Epidemiology and Economics: the two important e’s in diabEtEs

The epidemiology and the economic impact of diabetes are intimately intertwined. With the increase of the prevalence of type 2 diabetes this invariably not only impacts the health of the population, but also the costs to individuals and healthcare systems. From another perspective epidemiology and economics of diabetes are also linked in the fact that certain populations face higher rates of diabetes as well as worse outcomes due to barriers to access to care.

The International Diabetes Federation (IDF) estimated that in 2021 there were 537 million people aged 20–79 with diabetes. This is estimated to increase by 46% globally between 2021 and 2045 with the majority of these additional cases in low- and middle-income countries (LMIC).1 In 2017 there were 9 million people with type 1 diabetes worldwide with an overall global increase in incidence of 3%.2 Parallel to this increase in the numbers of people with diabetes the costs of diabetes are increasing, with the IDF estimating that total health expenditure on diabetes was close to US$ 1000 billion in 2019.1 Beyond the costs of diabetes linked to the increasing numbers of people with the condition, complications, and new medicines and technologies, there is the need to consider how the economic situation of individuals might impact their risk of developing diabetes as well as their diabetes management if they have already diabetes.3 These so called social determinants of health include the environments where people are born, live and interact with different institutions including the healthcare system.

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