Type 1 Diabetes Cases Projected to Double by 2040

In 2021, type 1 diabetes (T1D) cases around the world were estimated at 8.7 million. According to estimates by the global Type 1 Diabetes Index (T1D Index) that were recently published in The Lancet Diabetes and Endocrinology scientific journal, that number could double by 2040.

The article also provides details on the average age of people with T1D and the risk of complications, and especially on the positive impact that prevention measures and a cure could have.

The current situation

According to the global T1D Index, approximately 8.7 million people worldwide were living with T1D in 2021:

• 17% were under 20 years of age
• 64% were between 20 and 59 years of age
• 19% were 60 years of age or older 

Also in 2021, the number of new cases diagnosed was estimated at about half a million, and the median age of people at the time of onset was 39 years. This study therefore confirms that the age of onset is much later than it used to be. Late-onset diabetes is often referred to by the acronym “LADA” (Latent Autoimmune Diabetes of the Adult). Almost 10% of people with T1D who signed up to the BETTER registry reported having LADA. This form of T1D is often diagnosed late and is confused with type 2 diabetes at first.

The Index also provides data on T1D in low- and middle-income countries. Approximately 1.8 million people are estimated to have T1D in these countries, representing one fifth of the total number of T1D cases worldwide. In these countries, the life expectancy of a 10-year-old child upon diagnosis is estimated at 13 years, compared to 65 years in high-income countries. These numbers highlight how access to care and new treatment options have a major impact on the course of T1D.

2040 forecast 

If the Index’s projections turn out to be accurate, T1D cases are expected to rise to approximately 17 million in 2040, which is twice as many as in 2021. This increase, whose causes are debated, is expected to occur mainly in low- and middle-income countries. Possible hypotheses include viral infections (including COVID), certain pollutants, and certain food additives. 

The situation in Canada

Specific figures are available for Canada, since the Index measures and maps out the number of people with T1D by country.

Here are some of the estimates:

1. Currently, 285,000 people are living with T1D. 
2. By 2040, this number could rise to 455,000.
3. If diagnosed at age 10, the number of years of healthy life (without activity-limiting complications) is 62 years, almost 22 years less than the general population.
4. If all people living with T1D in Canada had access to continuous glucose monitors (CGM) systems and insulin pumps, six years of healthy life could be gained.

Advocating for equitable care

The Index suggests that 3.9 million people would still be alive today had they had equitable access to diabetes care and treatment tools. If the status quo is maintained, that number could skyrocket to 6.8 million deaths by 2040. 

The simulations conducted by the Index put forward four strategies that have the potential to change current predictions for T1D and its impacts by 2040:

• Promote timely diagnosis. If, by 2023, healthcare professionals could be trained to make a diagnosis quickly, 668,000 more lives could be saved.
• Facilitate access to insulin and blood sugar testing strips. If people had barrier-free access to insulin and test strips, combined with appropriate support, more than 1.98 million additional lives could be saved.
• Facilitate access to technologies (CGM, insulin pump and artificial pancreas). If all people living with T1D could benefit from the available technologies by 2023, 673,000 additional lives could be saved.
• Promote and invest in research. Finding a cure for T1D could save an additional 890,000 lives.

In addition to the strategies highlighted here, the Index encourages people with T1D to take action by sharing their data and results with their network (e.g., participating in the BETTER registry) and local policymakers, and by engaging with other T1D advocates in their community.

References :

• Gregory, Gabriel A et al. “Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study.” The lancet. Diabetes & endocrinology vol. 10,10 (2022): 741-760. doi:10.1016/S2213-8587(22)00218-2
• The T1D Index reveals the global scope and impact of type 1 diabetes, Type 1 Diabetes Index, consulté le 27 septembre 2022, https://www.t1dindex.org/
• About the T1D Index, Type 1 Diabetes Index, consulté le 27 septembre 2022, https://www.t1dindex.org/about/