Over the next quarter-century, the number of people living with type 1 diabetes is expected to grow from 9.4 million to 12.1 million worldwide — a rise shaped not only by biology and aging populations in wealthy nations, but by the slow, uneven spread of insulin access to places where survival itself has long been uncertain. Researchers at Steno Diabetes Center Odense have modeled this trajectory using historical patterns of care and population data, presenting their findings at the European Association for the Study of Diabetes meeting in Milan this autumn. The projection is, in one sense, a
Type 1 diabetes cases projected to surge 29% globally by 2049
Mortality among T1D patients projected to increase from 361,383 deaths in 2025 to 537,621 in 2049, with children aged 0-19 accounting for disproportionate mortality in low-income countries.
The annual rate of new cases stays flat even as the total population climbs.
Mark
So we're looking at roughly 2.7 million more people with type 1 diabetes by 2049. That's a significant number. What's driving the increase?
Mimi
It's different in different parts of the world. In wealthy countries like the US and UK, you're seeing growth mainly because people are living longer with the disease—the annual rate of new cases stays about the same, but the total population accumulates. In poorer countries, it's the opposite: the rate of new diagnoses is actually doubling because insulin and monitoring are becoming available for the first time.
Luke
Hold on. The source says the annual incidence is going up 14 percent globally. That's not nothing. So it's not just accumulation in rich countries—something is actually changing about how many people are getting diagnosed each year.
Mimi
Right, and that's partly because diagnosis is improving in low-income countries. But there may also be real increases in incidence—we don't fully know. The data is thin, especially outside wealthy nations.
Mark
The mortality numbers jumped out at me. From 361,000 deaths to 538,000. That's a 49 percent increase. Is that because more people have the disease, or because people are dying at higher rates?
Mimi
Mostly because more people have it. But there's also a stark disparity in where those deaths occur. In low-income countries, children aged 0 to 19 account for 34 percent of all deaths among people with type 1 diabetes. In high-income countries, it's 4 percent.
Luke
That's a devastating statistic, but I want to be careful about what it means. That 34 percent doesn't necessarily mean children are dying at higher rates in low-income countries—it could mean that fewer older adults with type 1 diabetes survive to old age there. The source doesn't give us age-specific mortality rates, so we can't say for certain.
Mark
Fair point. So what makes this model different from other projections?
Mimi
It accounts for insulin availability over time and uses more conservative survival assumptions, especially for older people in low-income countries. The authors say their prevalence estimates are actually lower than some other forecasts because of this.
Luke
Which raises a question: if this model is more conservative, and other models are higher, which one should policymakers actually use? The source doesn't really address that tension.
Mimi
That's why they're making it open-access. They want it to be a tool that can be refined as better data comes in, especially from low- and middle-income countries where the data is currently sparse.
Mark
So the real story here isn't just the numbers—it's that we don't have good numbers for most of the world, and that's a problem for planning.
Luke
Exactly. The epidemiological gap is the story.
O Pulso
- A 29% surge in global type 1 diabetes cases by 2049 signals not a single crisis but a slow-building pressure on health systems already stretched thin.
- Children under 20 bear a disproportionate share of deaths in low-income countries — 34% of all T1D mortality there — exposing a fault line between where the disease is diagnosed and where it is survived.
- Countries like Tanzania face a doubling of both new cases and total prevalence as insulin becomes more accessible, turning improved survival into a new epidemiological challenge.
- The United States alone is projected to add over half a million cases, while the UK's T1D population climbs by nearly a third — wealthy nations absorbing the largest absolute numbers.
- A new open-access modeling tool, the DIAMOND-T1D model, is being made available to policymakers so that country-specific scenarios can be tested and local planning can sharpen.
- The WHO's Global Diabetes Compact now faces a harder arithmetic: equitable care must scale to meet a disease load that is growing fastest precisely where infrastructure is weakest.
Over the next quarter-century, the number of people living with type 1 diabetes is expected to grow from 9.4 million to 12.1 million worldwide — a rise shaped not only by biology and aging populations in wealthy nations, but by the slow, uneven spread of insulin access to places where survival itself has long been uncertain. Researchers at Steno Diabetes Center Odense have modeled this trajectory using historical patterns of care and population data, presenting their findings at the European Association for the Study of Diabetes meeting in Milan this autumn. The projection is, in one sense, a story of medical progress reaching further into the world — and in another, a quiet reckoning with how much further it still must go.
A new epidemiological model developed at Steno Diabetes Center Odense projects that the global population living with type 1 diabetes will rise from 9.4 million in 2025 to 12.1 million by 2049 — a 29 percent increase — with annual new diagnoses climbing 14 percent over the same period. The findings are set to be presented at the European Association for the Study of Diabetes annual meeting in Milan in late September.
The burden will not fall evenly. High-income countries face the largest absolute increases: the United States is projected to surpass 2 million cases, up from 1.49 million today, while the United Kingdom's T1D population will grow by nearly a third. In these nations, robust health systems and early detection keep incidence rates relatively stable even as total prevalence climbs.
