Diabetes is a chronic metabolic disease, characterised by high levels of glucose in the blood. It occurs either because the pancreas stops producing the hormone insulin (type 1 diabetes, insulin-dependent diabetes, genetic predisposition), which regulates blood sugar, or it reduces its ability to produce insulin (type 2 diabetes, non-insulin dependent, can be lifestyle related), or the body reduces its ability to respond to insulin (i.e. insulin resistance). People with diabetes are at a greater risk of developing cardiovascular diseases such as heart attack and stroke. They also have elevated risks for vision loss, foot, and leg amputation due to damage to nerves and blood vessels, and renal failure requiring dialysis or transplantation.
Diabetes is one of the most common non-communicable diseases globally, affecting more than 520 million people in 2021, with an age‑standardised total prevalence of 6.1% (Ong et al., 2023[1]; IDF, 2022[2]). In Asia-Pacific, about 227 million people live with type 2 diabetes and about half of them are undiagnosed and unaware of developing long-term complications. In 2019, diabetes caused 1.5 million deaths worldwide and an additional 460 000 kidney disease deaths due to diabetes (WHO, 2023[3]). Between 2000 and 2019, mortality due to diabetes has increased by 3% (WHO, 2023[3]).
Type 2 diabetes comprises 90% of people with diabetes around the world, and until recently, this type of diabetes was seen only in adults, but it is now also occurring in children. For many people, the onset of type 2 diabetes can be prevented or delayed through regular physical exercise and maintaining a healthy weight (see indicators on “Child malnutrition (including undernutrition and overweight)” in Chapter 4) and a healthy diet. Although the cause of type 1 diabetes is not fully understood, it is known that genetic predisposition and environmental factors contribute to its development (WHO, 2023[3]).
Amongst all the 25 Asia-Pacific countries and territories in this report, the years lived with disability (YLDs) from diabetes per 100 000 population increased between 2010 and 2021, with increases of more than 200 YLDs per 100 000 population in high- and upper-middle-income countries (Figure 3.30). In Brunei Darussalam and Korea, this same indicator almost doubled between 2010 and 2021. In 2021, the OECD average had an absolute increase of 189 years of healthy life lost due to disability (YLDs) from diabetes mellitus per 100 000 population compared to 2010 (488 per 100 000) (Figure 3.30).
In general, both in men and women age‑standardised mortality due to diabetes has increase between 2010 and 2021 in most Asia Pacific countries, except for Korea (Figure 3.31). In 2021, amongst lower-middle- and low-income Asia-Pacific countries and territories, deaths attributable to diabetes has increased to 24 per 100 000 in men and to 32 per 100 000 in women (Figure 3.31). The country with the greatest number of deaths due to diabetes, and likewise, the greatest gap between men and women is Fiji, with an age‑standardise mortality of 168 per 100 000 in men and 202 per 100 000 in women (Figure 3.31).
