What will the global use of insulin by 2030 look like?

The researchers estimated from a modeling analysis that the amount of insulin needed to treat type 2 diabetes worldwide would increase by more than 20% by 2030.

Using a microsimulation technique compiling data from 221 countries, 15.5% of people with type 2 diabetes worldwide, or nearly 79 million individuals, should use insulin in 12 years old, according to Sanjay Basu, MD, PhD, of Stanford. University of Palo Alto, California, and colleagues.

The calculation was based on the assumption that if overall access to insulin improved by 2030, patients would be prescribed insulin to achieve a target target of HbA1c ≤7%, they wrote: Lancet Diabetes & Endocrinology.

They also reported that the disability-adjusted life years (DALYs) averted would increase by 44.2% if an 8% A1c was the target among those 75 years of age and older because of a disability. reduced hypoglycemia.

On the other hand, if access to insulin did not improve in the next 12 years, the research group predicted that the prevalence of overall use of the drug would increase. insulin for type 2 diabetes would remain unchanged: 7.5% of people with type 2 diabetes in 2018 (30.2 million people). ) against 7.4% in 2030 (37.6 million people).

Even in this model, the group had predicted that the average annual number of insulin vials used would increase from approximately 516.1 million vials of 1,000 IU per year in 2018 to 633.7 million vials per year by 2030.

Basu's group used the International Diabetes Federation's 2018 to 2030 type 2 diabetes prevalence projections. These data predict that the number of people with type 2 diabetes will rise from 405.6 million this year to 510.8 million by 2030.

In order to estimate the prevalence of people requiring insulin by 2030 if access to insulin did not improve, the researchers multiplied the absolute number people likely to be diagnosed with type 2 diabetes and to be treated with insulin each year during this 12-year period, based on current estimates in each country.

However, to model the need to improve overall access to insulin, the researchers first estimated the total number of patients not yet on insulin, and then simulated the maximal titers of ## EQU1 ## Oral antihyperglycaemic agents, such as metformin and sulfonylureas, to achieve A1c ≤ 7%. They then estimated whether additional insulin would be needed if the individual could not achieve this goal.

The group also predicted that if all people with type 2 diabetes universally achieved an HbA1c ≤7%, access to insulin would prevent 331 101 DALY by 2030 This figure was calculated from the ability of insulins to prevent microvascular complications in these patients, insulin-related hypoglycemia and the disadvantages of treatment.

By 2030, a greater number of disability-adjusted life years would be avoided thanks to expanded access to existing and new oral agents, increasing by almost 15%.

In an accompanying commentary, Hertzel Gerstein, MD, of McMaster University in Hamilton, Ontario, stated that the authors used a "very sophisticated approach" and "created a clear mathematical model, described with rigor and flexibility, which allowed them to estimate the number of insulin users and the amount of insulin needed in the world by 2030, according to various hypotheses. "

Nevertheless, Gerstein pointed out several limitations to microsimulation analysis, including the fact that it is "based on various assumptions", for example, that the prevalence of type 2 diabetes will increase linearly; people over 75 will also remain fragile in 2030; and that there will be no new treatments developed to prevent eye and nerve diseases related to diabetes.

1969-12-31T19: 00: 00-0500

Last update 20/11/2018