The direct cost estimates in this edition of the IDF Diabetes Atlas were calculated using an attributable fraction method, which relies on the following inputs:
■ IDF Diabetes Atlas estimates of diagnosed and undiagnosed diabetes prevalence for each country and for each age and sex sub-group, stratified by rural and urban setting.
■ UN population estimates for 2021 and UN population projections for 2030 and 2045.
■ WHO global health expenditures per capita for 2018 (latest available data).
■ The ratios of health expenditures for people with diabetes compared to people without diabetes, stratified by age, sex, rural versus urban setting, diagnosed and undiagnosed diabetes, and income per IDF Region.
The WHO definition of health expenditure includes provision of health services (preventive and curative), family planning activities, nutrition activities, and emergency aid designated for health, but does not include provision of water and sanitation services.
The definition includes health expenditures from both public and private sources.29 The same method was used as in the previous editions to distribute the total health expenditure in a given country into expenditure by age and sex.30
Another critical component of the analyses is the ratio of health expenditures for people with diabetes (diagnosed or undiagnosed) compared to those without diabetes. Since the publication of the IDF Diabetes Atlas 8th edition, these ratios have been refined by the work of Bommer et al. (2017)31, providing estimates for this ratio with much more specificity in relation to age, sex, rural versus urban setting, whether diabetes is diagnosed, region, and income levels of countries.
The diabetes-related health expenditure estimates are presented in US dollars (USD), and in international dollars (ID), as well as a percentage of total health expenditures and of gross domestic product (GDP). IDs account for local purchasing power and facilitate direct cross-country comparisons of health expenditures.
Health expenditures for diabetes as a percentage of total health expenditures and of GDP reflect the direct economic burden of diabetes to a national economy.
Map 2.5 Countries and areas with data sources on impaired fasting glucose in adults (20–79 years), 2021
■Countries with in-country data sources
1
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www.idf.org/mahasstory CYRINE'S STORY
■ An estimated 537 million adults aged 20–79 years are currently living with diabetes. This represents 10.5% of the world’s population in this age group
■ The total number is predicted to rise to 643 million (11.3%) by 2030 and to 783 million (12.2%) by 2045
■ An estimated 240 million people are living with undiagnosed diabetes worldwide, meaning almost one-in-two adults with diabetes are unaware they have the condition
■ Almost 90% of people with undiagnosed diabetes live in low- and middle- income countries
■ In Africa, South-East Asia and the Western Pacific more than half of people with diabetes are undiagnosed
■ Over 1.2 million children and adolescents have type 1 diabetes. Over half (54%) are under 15 years of age
■ The incidence of diabetes was stable or declined in the period from 2006 to 2017 in over 70% of mainly high-income populations, according to a systematic review of the literature
■ Over 80% of countries reported declining or stable diabetes incidence since 2010
Key messages