Experts are highlighting the escalating global diabetes crisis and the role of structural racism and geographic inequity in driving it.

According to new estimates, the number of people living with diabetes worldwide is projected to more than double from 529 million in 2021 to over 1.3 billion in 2050, with no country expected to see a decline in age-standardised diabetes rates over the next 30 years.

New reports say that rates of diabetes among minority ethnic groups in high-income countries, such as the USA, are 1.5 times higher than among their white counterparts. In low- and middle-income countries, diabetes death rates are double those in high-income countries.

While Australia has diabetes rates among the lowest in the world for high income countries, there is a cascade of widening diabetes inequity between First Nations Australians and the general community, the researchers say.

In Australia, for example, longstanding structural racism and inequity have led to the Aboriginal and Torres Strait Islander populations experiencing rates of type 2 diabetes that are three times higher than the general population and some of the highest rates of youth-onset type 2 diabetes worldwide.

“Transgenerational trauma may affect mental health and wellbeing as well as the home environment that people are living in, increasing diabetes risk,” explains co-author Professor Louise Maple-Brown, Menzies School of Health Research. 

“Food insecurity in remote communities and overcrowded housing also greatly impede diabetes self-management and care.” 

These disparities are exacerbated by limited access to essential medicines, poor blood sugar control, and reduced quality of life among marginalised communities.

The authors call for high-impact, high-quality, real-world research to address diabetes inequities and propose tried and tested interventions to improve diabetes care for marginalised populations.

They highlight the need to incorporate social determinants of health, tackle structural racism, and involve affected communities in the development and implementation of interventions. 

The series also showcases successful programs such as the Diabetes CarePak in sub-Saharan Africa, which has increased access to insulin and supplies, and the IMPaCT program in the USA, which uses community healthcare workers to improve chronic disease control.

The Lancet–Lancet Diabetes & Endocrinology Series underscores the urgent need to address the growing diabetes crisis and its impact on marginalised populations worldwide. Failure to take action could jeopardise the health of current and future generations.

More details are accessible here.