Is the world lacking insulin? Shortages could leave millions of diabetics untreated

Insulin is crucial for the treatment of people with type 1 diabetes and some type 2 patients. However, with type 2 growth rates of more than 20% worldwide over the next 12 years years, we risk reaching a point where insulin will be out of reach of nearly half of the 79 million adults who will need it by 2030. That is according to a study published in the journal The Lancet: Diabetes and Endocrinology.

The results are of particular concern for Africa, Asia and Oceania – areas where the study predicts a significant shortage of insulin if access remains at current levels. In light of the findings, the authors warn that strategies to make insulin more widely available and more affordable will be essential to ensure demand satisfaction.

"These estimates suggest that current levels of insulin access are very inadequate compared to projected needs, particularly in Africa and Asia, and that further efforts need to be made to overcome this health problem. who threatens, "Sanjay Basu, senior author of the Stanford University research, said in a statement.

"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, "he said. Diabetes is expected to increase over the next 12 years due to aging, urbanization and related changes in diet and physical activity. Unless governments launch initiatives to make insulin available and affordable, its use will still be far from optimal. "

In people with type 1 diabetes and some of them, insulin is used to reduce the risk of complications such as blindness, amputation, kidney failure, and other conditions. stroke. While the rates of type 2 diabetes were skyrocketing worldwide, researchers wanted to paint a complete picture of insulin requirements around the world.

To do this, they use data from the International Diabetes Federation and 14 cohort studies to estimate the burden of type 2 diabetes in 221 countries between 2018 and 2030. They determined the number of users in the world. Potential insulin and burden of diabetes complications at different levels. goals for insulin access and treatment for adults 18 years and older.

A high-speed insulin production line is shown at the Novo Nordisk plant, a global health company, on February 17, 2014 in Chartres. JEAN-FRANCOIS MONIER / AFP / Getty Images

The results showed that the number of adults with type 2 diabetes is expected to increase by more than one-fifth, from 406 million in 2018 to 511 million by 2030, with more than half of people living with in only three countries: China (130 million). , India (98 million) and the United States (32 million).

During this period, the global use of insulin is expected to increase from 526 million vials of 1,000 units in 2018 to 634 million in 2030. Demand is expected to be highest in Asia (322 million vials in 2030) and the lowest in Oceania (4 million). The authors then calculated that the number of people with type 2 diabetes using insulin worldwide in 2030 would double from about 38 million to 79 million.

It is important to note that the study has several limitations. First, the prevalence projections of type 2 diabetes do not take into account the evolution of physical and dietary activity, which means that the disease could have a much larger or smaller impact at the same time. 39; future.

In addition, the methodology used assumes that the relationship between underlying demographics, treatment goals, and complications is similar across countries, neglecting some variation across ethnicities.

"These detailed analyzes explicitly took into account a variety of circumstances," said Hertzel Gerstein of McMaster University, who did not participate in the study. "Nevertheless, they are based on mathematical models that are in turn based on other mathematical models, also based on various assumptions, which suggests that future predictions should be viewed with caution."

"Regardless of these uncertainties, insulin will likely continue to be a crucial treatment for type 2 diabetes and, as a result, sufficient global input must be estimated and assured," he added. "Continuous updates of models such as these, which incorporate new data and trends as they emerge, can be the most reliable way to ensure their reliability and reliability." relevance for evidence-based care.