Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030

The Costs of Diabetes

¹Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Goettingen, Germany
²Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
³Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
⁴Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA
⁵Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
⁶Heidelberg Institute of Public Health, University of Heidelberg, Heidelberg, Germany
⁷Africa Health Research Institute, Somkhele, South Africa
⁸Centre for Global Health, King’s College London, London, U.K.
⁹MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, Johannesburg, South Africa

Corresponding author: Christian Bommer, christian.bommer{at}wiwi.uni-goettingen.de.

Diabetes Care 2018 May; 41(5): 963-970. https://doi.org/10.2337/dc17-1962

Article Figures & Tables

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Figure 1
Summary of the main steps in the costing approach; we summarize the main components of the costing approach by conceptually dividing it into two interacting parts.
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Figure 2
Global distribution of costs by country in 2030 (as determined by authors’ calculations). Total costs as percentage of GDP for baseline scenario (A), past trends scenario (B), and target scenario (C).
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Figure 3
Regional economic burden: absolute and relative costs. Display of total absolute (2015 prices) and relative costs for different World Bank regions for the years 2015 and 2030. Numbers in parentheses are direct costs only. CA, Central Asia; EAP, East Asia and Pacific; LAC, Latin America and the Caribbean; MENA, Middle East and North Africa; SSA, sub-Saharan Africa.

Table 1

Overview of key statistics and results of projection scenarios

	2015	Projection for 2030
	2015	Baseline scenario	Past trends scenario	Target scenario
Included countries	180	180	180	180
Population (billion)	7.25	8.39	8.39	8.39
Global GDP (trillion $)^a	73.53	115.30	115.30	115.30
Prevalence, age-group 20–79 years (%)	8.8 (8.4–9.5)	10.0 (9.5–10.7)	11.8 (11.2–12.7)	9.8 (9.4–10.5)
Deaths in 1,000s, age-group 20–65 years	3,148 (3,013–3,327)	4,181 (4,001–4,412)	4,566 (4,364–4,822)	2,787 (2,668–2,941)
Total costs (trillion $)^a	1.32 (1.28–1.37)	2.25 (2.18–2.34)	2.48 (2.41–2.58)	2.12 (2.06–2.20)
Direct costs (trillion $)^a	0.86 (0.83–0.89)	1.51 (1.47–1.57)	1.70 (1.65–1.77)	1.50 (1.46–1.56)
Indirect costs (trillion $)^a	0.46 (0.45–0.48)	0.73 (0.71–0.77)	0.78 (0.75–0.82)	0.61 (0.60–0.65)
Mortality (%)^b	45.7	48.1	46.4	38.3
Dropout (%)^b	48.3	45.8	47.1	54.5
Absenteeism (%)^b	3.9	3.9	4.1	4.6
Presenteeism (%)^b	2.1	2.3	2.4	2.7
Share indirect costs (%)^c	35.0	32.7	31.3	29.0
Total costs/global GDP (%)	1.8 (1.7–1.9)	1.9 (1.9–2.0)	2.2 (2.1–2.2)	1.8 (1.8–1.9)
Mean (total costs/GDP) (%)	1.4 (1.4–1.4)	1.6 (1.6–1.7)	1.9 (1.8–1.9)	1.5 (1.5–1.5)
High-income countries only	1.2 (1.2–1.3)	1.3 (1.3–1.4)	1.4 (1.4–1.5)	1.3 (1.3–1.3)
Middle-income countries only	1.7 (1.6–1.7)	2.0 (1.9–2.1)	2.3 (2.3–2.4)	1.8 (1.8–1.9)
Low-income countries only	0.7 (0.6–0.8)	0.8 (0.8–1.0)	1.0 (0.9–1.1)	0.7 (0.7–0.8)

Data are presented as n unless indicated otherwise. Numbers in parentheses are 95% CI.
↵^aAbsolute costs and GDP are expressed in terms of constant 2015 U.S. dollars.
↵^bThe fraction of the respective indirect cost component in total indirect costs. 95% CI not shown.
↵^cThe fraction of total costs allotted to indirect costs. 95% CI not shown.