Diabetes: Cases double in 30 years - and the outlook is bleak

Nearly one in 10 adults now has the disease, according to major study

A major international study has revealed the number of adults worldwide with Type 2 diabetes has more than doubled in three decades, soaring to an estimated 347 million.

The research, published yesterday in The Lancet, shows levels have risen or at best remained unchanged in every part of the world. Over the past 30 years, the proportion of men with the condition rose from 8.3 to 9.8 per cent. The proportion of women with diabetes increased from 7.5 to 9.2 per cent.

Professor Majid Ezzati from Imperial College London, who led the research, says that the figures don't reflect the generations of overweight children and young adults who have yet to reach middle age. "We are not at the peak of this wave yet," he said. "And unlike high blood pressure and cholesterol, we still don't have great treatments for [Type 2] diabetes."

Unlike Type 1 diabetes, which is typically diagnosed in childhood and is due to the body's inability to produce insulin, Type 2 is linked to obesity and tends to strike in middle age.

Much of the increase in Type 2 diabetes can be attributed to ageing populations and by population growth, but part of it has also been fuelled by rising obesity rates. The study, the largest of its kind, was co-led by Dr Goodarz Danaei from the Harvard School of Public Health, in collaboration with the World Health Organisation and a number of other institutions.

Blood sugar measurements from 2.7 million participants aged 25 or over from around the world were examined. Professor Ezzati and his colleagues also scrutinised more than 150 national health surveys and studies that tracked Type 2 diabetes in adults over 25 in 199 countries and territories. They used modelling to estimate cases for another 92 countries. With numbers going up almost everywhere, experts said the disease has now become a global crisis. Countries in which the numbers rose fastest include Cape Verde, Samoa, Saudi Arabia, Papua New Guinea and the US. Prevalence rose most sharply in the Pacific Island nations, with the Marshall Islands being the diabetes capital of the world. One in three women and one in four men there have diabetes.

In the UK and elsewhere in Western Europe, there was only a slender rise, despite widening waistlines. Levels were lowest in the Netherlands, Austria and France. Experts admitted they were uncertain why and suggested several theories, including worse detection of the disease, genetic differences, or perhaps that Europeans were better at getting the overweight to reduce their risk factors through public campaigns on healthy eating, smoking and fitness.

Women in Singapore, France, Italy and Switzerland remained relatively slim, with almost no change in diabetes rates. Numbers also stayed flat in sub-Saharan Africa, central Latin America and rich Asian countries.

While increasing lifespan and body weight were acknowledged as two of the strongest factors influencing diabetes rates, especially among women, other factors exist. Genetic factors, nutrition in the womb and after birth, diet and physical activity are also important. South Asians were cited as an example of ethnic genetic factors at play. Men in southern Asia had the second smallest change in BMI (body mass index) of the 21 sub-regional studies, yet the sixth highest rate in mean FPG ("fasting plasma glucose") used to diagnose diabetes. Southern Asian women had the fourth smallest BMI change but the sixth largest rise in FPG, about the same as in high-income North America where female BMI increased three times as much.

Doctors warned of the higher susceptibility of certain groups such as Asians, blacks and Hispanics to diabetes. "Other ethnicities don't have to be as obese as people of European descent to get diabetes," said Dr Aaron Cypess, a physician at Joslin Diabetes Center not linked to the Lancet study. "It may be, for example, that Indians and Chinese store their fat in more dangerous places, like a pot belly," he said, putting forward the theory that this kind of abdominal fat can send out hormones to speed up diabetes.

Between 85 and 95 per cent of all diabetes cases fall into the lifestyle-related Type 2 category. Type 1, or insulin-dependent, diabetes is a separate auto-immune disorder and much less common. This week ,a study gave hope to the 2.9 million Type 2 diabetes sufferers in the UK. Researchers at Newcastle University discovered that an extreme eight-week diet of 600 calories a day can reverse the condition in newly diagnosed people. The study included 11 people following a strict low-calorie diet resulting in pre-breakfast blood sugar levels returning to normal within just a week. Results showed that reduced fat levels in the pancreas and liver helped insulin production return to normal. More research is planned to see whether the reversal is permanent.

