Attainment of global diabetes targets in 2021: a pooled analysis of individual-level data from national surveys in 100 low-income, middle-income, and high-income countries
Year: 2025
Type: article
Abstract: Background WHO launched the Global Diabetes Compact in 2021 to improve worldwide diabetes outcomes by scaling up access to comprehensive, affordable, and high-quality care. This initiative established population diabetes metrics and targets for countries to attain by 2030, namely, 80% of all people with diabetes are diagnosed; and, among people with diagnosed diabetes, 80% have good glycaemic control (HbA 1c <8·0%), 80% have good blood pressure control (<140/90 mm Hg), and 60% of people older than 40 years use statins. We aimed to estimate attainment of global diabetes targets worldwide and across country and individual characteristics in 2021. Methods We analysed pooled, individual participant data from nationally representative household health surveys done in 100 low-income, middle-income, and high-income countries between 2010 and 2023. The sample included non-pregnant adults aged 30–69 years. Diabetes was defined as use of glucose-lowering medications or biochemical evidence of diabetes (fasting plasma glucose ≥7·0 mmol/L or HbA 1c ≥6·5% [48 mmol/mol]). The primary outcomes were the proportion of people attaining each diabetes metric. We analysed data using hierarchical Bayesian logistic regression models with the survey year set to 2021. We estimated the age-standardised proportion attaining each metric across the pooled dataset, by country-level characteristics such as World Bank income group, by country, and by individual-level characteristics including age, sex, educational attainment, and BMI. Findings In 2021, across the pooled dataset, the age-standardised proportion of people with diabetes who had been diagnosed was 63·2% (95% CI 61·8–64·6). Among those diagnosed, 63·2% (62·1–64·4) achieved glycaemic control (HbA 1c <8·0%), 70·8% (69·8–71·9) achieved blood pressure control (<140/90 mm Hg), and 31·8% (30·4–33·2) were using statins. Of the 100 included countries, eight met the target for diabetes diagnosis, seven met the target for glycaemic control, 15 met the target for blood pressure control, and eight met the target for statin use. By country income group, the age-standardised proportion of people with diabetes who had been diagnosed ranged from 35·3% (33·5–37·1) in low-income countries to 69·9% (68·3–71·5) in high-income countries. Among those with diagnosed diabetes, glycaemic control ranged from 56·0% (54·2–57·8) in lower-middle-income countries to 73·7% (72·7–74·6) in high-income countries; blood pressure control ranged from 58·3% (57·3–59·4) in lower-middle-income countries to 82·4% (81·4–83·4) in high-income countries; and statin use ranged from 9·7% (8·0–11·4) in low-income countries to 58·7% (57·4–59·9) in high-income countries. Across individual-level characteristics, patterns of inequities were observed in the attainment of each metric. Interpretation There are pronounced inequities at multiple levels in the attainment of global diabetes metrics. Substantial progress is needed to reduce inequities and to achieve the 2030 targets. Funding US National Institutes of Health and the University of Michigan Caswell Diabetes Institute.
Source: The Lancet Global Health
Authors: Grace S. Chung, Yajuan Si, Krishna Aryal, Silver Bahendeka, José R Banegas, Till Bärnighausen, Marta Barreto, Abdul Basit, Omar Yaxmehen Bello-Chavolla, Pascal Bovet, Luisa CC Brant, Rodrigo M Carrillo-Larco, Babangida S Chori, Renata Cífková, Sarah Cuschieri, Albertino Damasceno, Maria Dorobantu, Farshad Farzadfar, Pascal Geldsetzer, Mongal Singh Gurung, David Guwatudde, Ian R Hambleton, Christin Heidemann, Dismand Houinato, Alpamys Issanov, Jutta J⊘rgensen, Khem Karki, Demetre Labadarios, Jinkook Lee, Zeyu Lou, Nuno Lunet, Konstantinos Makrilakis, Deborah C Malta, João S Martins, Kibachio Joseph Mwangi, Augustine N Odili, Binur Orazumbekova, Gastón Perman, Sarah Quesnel-Crooks, Hedley Knewjen Quitana, Timothy Raxworthy, Fernando Rodríguez-Artalejo, Sahar Saeedi Moghaddam, Antonio Sarria-Santamera, Ronel Sewpal, Abla Sibai, Xueling Sim, Mafalda Sousa-Uva, Lela Sturua, Mubarak A Sulola, Giota Touloumi, Jithin Sam Varghese, Kavita Venkataraman, Yuan S Zhang, Mingqian Zheng, Rifat Atun, Sebastian Vollmer, Maja E Marcus, Michaela Theilmann, Mohammed K Ali, Edward W Gregg, Justine Davies, Jennifer Manne Goehler, David Flood
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $6,680
Funders: University of Michigan, Ministry of Health -Singapore, National University of Singapore, Deutscher Akademischer Austauschdienst, Bundesministerium für Bildung und Forschung, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Fundação de Amparo à Pesquisa do Estado de Minas Gerais, National Institutes of Health, Instituto de Salud Carlos III, European Regional Development Fund, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, European Social Fund
Awards: Mega Meta Data Set of the Health and Retirement Surveys Around the World, Harmonized Diagnostic Assessment of Dementia (DAD) for Longitudinal Aging Study of India (LASI)-Genomic study., G3258737820, Archiving & Creating User Friendly Data: the Longitudinal Aging Survey in India, Preventing Weight Gain and Diabetes in People with HIV in South Africa, G4752218521, REDE DE TELESSAÚDE DE MINAS GERAIS - INOVAÇÃO EM SAÚDE DIGITAL, G5070971123, G5641959371, G6132485245, G6610699297, G677391005, G7318988832, G7534112628, G7788850799, Michigan Center for Diabetes Translational Research, Harmonized Diagnostic Assessment of Dementia (DAD) for Longitudinal Aging Surveys in India (LASI), Claude D. Pepper Older Americans Independence Center at the University of Michigan (UM Pepper Center), A cross-national comparative study on cardiometabolic risk, education, and cognitive aging, Integrating Information about Aging Surveys: Novel Integration of Contextual Data to Study Late-Life Cognition and Alzheimer’s Disease and Related Dementia and Dementia Care
OpenAlex ID: W4417304470