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

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 and Caroline Bulstra

Open Access Publications from Kiel Institute for the World Economy from Kiel Institute for the World Economy

Abstract: 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 undiag-nosed. 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 med-ication 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 diag-nosed, 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.

Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:zbw:ifwkie:342309

DOI: 10.1038/s41467-025-59123-4

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