The overall outlook, however, is bleak. Hyperglycaemia and diabetes are responsible for more than three million deaths worldwide every year, through both direct clinical complications and indirect health problems such as heart disease and strokes. "Diabetes may well become the defining issue of global health for the next decade," said Professor Ezzati.

Dr Danaei said: "Unless we develop better programmes for detecting people with elevated blood sugar and helping them to improve their diet and physical activity, diabetes will continue to impose a major burden on health systems around the world."

Case studies...

Surjeet Soin; Accountant

Surjeet, 66, an accountant from Luton, was diagnosed with Type 2 diabetes in 1995. It was no surprise when the doctor came back with his glucose test results

"I had all the typical symptoms – I was overweight and had been inactive for years," he says. He started medication and overhauled his lifestyle. He gave up alcohol and took up walking. "I realised I had to do something," he adds. His charity work for Diabetes UK has taken him to the volcanic mountains in Ecuador and the Everest base camp. "I have done the three peaks in Yorkshire every year for many years. It helps me maintain my health." Every three months he goes for a blood test. He runs a local support group offering advice to other diabetics and also participates in Diabetes UK awareness days. Surjeet says he believes patients need to be educated. "It is not a big part of my life but it is something I have to deal with."

Kate Baumber; Development manager

Kate, 42, from Woodhall Spa, Lincolnshire, was diagnosed with Type 1 diabetes aged nine

"Back then insulin injections involved stainless steel needles," she says. It impacted enormously on her life: as a teen she suffered numerous hypoglycaemic episodes (when blood sugar levels fall too low) and struggled during pregnancy. Kate's insulin pump has changed her life immeasurably. "I am a lot more confident, don't have to inject and there are no more comas."

Roger Lewis; Retired drama teacher

Roger, 61, from Watford, was diagnosed with Type 2 diabetes in 2000. He had his leg amputated below the knee after developing ischaemia (blood supply damage)

"I assumed medication was enough. The amputation was one of the most horrible experiences, but I would be dead if I had continued as I was." He no longer smokes, and eats healthily and goes to the gym. Roger has also been invited by Watford General Hospital to talk to prospective amputees, to show them "life isn't over".

Interviews by Katie Binns

Voices
voices
Life and Style
Upright, everything’s all right (to a point): remaining on one’s feet has its health benefits – though in moderation
HealthIf sitting is bad for your health, what happens when you stay on your feet for a whole month?
Arts and Entertainment
Peter Griffin holds forth in The Simpsons Family Guy crossover episode
arts + ents
Sport
Laura Trott with her gold
Commonwealth GamesJust 48 hours earlier cyclist was under the care of a doctor
PROMOTED VIDEO
Life and Style
ebookA wonderful selection of salads, starters and mains featuring venison, grouse and other game
Arts and Entertainment
Gal Gadot as Wonder Woman
arts + entsFilmmaker posted a picture of Israeli actress Gal Gadot on Twitter
News
Bryan had a bracelet given to him by his late father stolen during the raid
people
Arts and Entertainment
Chris Pratt stars in Guardians of the Galaxy
arts + ents
Arts and Entertainment
Pedro Pascal gives a weird look at the camera in the blooper reel
arts + entsPrince Oberyn nearly sets himself on fire with a flaming torch
News
Danny Nickerson, 6, has received 15,000 cards and presents from well-wishers around the world
newsDanny loves to see his name on paper, so his mother put out a request for cards - it went viral
Sport
France striker Loic Remy
sportThe QPR striker flew to Boston earlier in the week to complete deal
News
Orville and Keith Harris. He covered up his condition by getting people to read out scripts to him
People
Arts and Entertainment
Zoe Saldana stars in this summer's big hope Guardians of the Galaxy
filmHollywood's summer blockbusters are no longer money-spinners
Arts and Entertainment
O'Shaughnessy pictured at the Unicorn Theatre in London
tvFiona O'Shaughnessy explains where she ends and her strange and wonderful character begins
Life and Style
Workers in Seattle are paid 100 times as much as workers in Bangladesh
fashionSeattle company lets customers create their own clothes, then click 'buy' and wait for delivery
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Data Analyst

    £30000 per annum: Ashdown Group: A highly reputable software house is looking ...

