Insulin use in the treatment of type 2 diabetes could go up by more than 20% by 2030, according to a new analysis.
Using information from the International Diabetes Federation and 14 cohort studies, researchers created a microsimulation of the burden associated with type 2 diabetes from 2018 to 2030 in 221 countries. They predicted how many people with type 2 diabetes would likely use insulin, how many international units (IU) would be required, and disability-adjusted life-years (DALYs) averted annually with alternative treatment algorithms aimed at HbA1c from 6.5% to 8%, lower microvascular risk, or higher HbA1c for those aged 75 years and older.
Half of people worldwide who need #insulin to treat type 2 #diabetes will not receive it in 2030 unless access is improved—finding from a microsimulation analysis @TheLancetEndo https://t.co/kMGgtU1eVP pic.twitter.com/1UIcRQRjqG
— The Lancet (@TheLancet) November 21, 2018
The researchers estimate that the number of type 2 diabetes patients worldwide will increase from 405.6 million (95% CI 315.3 million–533.7 million) in 2018 to 510.8 million (395.9 million–674.3 million) in 2030. Based on these figures, they predict annual insulin use across the globe will jump from 516.1 million 1,000 IU vials (95% CI 409.0 million–658.6 million) in 2018 to 633.7 million (500.5 million–806.7 million) in 2030. Insulin accessibility will also play a large role. If access does not get better, 7.4% (95% CI 5.8–9.4) of all type 2 diabetes patients in 2030 will use insulin, but if accessibility improves and insulin is prescribed to achieve an HbA1c of 7% (53 mmol/mol) or lower, the number of patients receiving insulin will more than double to 15.5% (12.0–20.3). If all type 2 diabetes patients achieve HbA1c of 7% or lower, by 2030, insulin would avert 331,101 DALYs each year (95% CI 256,601–437,053). The researchers also predict that accessibility to new oral antihyperglycaemic drugs would avert DALYs by 14.9%, and averted DALYs would increase by 44.2% if patients aged 75 years and older had a target HbA1c of 8% (64 mmol/mol) due to reduced hypoglycaemia.
— CNN International (@cnni) November 21, 2018
The study authors concluded, “The insulin required to treat type 2 diabetes is expected to increase by more than 20% from 2018 to 2030. More DALYs might be averted if HbA 1c targets are higher for older adults.”