The number of T1D cases is expected to double worldwide by 2040

About 8.4 million people around the world were living with type 1 diabetes (T1D) in 2021, and that number is expected to rise to 17.4 million by 2040, according to a modeling study published in The Lancet Diabetes & Endocrinology.

The study was conducted by researchers from the United States, Canada, Australia and Luxembourg. These researchers also estimated that by 2021, about 3.1 million people with T1D would have been alive if they had not died prematurely as a direct result of poor T1D care, and that an additional 700,000 people would have been alive if they had not would have died due to deficiency of diagnosis.

As reported by BMJ, These results were entered into an open-source database for the T1D Index project, launched this month by the nonprofit Juvenile Diabetes Research Foundation (JDRF), which shows how many people are living with T1D around the world and what actions can be taken to reduce its impact. The study was funded by JDRF.

Researchers applied a discrete-time disease-death (Markov) model to data on T1D incidence and associated mortality to estimate T1D incidence, prevalence, associated mortality, and life expectancy in 201 countries.

Incidence and mortality data were available from 97 and 37 countries, respectively, and data from an expert survey were used to estimate T1D diagnosis rates. Random forest regression of published T1D mortality data was used to model estimated mortality and life expectancy was calculated using life tables.

These estimates were validated using observed prevalence data from 15 countries.

The authors found that in 2021, between 8.1 and 8.8 million people were living with T1D worldwide.

Of this group, 1.5 million (18%) were under the age of 20, 5.4 million (64%) were between the ages of 20 and 59, and 1.6 million (19%) were 60 years and older.

“There is a systemic trend towards other published estimates with a lower pediatric prevalence and higher adult prevalence than in our model,” the authors noted.

Half a million new cases of T1D were diagnosed in 2021, with a median age of onset of 39 years. Additionally, approximately 35,000 people who did not receive a T1D diagnosis died within 12 months of symptom onset.

“The burden of type 1 diabetes in 2021 is enormous and is expected to increase rapidly, particularly in resource-constrained countries,” the authors said, noting that 1.8 million, or one in five, of the people who will die in 2021 living with T1D worldwide, living in low-income or low- to middle-income countries.

Additionally, the median remaining life expectancy for a 10-year-old diagnosed with T1D in 2021 ranged from 13 years in low-income countries to 65 years in high-income countries.

Researchers predict between 13.5 and 17.4 million cases of type 1 diabetes (T1D) in 2040, representing a 60% to 107% increase in global cases compared to 2021.

The researchers also estimated 3.7 million missing cases of T1D in 2021.

“The significant lack of prevalence underscores the premature mortality of type 1 diabetes and an opportunity to save and prolong the lives of people with type 1 diabetes,” the authors said. “Our new model, which will be made publicly available as the Type 1 Diabetes Index Model, will be an important tool to support healthcare, advocacy and funding decisions for type 1 diabetes.”

Relation

Gregory GA, Robinson TIG, Linklater SE, et al. Global incidence, prevalence and mortality of type 1 diabetes in 2021 with projection to 2040: a model study. Lancet Diabetes Endocrinol. 2022;S2213-8587(22)00218-2. doi:10.1016/S2213-8587(22)00218-2