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<p>Given rising diabetes prevalence globally, access to diabetes treatments is gaining urgency. Yet, it remains unknown which glucose-lowering medication types people with diabetes across low- and middle-income countries (LMICs) use. In this cross-sectional analysis, we pooled nationally representative data of 223,283 adults aged ≥25 years in 62 LMICs from 2009 to 2019. We found that 51.9% [95%-CI: 49.6%, 54.2%] of 21,715 individuals with diabetes were undiagnosed. Among individuals with diagnosed diabetes, 18.6% [95%-CI: 14.5%, 23.4%] reported using no glucose-lowering medication, 57.3% [95%-CI: 53.1%, 61.4%] only used oral medication, 19.5% [95%-CI: 17.6%, 21.5%] used oral medication and insulin, and 4.7% [95%-CI: 3.9%, 5.6%] used insulin alone. In low-income countries, fewer individuals with diabetes were diagnosed and treated than in middle-income countries. Yet, among individuals who did get diagnosed, insulin use was two-thirds higher in low-income countries (38.9% [95%-CI: 31.6%, 46.7%]) compared to middle-income countries (23.2%; 95%-CI: 21.0%, 25.5%]). This finding could suggest a need for earlier diagnosis and treatment initiation. Our results can inform national and regional drug procurement efforts across LMICs.</p>

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National evidence on glucose-lowering medication use for diabetes from 62 low- and middle-income countries

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月4日

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  • Felix Teufel,
  • Pia Roddewig,
  • Maja E. Marcus,
  • Michaela Theilmann,
  • Glennis Andall-Brereton,
  • Krishna Aryal,
  • Sina Azadnajafabad,
  • Pascal Bovet,
  • Maria Dorobantu,
  • Farshad Farzadfar,
  • Corine Houehanou,
  • Abla Sibai,
  • Andrew C. Stokes,
  • Demetre Labadarios,
  • Mongal Gurung,
  • Jutta Jorgensen,
  • Khem Karki,
  • Nuno Lunet,
  • Sahar Saeedi Moghaddam,
  • Kibachio J. Mwangi,
  • Lela Sturua,
  • Till Bärnighausen,
  • David Flood,
  • Pascal Geldsetzer,
  • Albertino Damasceno,
  • Justine Davies,
  • Sebastian Vollmer,
  • Mohammed K. Ali,
  • Jennifer Manne-Goehler,
  • Caroline Bulstra

摘要

Given rising diabetes prevalence globally, access to diabetes treatments is gaining urgency. Yet, it remains unknown which glucose-lowering medication types people with diabetes across low- and middle-income countries (LMICs) use. In this cross-sectional analysis, we pooled nationally representative data of 223,283 adults aged ≥25 years in 62 LMICs from 2009 to 2019. We found that 51.9% [95%-CI: 49.6%, 54.2%] of 21,715 individuals with diabetes were undiagnosed. Among individuals with diagnosed diabetes, 18.6% [95%-CI: 14.5%, 23.4%] reported using no glucose-lowering medication, 57.3% [95%-CI: 53.1%, 61.4%] only used oral medication, 19.5% [95%-CI: 17.6%, 21.5%] used oral medication and insulin, and 4.7% [95%-CI: 3.9%, 5.6%] used insulin alone. In low-income countries, fewer individuals with diabetes were diagnosed and treated than in middle-income countries. Yet, among individuals who did get diagnosed, insulin use was two-thirds higher in low-income countries (38.9% [95%-CI: 31.6%, 46.7%]) compared to middle-income countries (23.2%; 95%-CI: 21.0%, 25.5%]). This finding could suggest a need for earlier diagnosis and treatment initiation. Our results can inform national and regional drug procurement efforts across LMICs.