Diabetes has emerged as one of the most pressing global health challenges of the 21st century. Affecting hundreds of millions of people across every continent, the disease’s impact extends far beyond the individual, shaping economies, healthcare systems, and the fabric of societies worldwide. This article explores the multifaceted burden of diabetes, examining its economic, social, and health-related consequences, and highlighting the urgent need for coordinated action.
Global Prevalence and Trends
The prevalence of diabetes has risen at an alarming rate over the past decades. According to the World Health Organization (WHO), the number of adults living with diabetes worldwide has surpassed 800 million, more than quadrupling since 19904. The global prevalence in adults doubled from 7% in 1990 to 14% in 2022, with the most significant increases observed in low- and middle-income countries4. Factors such as rapid urbanization, population aging, sedentary lifestyles, and the widespread marketing of unhealthy foods have contributed to this surge24.
Type 2 diabetes accounts for 90-95% of all cases, while Type 1 diabetes comprises 5-10%2. The disease affects people of all ages, but its burden is particularly acute among older adults and disadvantaged populations.
Economic Impact
Direct and Indirect Costs
The economic burden of diabetes is staggering and continues to grow. In 2015, the global costs of diabetes and its consequences reached $1.3 trillion, accounting for 1.8% of global GDP1. Projections indicate that this figure will rise to as much as $2.5 trillion by 2030, even if international targets for diabetes control are met1. The International Diabetes Federation (IDF) estimated that direct healthcare costs from diabetes reached $727 billion in 2017, with the total economic impact, including indirect costs, exceeding $1 trillion2.
Direct costs primarily include medical expenses such as hospitalizations, medications, and outpatient care. In high-income countries, direct medical costs account for up to 74% of the economic impact, while in low-income nations, they represent 56%5. Indirect costs-such as lost productivity, absenteeism, disability, and premature mortality-also constitute a significant portion of the overall burden, particularly in low- and middle-income countries where access to effective care is limited5.
| Aspect | High-Income Countries | Low-Income Countries |
|---|---|---|
| Direct Medical Costs | 74% | 56% |
| Indirect Productivity Losses | High | High |
| Per Capita Cost (Type 2 Diabetes) | $10,801 | $242 |
Impact on National Economies
Diabetes not only strains individuals and families but also has macroeconomic consequences. The loss of workforce due to diabetes-related complications and premature deaths reduces economic productivity and hinders national development2. Governments are struggling to meet the rising costs of diabetes care, and in many countries, health systems are ill-equipped to provide effective management due to resource constraints and shortages of trained professionals2.
The financial burden is particularly acute in low- and middle-income countries, where the majority of people with diabetes reside and where treatment coverage remains persistently low4. As a result, the economic impact of diabetes threatens to overwhelm healthcare systems and impede economic growth, exacerbating existing inequalities2 3 4.
Social Impact
Health Inequalities and Social Exclusion
Diabetes disproportionately affects disadvantaged populations, intensifying existing social and economic inequalities. Individuals with lower socioeconomic status often face greater challenges in managing the disease due to limited access to healthcare, nutritious food, and stable housing3. The personal financial burden of increased healthcare costs can further entrench poverty, creating a vicious cycle of deprivation and social exclusion3.
Diabetes can also reduce educational attainment and limit employment opportunities, particularly if the condition is poorly managed3. This, in turn, leads to decreased productivity and further economic hardship, perpetuating the cycle of inequality.
Impact on Families and Communities
The consequences of diabetes extend beyond the individual to families and communities. Family members may need to provide care for those with diabetes-related disabilities, leading to lost income and increased stress. Communities bear the collective burden of increased healthcare costs, reduced workforce participation, and the social consequences of chronic illness.
Healthcare Systems Under Strain
Rising Demand and Treatment Gaps
The rapid increase in diabetes prevalence has placed unprecedented demands on healthcare systems worldwide. Many countries, particularly low- and middle-income countries, lack the resources and infrastructure to provide adequate prevention, early detection, and ongoing management of diabetes2 4. As of 2022, almost 450 million adults with diabetes-about 59% of all adults with the disease-remained untreated, with 90% of these untreated individuals living in low- and middle-income countries4.
Treatment coverage is lowest in regions such as South-East Asia, the Eastern Mediterranean, and Africa, where fewer than four in ten adults with diabetes receive glucose-lowering medication4. This treatment gap leads to higher rates of complications, hospitalizations, and premature deaths, further increasing the societal burden.
Complications and Comorbidities
Diabetes is a major risk factor for a range of serious health complications, including cardiovascular disease, kidney failure, blindness, and lower limb amputations. These complications not only reduce quality of life but also drive up healthcare costs and contribute to increased mortality5. The management of diabetes-related complications accounts for a significant share of the overall economic burden, particularly in high-income countries where advanced treatments are available5.
Impact on Human Development and Global Goals
Diabetes has far-reaching implications for human development and the achievement of global development goals. Preventable deaths and disability from diabetes undermine efforts to reduce poverty, improve health, and promote economic growth2. The disease threatens to derail progress toward the United Nations Sustainable Development Goals (SDGs), particularly those related to health, education, and inequality12.
Conclusion
The burden of diabetes on society is profound and multifaceted. It affects individuals, families, communities, economies, and nations. With prevalence continuing to rise, the disease poses a significant threat to global health, economic stability, and social progress. Addressing diabetes requires a comprehensive, multi-sectoral approach that prioritizes prevention, equitable access to care, and the reduction of health inequalities. Without decisive action, the impact of diabetes will continue to grow, with far-reaching consequences for generations to come.
Reference：
- Bommer C, Sagalova V, Heesemann E, Manne-Goehler J, Atun R, Bärnighausen T, Davies J, Vollmer S. Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030. Diabetes Care. 2018 May;41(5):963-970. doi: 10.2337/dc17-1962. Epub 2018 Feb 23. PMID: 29475843.
- Diabetes: A Global Health Challenge. (2018, June 25). Open Access Government. https://www.openaccessgovernment.org/diabetes-a-global-health-challenge/46992/
- Hill J, Nielsen M, Fox MH. Understanding the social factors that contribute to diabetes: a means to informing health care and social policies for the chronically ill. Perm J. 2013 Spring;17(2):67-72. doi: 10.7812/TPP/12-099. PMID: 23704847; PMCID: PMC3662286.
- Urgent Action Needed as Global Diabetes Cases Increase Four-Fold over Past Decades. (2024, November 13). WHO. https://www.who.int/news/item/13-11-2024-urgent-action-needed-as-global-diabetes-cases-increase-four-fold-over-past-decades
- Butt MD, Ong SC, Rafiq A, Kalam MN, Sajjad A, Abdullah M, Malik T, Yaseen F, Babar ZU. A systematic review of the economic burden of diabetes mellitus: contrasting perspectives from high and low middle-income countries. J Pharm Policy Pract. 2024 Apr 19;17(1):2322107. doi: 10.1080/20523211.2024.2322107. PMID: 38650677; PMCID: PMC11034455.