More than four in 10 people with diabetes are unaware that they are living with the condition, a study has found.
Diagnosis stood at nearly 56 per cent globally and 65.4 per cent in North Africa and the Middle East. In the region, it ranged from 41.5 per cent in Afghanistan, 53.6 per cent in Yemen, 68.3 per cent in Saudi Arabia and 76 per cent in the UAE.
It rose to 77.5 per cent in western European countries, 82.8 per cent in the US and 86 per cent in Canada.
In contrast, central sub-Saharan Africa faced the largest gaps in diagnosis, with less than 20 per cent of people with diabetes being aware of their condition, according to the study by the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine which used data from 2023.
Under-diagnosis is greatest among young adults, despite them facing higher risks of long-term complications, the report said.
The researchers pointed out that while Middle East countries followed global patterns of diagnosis, treatment and management rates, the region had some of the highest rates of diabetes globally, with increasing rates projected to continue over the coming decades.
“Given this, there’s more people living with undiagnosed and unmanaged diabetes in the Middle East proportional to the total population, and therefore more strain on the healthcare systems,” Lauryn Stafford, first author and researcher at IHME told The National.
Treatment
Diabetes is a condition in which the body does not produce enough insulin, resulting in high blood glucose levels.
Among those who were diagnosed, 91 per cent were receiving some form of treatment, but only 42 per cent of those who were receiving treatment had their blood sugar levels managed optimally.
This means just 21 per cent of all people with diabetes had their condition under optimal management. The study did not differentiate between diabetes type. In Type 1, the body makes no insulin, while in Type 2 the body does not make enough insulin or use its insulin properly.
In 2022, the WHO set a target to have 80 per cent of people with diabetes clinically diagnosed by 2030.
Ms Stafford said it was important to recognise that diabetes may go undiagnosed for a while as it can sometimes take time for someone to develop symptoms or complications that are serious enough to warrant a visit to a healthcare provider, particularly in the case of Type 2 diabetes.
“That’s why there’s often screening protocols in place for glucose testing to be part of common health panels for people over a certain age or with certain risk factors such as obesity, hypertension, chronic kidney disease.
“However, the proper implementation of screening protocols requires regular visits with primary care providers, which may be difficult for people who are underinsured or live in rural/low-resource areas with limited healthcare facilities.
“For young adults, which we found to be at a greater risk of underdiagnosis, it may not be standard practice to regularly screen for diabetes. This is due to the fact that diabetes largely develops in middle or older age, however, given increasing rates of obesity among young adults, the presence of risk factors should be taken into account when determining screening standards for this younger population.”
Diagnosis
Researchers pointed out that complications linked to diabetes “can be averted with timely and appropriate diagnosis”.
“We find major gaps in diagnosing, treating, and managing diabetes globally, with substantial variation between countries,” the authors of the report wrote in the journal Lancet Diabetes and Endocrinology.
“Despite improvements over the past two decades, underdiagnosis and suboptimal glycaemic management of diabetes remain major challenges globally, particularly in low-income and middle-income countries.
“These findings highlight the urgent need for enhanced strategies and capacity building to improve the detection, treatment, and management of diabetes worldwide.”
Given the pace at which cases are rapidly rising, the researchers said their study underscores the urgent need for investment in screening programmes for younger populations and access to medications and glucose-monitoring tools, especially in underserved regions.
