Stanford researchers this week released a sobering study that predicts about 40 million people around the world won’t be able to get the insulin they need for their diabetes in 12 years’ time — if trends continue.
The modelling study, led by Dr. Sanjay Basu, MD, PhD, of Stanford’s Center for Health Policy, was published November 19th in The Lancet Diabetes & Endocrinology. The university released a press release and a number of news outlets also covered the story.
Using data from 221 countries, the researchers modelled various scenarios and estimated that by 2030 the number of people with diabetes worldwide will rise by 20%, from 406 million up to 511 million. The United States will have the third highest numbers, with an expected 32 million people with diabetes in 12 years.
Of those with type 2 diabetes, about 15.5% — some 79 million people globally — are expected to require insulin to keep their blood glucose in check. However, the study projects that without major improvements in the cost and access to insulin, almost half of those — some 40 million people — will not be able to get it. The impact is predicted to be greatest in Africa and Asia.
Basu and his co-authors warn that strategies must be adopted to make insulin more widely available and affordable. Insulin is expensive and the market is currently dominated by just three manufacturers, they noted.
One strategy that they modelled was to relax the guidelines for blood sugar targets for diabetics over the age of 75. Rather than aim for current HbA1C targets of 6.5 to 7%, aiming instead for 8% in older people “would halve the need for insulin” and better balance the health risks and benefits to those affected.
Basu and his team, however, did not model the impact of a widespread change in diet and lifestyle, which they noted was one of the limitations of their study.
How might a significant global uptake of low-carb ketogenic diets, which helps prevent and reverse diabetes, impact insulin needs?
Their study can’t say. However, the results of the 1-year Virta Health clinical trial, released earlier this year, gives some promising clues. The Virta study found that an impressive 94% of their diabetic participants who followed the low-carb ketogenic diet reduced or completely eliminated their use of insulin.