Global prevalence of type 1 diabetes to double by 2040, finds study

Close to 8.4 million people are currently living with type 1 diabetes, and this number is expected to rise to 13.5 to 17.4 million by 2040, a new modeling study published in The Lancet Diabetes & Endocrinology has found.

Type 1 diabetes, also known as juvenile diabetes, is a severe condition in which the pancreas does not make insulin. It is an autoimmune condition which the body goes through. The reaction destroys the cells in the pancreas that make insulin called the beta cells.

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"An estimated 8.4 million people around the world had type 1 diabetes in 2021, and this number may rise to 17.4 million by 2040, a modelling study has predicted. The study, by researchers from Australia, Canada, Luxembourg, and the US, also estimated that around 3.1 million people would have been alive in 2021 if they hadn’t died prematurely as a result of poor care for type 1 diabetes and that a further 700 000 would still be alive if they hadn’t died because their illness wasn’t diagnosed," the study found.

For the study, researchers modelled data on childhood, adolescent and adult type 1 diabetes prevalence in 97 countries, with projections of future prevalence through 2040.

The study found that of the 8.4 million people with type 1 diabetes, 18% were under 20 years old, 64% were between 20-59 years, and 19% were over 60 years.

The study revealed that more adults than children are diagnosed every year, with a mean diagnosis age of 32 years.

Dr. Ambrish Mithal, Chairman of Endocrinology and Diabetology, Medanta explains, "Type 1 diabetes is widely seen in children and also seen in adults. It is characterized by severe insulin deficit as there is a lack of insulin secretion in pancreas - this develops a life threatening condition called diabetic ketoacidosis.”

The countries with the highest estimated prevalence of this type of diabetes are: USA, India, Brazil, China, Germany, UK, Russia, Canada, Saudi Arabia, and Spain. These countries account for 5.08 million or 60% of the global cases of type 1 diabetes, the study found.

This disease, which is a highly prevalent endocrine disorder in children, is widely seen in India.

According to data from the International Diabetes Federation, with 229,400 cases, India currently has the highest estimated prevalence of type 1 diabetes cases among people under the age of 20. Nearly 24000 new cases of type 1 diabetes are added every year.

"Type 1 Diabetes is characterized by decreased or nonexistent insulin production due to the autoimmune destruction of the pancreatic islet cells which produce insulin. The immune system of the body destroys the pancreatic beta-cells that produce insulin as a result, either very little or no insulin is produced by the body,” explains Dr. Khalid J Farooqui, Principal Consultant - Endocrinology & Diabetes, Max Hospital Gurugram.

“Although the exact reasons for this destructive process are unknown, a reasonable theory is that the autoimmune reaction is caused by a combination of genetic vulnerability and an environmental trigger, such as a viral infection," he adds.

On the various risk factors associated with type 1 diabetes, Dr Farooqui says, in comparison to type 2 diabetes, type 1 diabetes risk factors are less well understood.

“Genetic factors have a key role to play. Type 1 diabetes is more likely to occur in those who have specific genes. A person's risk of getting type 1 diabetes is marginally increased if they have a parent or sibling who has the disease,” says the experts.

“Exposure to certain viral infections, bacterial infections and alteration in gut microbiota also have a role to play,” he adds.

There is no known way to prevent type 1 diabetes.

“Crudely speaking, type 1 diabetic patients require insulin treatment to survive; oral medication plays a very small role to reduce the effect of type 1 diabetes in patients,” says Dr Mithal.

“Various approaches have been tried like immunosuppressive and immunomodulatory agents. These medications are at present limited to trial setting only and not recommended in routine clinical practice.Primary prevention targets individuals at high risk of developing Typ1 DM prior to appearance of autoimmunity. Secondary prevention trials aim to halt the progression of complete beta-cell destruction in subjects who have established islet autoimmunity,” explains Dr Farooqui.