Millions of people worldwide may be at risk of early death from diabetes and related cardiovascular illnesses because of poor diagnosis and ineffective treatment, a new study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington suggests. The study examines diabetes diagnosis, treatment, and management in Colombia, England, Iran, Mexico, Scotland, Thailand and the United States.
In the United States alone, nearly 90% of adult diabetics – more than 16 million adults aged 35 years and older – have blood sugar, blood pressure, and cholesterol that are not treated effectively. In Mexico, 99% of adult diabetics are not meeting those targets.
“Too many people are not being properly diagnosed with diabetes and related cardiovascular risk factors. Those who are diagnosed aren’t being effectively treated,” Stephen Lim, PhD, one of the study’s co-authors and an associate professor of global health at IHME, stated in a press release. “This is a huge missed opportunity to lower the burden of disease in both rich and poor countries.”
The researchers found that the diagnosis rates were higher for women than men, with the largest difference seen in Colombia, where 15% more women than men with diabetes are diagnosed. The percentage of diabetics in the seven countries studied who are reaching International Diabetes Federation treatment goals for blood glucose, blood pressure, and serum cholesterol is low, ranging from 1% to 12%. In Scotland, researchers had difficulty finding women with diabetes who had met the targets for managing these risks.
In an attempt to determine the cause of the low rates of diagnosis and effective treatment, researchers examined a range of factors and found that there were no inequalities in diagnosis and treatment of diabetes related to socioeconomic status.
“We were surprised to see that wealth did not have a big impact on diagnosis and treatment,” Emmanuela Gakidou, MSc, PhD, the paper’s lead author and an associate professor of Global Health at IHME, stated. “And in the three countries where we had health insurance data, we thought it was noteworthy that health insurance actually played a much bigger role than wealth, especially in the United States.”
In the United States, people who had insurance were twice as likely to be diagnosed and effectively treated for diabetes as those who did not have insurance.
The researchers said the findings underscore the need for countries to tackle the growing problem of noncommunicable diseases (NCDs), in part by gathering better data.
“We don’t have enough data from actual physical exams to accurately document the trend in most countries,” Rafael Lozano, MSc, MD, a co-author on the paper and a professor of Global Health at IHME, stated. “We looked at surveys from nearly 200 countries and only could find data on blood glucose, cholesterol, or blood pressure in seven. We hope that in the build-up to the UN Summit on NCDs this September, countries will make a commitment to more surveys that take blood samples from a representative percentage of the population.”
