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Millions left behind and diabetes drives surge in insulin demand

A global diabetes epidemic is fueling record demand for insulin but tens of millions will
not get the injections they need unless there is a dramatic improvement in access and
affordability, a new study concluded on Wednesday.

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

The vast majority have type 2 diabetes, the kind linked to obesity and lack of exercise,
and cases are spreading particularly rapidly in the developing world as people adopt more
Western, urban lifestyles.

Researchers said the amount of insulin needed to effectively treat type 2 diabetes would
rise by more than 20 percent over the next 12 years, but insulin would be beyond the reach of
half the 79 million type 2 diabetics predicted to need it in 2030.

The shortfall is most acute in Africa, where the team led by Dr Sanjay Basu from
Stanford University estimated supply would have to rise sevenfold to treat at-risk patients who
had reached the stage of requiring insulin to control their blood sugar.

"These estimates suggest that current levels of insulin access are highly inadequate
compared to projected need, particularly in Africa and Asia," Basu said.

"Despite the U.N.'s commitment to treat non-communicable diseases and ensure


universal access to drugs for diabetes, across much of the world insulin is scarce and
unnecessarily difficult for patients to access."

Global insulin supply is dominated by three companies -- Novo Nordisk, Sanofi and Eli
Lilly -- which have various programs to try to improve access to their products.

Insulin, however, remains costly and prices can be especially out of reach in poorer
countries where tortuous supply chains and high mark-ups by middlemen often make it
unaffordable for many patients.

Overall, Basu and colleagues calculated that global insulin use was set to rise to 634
million 1,000-unit vials by 2030 from 526 million in 2018.
Their study, published in the Lancet Diabetes & Endocrinology journal and funded by the
Helmsley Charitable Trust, was based on projections of diabetes prevalence from the
International Diabetes Federation.

Dr Hertzel Gerstein from Canada's McMaster University wrote in an accompanying


commentary that it was important to estimate and ensure insulin supplies, but added the forecasts
should be treated cautiously as they were based on mathematical models.

Millions left behind and diabetes drives surge in insulin demand

A global diabetes epidemic triggers demand for insulin, but tens of millions will not get
the injections they need unless there is a dramatic increase in access and affordability. Diabetes -
which can cause blindness, kidney failure, heart problems, neuropathic pain and amputation -
now affects 9 percent of all adults worldwide, up from 5 percent in 1980.

Most have type 2 diabetes, the type associated with obesity and lack of exercise, and
cases spread very rapidly in developing countries because people adopt more Western, urban
lifestyles. The researchers say the amount of insulin needed to effectively treat type 2 diabetes
will increase by more than 20 percent over the next 12 years, but insulin will be beyond the reach
of half of the 79 million type 2 diabetics expected to need by 2030.

The most acute shortage in Africa, where the team led by Dr Sanjay Basu from Stanford
University estimates that supply must increase sevenfold to treat risky patients who have reached
the stage of needing insulin to control their blood sugar. He estimates that insulin access levels
are currently very inadequate compared to projected needs, especially in Africa and Asia.

Global insulin supply is dominated by three companies - Novo Nordisk, Sanofi and Eli
Lilly - who have various programs to try to increase access to their products. However, insulin
remains expensive and prices can be very unaffordable in poor countries where tortuous supply
chains and high mark-ups by intermediaries often make it unaffordable for many patients.

Overall, Basu and colleagues calculated that global insulin use would increase to 634
million 1,000 vials by 2030 from 526 million in 2018. Their study, published in the Lancet
Diabetes & Endocrinology journal and funded by the Helmsley Charitable Trust, was based on
prevalence projections diabetes from the International Diabetes Federation.

Dr. Hertzel Gerstein of McMaster University of Canada wrote that it is important to


estimate and ensure insulin supply, but adding estimates should be treated with caution because
they are based on mathematical models.

Conclusion: Africa is a country that lacks a lot of insulin so there must be a seven-
fold increase in insulin supply in treating and controlling blood sugar.

Source : http://www.thejakartapost.com/life/2018/11/21/millions-left-behind-as-diabetes-drives-surge-in-insulin-demand.html