Diabetes: What to know about the 'silent epidemic' that kills nearly 7 million of us every year

It’s the silent epidemic that claims an estimated 6.7 million lives around the world each year – close to the total recorded death toll from the COVID-19 pandemic. One in ten adults is affected by the condition, and it is one of the top 10 causes of death globally.

Diabetes is a chronic condition that occurs when the body cannot produce any or enough insulin, or cannot effectively use the insulin it produces. It can cause blindness, kidney failure, heart attacks, stroke and lower limb amputation, among other medical issues.

The number of people with diabetes is currently on track to rise to over 780 million by 2045, according to the International Diabetes Federation (IDF).

In a bid to change that trajectory, in 2022, the World Health Organization (WHO) laid out five global diabetes coverage targets to be achieved by 2030. They are:

With this year's World Diabetes Day on 14 November focusing on 'Breaking Barriers, Bridging Gaps', here are some of the breakthroughs and challenges of this ongoing global health issue.

The World Health Organization (WHO) says the number of cases has nearly quadrupled since 1980. When the IDF first published global data in 2000, there were around 151 million people with the condition.

An estimated 240 million people are living with undiagnosed diabetes worldwide, meaning that almost half of all adults with diabetes are unaware they have the condition, says the IDF. Nine out of ten people with undiagnosed diabetes live in low- and middle-income countries.

Global health expenditure on diabetes in 2021 was an estimated $966 billion and is expected to reach $1 trillion by 2045. The WHO says most of the burden falls on middle- and low-income countries, which are also seeing the greatest increase in cases.

The United Nations Sustainable Development Goals include a pledge to ensure healthy lives for all people, listing diabetes alongside cancer and heart disease as one of the noncommunicable diseases responsible for one death every two seconds among 30-70-year-olds.

China, India, Pakistan and the United States had the highest rates of diabetes in 2021, each with over 30 million cases, according to IDF’s Diabetes Atlas. The condition is rising fastest in sub-Saharan Africa with the number of cases forecast to increase by 134% by 2045.

The number of people with diabetes in the Middle East and North Africa is expected to grow by 87% in the same period with an increase of 68% forecast in South East Asia.

Around 90% of diabetics worldwide have type 2 diabetes, which has been linked to obesity, poor diet, as well as certain ethnic backgrounds. Changes in diet, increased exercise, stopping smoking and maintaining a healthy body weight can manage and even reverse the condition, say experts.

Recent research revealed that daily consumption of processed meat - an amount equivalent to two slices of ham - increased the risk of developing type 2 diabetes by 15%, although experts subsequently reassured that meat needn't be scrubbed from people's diets.

Another recent study linked a sugary diet in the first two years of life to a higher risk of developing type 2 diabetes decades later. The researchers found that people conceived during the sugar rationing period of the 1950s in the UK had a 35% lower risk of diabetes than people conceived after the rationing, when sugar was more readily available.

Again, though, the experts are not saying all sugar should be eliminated, even while pregnant. "It's all about moderation," says one of the study's authors, Tadeja Gracner.

While type 1 diabetes is a life-long condition, type 2 is largely lifestyle-related and therefore has the potential to be reversed.

A UK programme to prevent diabetes via behaviour change has proved successful, with participants' blood sugar levels decreasing as a result of their lifestyle changes.

The approach is inspiring other countries to follow suit - and businesses too. In 2023, US employers spent an estimated $90 billion on workplace healthcare related to obesity - a key cause of type 2 diabetes. A new World Economic Forum report shows how implementing workplace well-being programmes benefits both employers and employees.

Medicine is also proving effective, with the weight-loss drug tirzepatide cutting the risk of type 2 diabetes in prediabetic adults by 94%, according to the drug-maker.

Meanwhile, in a world-first, a woman with type 1 diabetes started producing her own insulin after reprogrammed stem cells were transplanted into her body.