Why is the world about to run out of insulin?

LONDON: A global diabetes epidemic is fueling a record demand for insulin, but tens of millions of other people will not get the injections they need unless there is a dramatic improvement in the number of people who inject. Access and affordability, concluded Wednesday 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 it would be out of reach by half of the 79 million of type 2 diabetic patients who would need it in 2030.

The lack is especially acute in Africa, where the team led by Dr. Sanjay Basu of Stanford University estimated that the offer should be multiplied by seven to treat patients at risk who were at the stage of the need to control their blood sugar.

"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 UN'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 tortuous supply chains and high profit margins often make the solution unaffordable for many patients.

Overall, Basu and colleagues have calculated that global use of insulin is expected to increase from 526 million in 2018 to 634 million vials of 1,000 units by 2030.

Their study, published in the journal Lancet Diabetes & Endocrinology and funded by Helmsley Charitable Trust, was based on diabetes prevalence projections from the International Diabetes Federation. Dr. Hertzel Gerstein of McMaster University of Canada wrote in an accompanying commentary that it was important to estimate and secure insulin supplies, but added that the forecasts needed to be treated with caution because they were based on mathematical models.