, comprehensive, affordable and quality care.

Unlike earlier forecasting systems, the DIAMOND-T1D model takes historical patterns of insulin availability into account.

It aims to provide global, regional and country-level estimates of type 1 diabetes incidence, prevalence and mortality covering the period from 1900 to 2050.

The model combines available information about disease incidence, population age distribution and survival with assumptions about age-specific incidence and mortality rates. It also considers the year in which insulin became available in each country.

Its estimates have been validated against population-based diabetes registry data from Denmark and Scotland.

Researchers plan to make the model available through a user-friendly, open-access online platform. Users will be able to develop alternative country-specific scenarios by adjusting important variables, including assumptions about incidence and survival.

Children and adolescents remain heavily affected by the disease. People aged between birth and 19 years were estimated to account for 42% of new cases worldwide in 2025. The proportion ranged from 37% in high-income countries to 49% in low-income countries.

The same age group accounted for an estimated 15% of all deaths among people with type 1 diabetes in 2025. However, the inequality was stark: children and young people represented only 4% of deaths in high-income countries but 34% in low-income countries.

The model forecasts that annual deaths from all causes among people living with type 1 diabetes will increase from 361 383 in 2025 to 537 621 in 2049.

The researchers acknowledge that their prevalence projections are lower than estimates produced by the T1D Index and the Global Burden of Disease Study.

They attribute the difference mainly to their more conservative assumptions about survival, particularly among older people and those living in low- and middle-income countries.

They conclude that the projected growth in the global burden of type 1 diabetes strengthens the case for improved access to insulin and quality care, especially in under-resourced health systems. – Newswise