    Application Support Analyst / Junior SQL Server DBA

    £40000 - £45000 per annum: Ashdown Group: An established professional services...

    Commercial Litigation

    Highly Attractive Salary: Austen Lloyd: CITY - SENIOR COMMERCIAL LITIGATION SO...

    BI Developer - Sheffield - £35,000 ~ £40,000 DOE

    £35000 - £40000 per annum + competitive: Progressive Recruitment: My client is...

    Day In a Page

    A new Russian revolution: Cracks start to appear in Putin’s Kremlin power bloc

    A new Russian revolution

    Cracks start to appear in Putin’s Kremlin power bloc
    Eugene de Kock: Apartheid’s sadistic killer that his country cannot forgive

    Apartheid’s sadistic killer that his country cannot forgive

    The debate rages in South Africa over whether Eugene de Kock should ever be released from jail
    Standing my ground: If sitting is bad for your health, what happens when you stay on your feet for a whole month?

    Standing my ground

    If sitting is bad for your health, what happens when you stay on your feet for a whole month?
    Commonwealth Games 2014: Dai Greene prays for chance to rebuild after injury agony

    Greene prays for chance to rebuild after injury agony

    Welsh hurdler was World, European and Commonwealth champion, but then the injuries crept in
    Israel-Gaza conflict: Secret report helps Israelis to hide facts

    Patrick Cockburn: Secret report helps Israel to hide facts

    The slickness of Israel's spokesmen is rooted in directions set down by pollster Frank Luntz
    The man who dared to go on holiday

    The man who dared to go on holiday

    New York's mayor has taken a vacation - in a nation that has still to enforce paid leave, it caused quite a stir, reports Rupert Cornwell
    Best comedians: How the professionals go about their funny business, from Sarah Millican to Marcus Brigstocke

    Best comedians: How the professionals go about their funny business

    For all those wanting to know how stand-ups keep standing, here are some of the best moments
    The Guest List 2014: Forget the Man Booker longlist, Literary Editor Katy Guest offers her alternative picks

    The Guest List 2014

    Forget the Man Booker longlist, Literary Editor Katy Guest offers her alternative picks
    Jokes on Hollywood: 'With comedy film audiences shrinking, it’s time to move on'

    Jokes on Hollywood

    With comedy film audiences shrinking, it’s time to move on
    It's the best of British art... but not all is on display

    It's the best of British art... but not all is on display

    Voted for by the British public, the artworks on Art Everywhere posters may be the only place where they can be seen
    Critic claims 'I was the inspiration for Blanche DuBois'

    Critic claims 'I was the inspiration for Blanche DuBois'

    Blanche Marvin reveals how Tennessee Williams used her name and an off-the-cuff remark to create an iconic character
    Sometimes it's hard to be a literary novelist

    Sometimes it's hard to be a literary novelist

    Websites offering your ebooks for nothing is only the latest disrespect the modern writer is subjected to, says DJ Taylor
    Edinburgh Fringe 2014: The comedy highlights, from Bridget Christie to Jack Dee

    Edinburgh Fringe 2014

    The comedy highlights, from Bridget Christie to Jack Dee
    Dame Jenny Abramsky: 'We have to rethink. If not, museums and parks will close'

    Dame Jenny Abramsky: 'We have to rethink. If not, museums and parks will close'

    The woman stepping down as chair of the Heritage Lottery Fund is worried