Millions of people left behind by diabetes lead to increased insulin demand

A new diabetes epidemic is fueling a record demand for insulin, but tens of millions of people will not receive the injections they need, unless there is a dramatic improvement in access and treatment. Affordability, concludes a new study.

Diabetes – which can lead to blindness, kidney failure, heart problems, neuropathic pain and amputations – now affects 9% of adults worldwide, up from 5% in 1980.

The vast majority suffer from type 2 diabetes, which is linked to obesity and lack of exercise, and cases are spreading particularly rapidly in developing countries as people adopt more lifestyles. Western and urban.

The researchers said that the amount of insulin needed to effectively treat type 2 diabetes would increase by more than 20% over the next 12 years, but that insulin would not be within half the reach 79 million people with type 2 diabetes who would need it in 2030.

The gap is particularly acute in Africa, where the research team, led by Dr. Sanjay Basu of Stanford University, estimated that the supply should be multiplied by seven to treat patients at risk who had reached the stage. need insulin to control their blood sugar. . Their study was published Tuesday in the journal The Lancet Diabetes & Endocrinology.

"These estimates suggest that current levels of insulin access are very inadequate compared to projected needs, particularly in Africa and Asia," Basu said.

"Despite the US government's commitment to treating noncommunicable diseases and ensuring universal access to diabetes medications, insulin is scarce and unnecessarily difficult to access for patients."

The global insulin supply is dominated by three companies – Novo Nordisk, Sanofi and Eli Lilly – that offer various programs to try to improve access to their products.

However, insulin remains expensive and prices can be particularly out of reach of the poorest countries, where the tortuous supply chains and the high margins of maneuvering of intermediaries often make it unaffordable for many. patients.

Overall, Basu and his colleagues calculated that global insulin use would increase to 634 million vials by 1,000 units by 2030, up from 526 million in 2018.

Their study, funded by the Helmsley Charitable Trust, was based on diabetes prevalence projections from the International Diabetes Federation.

Dr. Hertzel Gerstein of McMaster University in Hamilton, Ontario, wrote in an accompanying commentary that it was important to estimate and secure insulin supplies, but added that the forecasts had to be treated with care because they were based on mathematical models.