Diabetes: Record insulin demand, shortage threatens poorest

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by Ben Hirschler

LONDON (Reuters) – Diabetes is spreading around the world and is fueling a record demand for insulin, but tens of millions of people will not be able to receive treatment if access and cost of insulin are not significantly improved, according to a study published Wednesday.

Three pharmaceutical groups dominate the global supply of insulin – Novo Nordisk, Sanofi and Eli Lilly – and have programs in place to improve access to their products.

Insulin, however, remains expensive and prices may be particularly out of reach for the poorest countries, where complex supply chains and high profit margins often make the product unaffordable for many patients.

Diabetes – which can lead to blindness, kidney failure, heart problems, neuropathic pain and amputations – affects 9% of adults worldwide, up from 5% in 1980.

The vast majority of people with diabetes have type 2 diabetes, linked to obesity and lack of exercise, and cases are increasing particularly rapidly in developing countries, whose populations are increasingly adopting Western lifestyles and urban.

According to the researchers, the amount of insulin needed to effectively treat type 2 diabetes will increase by more than 20% over the next 12 years, but the drug will be out of reach for half of the 79 million people with type 2 diabetes who will need it in 2030.

The shortage is most acute in Africa, where the team of Dr. Sanjay Basu, from Stanford University, estimated that the offer should be multiplied by seven to treat at-risk patients who have arrived at the stage where they have to take care. insulin to control their blood sugar.

"These estimates suggest that current levels of insulin access are really inadequate for projected needs, particularly in Africa and Asia," said Dr. Basu.

"Despite the UN's commitment to treating noncommunicable diseases and ensuring universal access to diabetes medications, in much of the world insulin is scarce and its access is unnecessarily difficult for patients."

Dr. Basu and his team have calculated that the amount of insulin needed should increase from 526 million vials of 1,000 units in 2018 to 634 million by 2030.

Their study, published in Lancet Diabetes & Endocrinology and funded by Helmsley Charitable Trust, was based on diabetes prevalence projections by the International Diabetes Federation.

Dr. Hertzel Gerstein of McMaster University of Canada writes in a commentary accompanying the study that it is important to estimate and secure insulin supplies. But he adds that forecasts must be treated with caution because they are based on mathematical models.

(Dominique Rodriguez for French service, edited by Benoît Van Overstraeten)