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02-28-2018 | Epidemiology | News

# Urgent action needed to reduce future economic burden of diabetes

medwireNews: The global cost of diabetes is set to be at least 61% higher in 2030 than it was in 2015, even if international targets to reduce diabetes prevalence and mortality are met, study findings indicate.

And although the increase in global cost will be largely counteracted by increased economic capacity, global economic burden relative to gross domestic product (GDP) will not improve, meaning that “[c]oordinated action is needed to prepare for this development,” Christian Bommer (University of Goettingen, Germany) and co-authors write in Diabetes Care.

Using epidemiologic and demographic data, Bommer and team created three scenarios to predict future costs of diabetes in individuals aged 20–79 years living in 180 countries worldwide.

In the first scenario they assumed that diabetes prevalence and mortality increased only with urbanization and population aging (baseline scenario), while in the second it increased in line with previous trends (past trends scenario).

In the third scenario, the researchers assumed that countries met the Sustainable Development Goals (SDG) of a one-third reduction in premature mortality due to diabetes and the World Health Organization Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020, which aims to stop the increasing prevalence of diabetes until 2025 (target scenario).

In all scenarios, the total economic burden of diabetes was defined as “the sum of excess health expenditure (direct costs) and the value of forgone production (indirect costs) due to diabetes and its complications.”

Bommer et al calculated that, in the baseline scenario, global diabetes prevalence would increase from 8.8% in 2015 to 10.0% in 2030 and the number of diabetes-related deaths would increase from 3.1 million to 4.2 million.

The projected prevalence in the past trends scenario is 11.8%, with an increase in the number of predicted deaths to 4.6 million. Corresponding predictions for the target scenario are 9.8% prevalence and a reduction to 2.8 million deaths.

In terms of cost, the absolute global economic burden is predicted to increase from US$1.3 trillion in 2015 to US$ 2.3 trillion in the baseline, US$2.5 trillion in the past trends, and US$ 2.1 trillion in the target scenarios by 2030.

As a percentage of GDP, the increase was less pronounced in each scenario, rising from 1.8% in 2015 to 1.9% and 2.2% in 2030 under the baseline and past trends scenarios, respectively, and remaining stable at 1.8% under the target scenario.

“Our findings should provide a strong and urgent incentive for countries, international health organizations, and local public health agencies to take action to reduce the burden of diabetes and its complications,” Bommer and colleagues remark.

And they conclude: “Although we have found that costs of diabetes in 2030 do not fall if global targets to reduce diabetes prevalence and mortality are met, it is imperative that actions are taken to reduce modifiable risk factors, for instance, obesity and physical inactivity, to ensure that costs do not rise even further.”

By Laura Cowen

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