Global Trends and Inequalities in Diabetes Prevalence and Treatment Coverage, 1990–2022: Progress toward International Targets Across 195 Countries
Mohammed Qassime *
Arab Board Candidate in Community Medicine, Arab Board of Health Specializations, Sana’a, Yemen.
Hind Awad Elderiny
Samannoud Central Hospital, Ministry of Health and Population, Gharbia Governorate, Egypt.
Naseem Farwan
Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen.
Emad Saif
Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen.
*Author to whom correspondence should be addressed.
Abstract
Background: Diabetes prevalence and treatment coverage have changed markedly, raising questions about inequalities and progress towards international targets.
Aim: This study examined country-level trends, disparities, target attainment, and projected treatment coverage in 2030.
Methods: This ecological analysis used age-standardised estimates (means) from the WHO Global Health Observatory for diabetes prevalence among adults aged ≥18 years and treatment coverage among adults aged ≥30 years from 1990 to 2022. Changes were assessed by WHO region and income group. The halt-the-rise criterion was defined as prevalence in 2022 being at or below the 2010 level. Treatment coverage was projected to 2030 using logit-linear regression and 10,000 simulations.
Results: Mean prevalence rose from 7.7% in 1990 to 13.9% in 2022, an increase of 6.2 percentage points. Prevalence increased in 187/195 countries (95.9%); only eight (4.1%) were stable or declined. Between 2010 and 2022, 32 countries (16.4%) met the halt-the-rise criterion, while 163 (83.6%) remained off track. In 2022, prevalence ranged from 9.1% in Europe to 20.8% in the Eastern Mediterranean. Treatment coverage increased from 29.0% in 1990 to 41.3% in 2022 (+12.3 points) and improved in 180 countries (92.3%). Coverage ranged from 7.1% to 81.3% across countries, from 22.0% in Africa to 55.7% in Europe, and from 22.8% in low-income to 58.1% in high-income countries. Projected 2030 coverage was 45.0% (95% simulation interval 44.7%–45.4%); none of 10,000 simulations reached the 80% analytical benchmark based on the annual mean. Fifty-one countries (26.2%) had high prevalence and low treatment coverage.
Conclusions: Diabetes prevalence increased in nearly all countries, while progress in treatment coverage remained insufficient and unequal. Accelerated prevention, diagnosis, and access to treatment are required.
Keywords: Diabetes mellitus, prevalence, health services accessibility, healthcare disparities, global health