Newly published research recognizes that the amount of insulin needed worldwide to treat type 2 diabetes (T2DM) in the future is unknown, and that the impact of alternative treatment alogrithms on insulin use and adverse outcomes, given the limited access to insulin in numerous areas, is unclear. The research goal was to examine projected global insulin use under different treatment algorithms and varying access to insulin.

Lead author, Sanjay Basu, PhD, affiliated with Stanford University, Palo Alto, California, along with other members of the research team, extracted data from the International Diabetes Federation that supported the development of a simulated burden for the treatment of diabetes spanning from 2018 to 2030 and covering 221 countries. Researchers used the International Diabetes Federation prevalence projections statistics, along with data from 14 cohort studies, to support estimates of the number of people who would need insulin, as well as the daily amount of insulin (measured as IU) they would likely require. The team considered algorithms that prevented adverse diabetic consequences by adequately targeting A1C reductions from 6.5% to 8%, as well as opportunities to lower microvascular risk, and allowing a more lenient (higher) A1C for those aged 75 years and older.

Basu et al estimated that worldwide, the number of people with T2DM is expected to increase from roughly 405 million in 2018 to just under 511 million in 2030 and that based on these numbers, the estimated need for insulin would increase from roughly 516 million vials (1,000 IU per vial) per year in 2018 to just under 634 million per year in 2030. The team further concluded that without improved insulin access, only 7.4% of people with T2DM in 2030 would likely be able to use insulin.

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