Low-income countries tell a different story. Tanzania, for example, is expected to see its annual new cases roughly double and its total T1D population grow from around 19,000 to nearly 40,000. The researchers attribute this relative surge not to worsening conditions but to improving ones — more insulin availability, better glucose monitoring, and rising survival rates in settings where these resources have historically been scarce.
The human cost is significant. Global deaths among people with type 1 diabetes are projected to rise from 361,000 in 2025 to 538,000 by 2049. Children and adolescents account for 34 percent of all T1D deaths in low-income countries, compared to just 4 percent in wealthy ones — a disparity that reflects both the age of diagnosis and the fragility of care infrastructure.
The DIAMOND-T1D model distinguishes itself by incorporating historical insulin availability and age-specific survival data, validated against registry records from Denmark and Scotland. Its projections are deliberately conservative about survival in older and lower-income populations. Crucially, the model will soon be released as an open-access web tool, allowing policymakers to generate country-specific scenarios and test assumptions about how incidence, access, and survival might evolve. The underlying message is clear: type 1 diabetes is becoming more common everywhere, and the world's health systems — especially those with the least — must be prepared to meet it.
Researchers working with a new epidemiological model project that the global population living with type 1 diabetes will grow from 9.4 million people in 2025 to 12.1 million by 2049—a 29 percent increase. The annual rate of new diagnoses is expected to climb 14 percent over the same quarter-century. These estimates, developed by Professor Anders Green at Steno Diabetes Center Odense in Denmark using the DIAMOND-T1D model, will be presented at the European Association for the Study of Diabetes annual meeting in Milan from September 28 through October 2.
The burden will not distribute evenly across the world's economies. High-income countries face the steepest absolute growth. The United States is projected to add more than half a million new cases, rising from 1.49 million people with type 1 diabetes in 2025 to over 2 million by 2049. The United Kingdom will see its population nearly jump by a third, from roughly 314,000 to 421,000. Italy, the host nation for the conference, will see a more modest 16 percent increase, though still reaching an estimated 239,000 people by 2049, up from 205,000 today. In these wealthy nations, the annual rate of new cases is expected to remain relatively stable even as the total number of people living with the disease climbs—a pattern the researchers attribute to a combination of genetic predisposition, environmental factors, and robust health systems that catch cases early.
The picture in low-income countries tells a different story. Tanzania, for instance, will see the rate of new diagnoses double, from 3,275 cases per year to 6,177. The total population living with type 1 diabetes in Tanzania will also roughly double, from about 19,000 to nearly 40,000. While these absolute numbers remain small compared to high-income nations, the relative growth is dramatic. The researchers expect this surge in low-income and middle-income countries as insulin becomes more available, glucose monitoring improves, and survival rates climb—conditions that have long been taken for granted in wealthy nations but remain scarce in much of the developing world.
The human toll extends beyond prevalence. Deaths among people with type 1 diabetes are projected to rise from 361,000 globally in 2025 to 538,000 by 2049. Children and adolescents aged 0 to 19 account for a disproportionate share of this mortality burden in low-income countries, representing 34 percent of all deaths among the type 1 diabetic population there, compared to just 4 percent in high-income countries. In 2025, this age group represents 42 percent of all new diagnoses worldwide, though the proportion varies significantly by income level—ranging from 37 percent in wealthy nations to 49 percent in low-income ones.
The DIAMOND-T1D model represents a departure from previous forecasting approaches. It incorporates historical patterns of insulin availability and uses data on incidence rates, population age structure, and survival outcomes combined with assumptions about age-specific mortality and the year insulin was introduced in each country. The model has been validated against population-based registry data from Denmark and Scotland. Unlike some competing estimates from sources like the Global Burden of Disease Study, the DIAMOND-T1D projections are more conservative about survival rates, particularly among older adults and in low- and middle-income settings.
Accurate data on type 1 diabetes incidence and prevalence remain scarce, especially in low- and middle-income countries. This gap matters because governments and health systems rely on such estimates to design policy and allocate resources. The World Health Organization's Global Diabetes Compact, which aims to ensure equitable access to affordable, quality diabetes care worldwide, depends on reliable epidemiological forecasts. The researchers note that their model will soon be available as an open-access web-based tool, allowing policymakers and researchers to generate country-specific scenarios by adjusting key variables—a step toward more granular, locally relevant planning.
The authors acknowledge that their prevalence estimates are lower than some alternative projections, a difference they attribute to more cautious assumptions about survival in older age groups and in resource-limited settings. They frame this as a strength: the model's flexibility allows it to be refined as better data emerges, and it enables decision-makers to test different assumptions about how insulin access, survival, and incidence might evolve. The core message is straightforward. Type 1 diabetes will become more common globally over the next two decades, driven partly by demographic aging in wealthy countries and partly by improving survival and detection in poorer ones. The challenge ahead is ensuring that the world's health systems—particularly those in low-resource settings—can meet this rising demand.
Citações Notáveis
We estimate a rising global type 1 diabetes burden, underscoring the need to continue to improve access to insulin and quality of care, particularly in low-resource settings.— DIAMOND-T1D research team, led by Professor Anders Green
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