There has been a significant rise in the number of people with type 1 diabetes (T1DM) who are living beyond the age of 65, but global healthcare inequalities are still evident, a new study has found.

Researchers in China evaluated data from more than 200 countries and found between 1990 and 2019, the number of people aged 65 and older with type 1 diabetes rose from 1.3 million to 3.7 million.

Another key finding was that death rates dropped by 25% over the same period, from 4.7 per 100,000 population to 3.5.

However, the findings also demonstrated the inequalities in diabetes healthcare, as mortality rates dropped 13 times faster in high-income nations in comparison to low and middle-income countries.

The study authors said: “For older people with T1DM and their families worldwide, the decreasing mortality…associated with this disease is encouraging.

“For policy makers, health resource preparedness is needed for the growing number of people with both T1DM and ageing related problems, especially in countries with a middle and low sociodemographic index.

“Our study also advocates for urgent attention to coping strategies for aging populations and older people with type 1 diabetes, rational allocation of health resources, and the provision of targeted guidelines.”

Rising incidence of type 1 diabetes was seen amongst men in particular. Prevalence of the condition tripled as a minimum in all age brackets from 65 to 94.

The decrease in death rates was seen most significantly among women and people under the age of 79.

The research team also used another measure – disability adjusted life years, which combines measure of quantity and quality of life. They found that in people aged under 79, the decrease in DALYs was seen most significantly.

The authors said: “A high fasting plasma glucose level was the major contributor to disability adjusted life years, indicating that hyperglycaemia management remained challenging for the older people with T1DM.”

North America, Australasia, and western Europe have the highest rates of type 1 diabetes, but the highest rates of DALY were seen in southern sub-Saharan Africa, Oceania and the Caribbean.

Read more in The BMJ.

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