Teufel Felix, Roddewig Pia, Marcus Maja E, Theilmann Michaela, Andall-Brereton Glennis, Aryal Krishna, Azadnajafabad Sina, Bovet Pascal, Dorobantu Maria, Farzadfar Farshad, Houehanou Corine, Sibai Abla, Stokes Andrew C, Labadarios Demetre, Gurung Mongal, Jorgensen Jutta, Karki Khem, Lunet Nuno, Saeedi Moghaddam Sahar, Mwangi Kibachio J, Sturua Lela, Bärnighausen Till, Flood David, Geldsetzer Pascal, Damasceno Albertino, Davies Justine, Vollmer Sebastian, Ali Mohammed K, Manne-Goehler Jennifer, Bulstra Caroline
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, GA, USA.
Nat Commun. 2025 Aug 4;16(1):7139. doi: 10.1038/s41467-025-59123-4.
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.
鉴于全球糖尿病患病率不断上升，获取糖尿病治疗药物变得愈发紧迫。然而，低收入和中等收入国家（LMICs）中糖尿病患者使用何种降糖药物类型仍不明确。在这项横断面分析中，我们汇总了2009年至2019年62个低收入和中等收入国家223,283名年龄≥25岁成年人具有全国代表性的数据。我们发现，在21,715名糖尿病患者中，51.9%[95%置信区间：49.6%，54.2%]未被诊断出来。在已诊断出糖尿病的患者中，18.6%[95%置信区间：14.5%，23.4%]报告未使用任何降糖药物，57.3%[95%置信区间：53.1%，61.4%]仅使用口服药物，19.5%[95%置信区间：17.6%，21.5%]使用口服药物和胰岛素，4.7%[95%置信区间：3.9%，5.6%]仅使用胰岛素。在低收入国家，与中等收入国家相比，被诊断和治疗的糖尿病患者较少。然而，在已被诊断的患者中，低收入国家的胰岛素使用率比中等收入国家高2/3（38.9%[95%置信区间：31.6%，46.7%]），而中等收入国家为23.2%；95%置信区间：21.0%，25.5%]。这一发现可能表明需要更早进行诊断和开始治疗。我们的结果可为低收入和中等收入国家的国家和地区药品采购工作提供参考。
