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Diabetes: insulin requirements are rising throughout the world



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Palo Alto – The global diabetes epidemic increases the demand for insulin. The need for calculations in Lancet diabetes and endocrinology (2018, doi: 10.1016 / S2213-8587 (18) 30303-6) will increase by about 20% by 2030.

All people with type 1 diabetes should inject insulin if they want to survive. People with type 2 diabetes are initially treated with other drugs. In advanced disease, however, insulin is often the only agent with satisfactory long-term blood glucose levels (HbA1c) can be achieved.

Insulin was the first genetic engineering drug 40 years ago. Therefore it can be theoretically produced in unlimited quantities. Prices are relatively high. There are only 3 producers in the world (Novo Nordisk, Sanofi and Eli Lilly). Therefore, in poorer countries, many patients can not afford treatment.

At present, the shortfall is most pronounced in Africa. In order to treat all patients who need insulin, production will need to increase by factor 7, according to a team led by Sanjay Bassu from Stanford University in Palo Alto, California: instead of the current 718,000 bottles, by 2030 5 , 1 million needed.

In Asia, too, demand will increase sharply by 2030. Bassu expects an increase of 26.5 million ampoules annually.

It is currently estimated that there will be 406 million people with type 2 diabetes worldwide, compared with 511 million by 2030. More than half of them live in 3 countries: China (130 million), India (98) million euros) and the United States (32 million).

Basu estimates that global annual insulin requirements will increase by about 20% from 526 million bottles in 2018 to 634 million in 2030.

The need depends on which HbA1cTarget values ​​should be sought. According to today's standards, 7.4% of all type 2 diabetics are treated with insulin. In (diabethologically significant but challenging) HbA1cFor the target of 7.0%, 15.5% of all people with insulin with type 2 diabetes will need it.

A HbA1cThe value of 7% today has been achieved only by a few people with type 2 diabetes. However, according to further calculations from Basu, he can prevent the loss of many years without disease (DALY). Currently, 262,884 DALY is lost because diabetics do not reach target levels. By 2030, it may be 331,101 if insulin is not available in sufficient quantities and at reasonable prices. © heat / aerzteblatt.de


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