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How many people have type 1 diabetes worldwide and how long they live
Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study.
Overview
Gregory GA et al.. Lancet Diabetes Endocrinol 2022 · PMID 36113507 · DOI 10.1016/S2213-8587(22)00218-2
About 8.4 million people had type 1 diabetes in 2021; a 10-year-old diagnosed in a low-income country could expect about 13 more years of life, versus 65 in a high-income country.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Estimate the global burden of type 1 diabetes.
- How was the study done?
Computer model fitted to registry and published data from many countries.
- How many people, animals or samples were studied?
Model of 201 countries.
- What was actually found?
8.4 million cases; 35,000 undiagnosed deaths within a year of symptoms; life expectancy gap 13 vs 65 years.
- How large was the observed effect?
Life expectancy difference about 52 years for a child diagnosed at 10.
- What do the results mean in everyday life?
Where insulin and care are hard to get, children with type 1 diabetes die young.
- What are the study's limitations?
Model estimates with uncertainty; funded by a T1D charity.
- What does it say about Elawady's specific claim?
Contradicts 'type 1 does not exist' and any advice to stop insulin.
- Do the results apply to Germany and Europe?
Europe is in the high-income group with long survival under insulin treatment.
- What can explicitly not be concluded from this study?
Cannot attribute individual deaths to specific causes.
Scientific in-depth review
1. Full reference
- Authors
- Gregory GA et al.
- Journal
- Lancet Diabetes Endocrinol
- Year
- 2022
- Identifier
- PMID 36113507 DOI 10.1016/S2213-8587(22)00218-2
- Verification
- verified – PubMed efetch 2026-10-26; Crossref 2026-10-26
- Retracted
- no
- Corrections
ErratumIn Lancet Diabetes Endocrinol 2022;10(11):e11 (PubMed CommentsCorrections); not a retraction
- Extent checked
- abstract only
- Conflicts of interest and funding
Funded by JDRF International; four authors are JDRF employees (record).
2. Research question
What are T1D prevalence, incidence, associated mortality and life expectancy in 201 countries?
3. Study design and population
- Study design
- Other – Discrete-time illness-death (Markov) model fitted to incidence data from 97 and mortality data from 37 countries; validated against prevalence in 15 countries
- Population
People with type 1 diabetes worldwide
- Country
201 countries
- Period
2021, projections to 2040
- Sample size
Model estimates (8.4 million prevalent cases)
- Inclusion and exclusion criteria
Published incidence/mortality data; expert survey for diagnosis rates
4. Methods and endpoints
- Exposure / intervention
Country income level / health-system access
- Comparator
General population mortality
- Endpoints
Prevalence, incidence, mortality, remaining life expectancy, 'missing prevalence'
- Statistical methods
Markov model; random-forest regression for mortality; uncertainty intervals
5. Actual results
- Results
2021: about 8.4 (95% UI 8.1-8.8) million people with T1D; about 35,000 non-diagnosed individuals died within 12 months of symptomatic onset. Remaining life expectancy of a 10-year-old diagnosed in 2021 ranged from a mean of 13 years in low-income countries to 65 years in high-income countries. Missing prevalent cases (people who would be alive if their mortality matched the general population) estimated at 3.7 million.
- Absolute risks
not reported
- Authors' conclusion
The substantial missing prevalence highlights the premature mortality of type 1 diabetes and an opportunity to save and extend lives.
6. Strengths
- Global scope
- Validated against observed prevalence
7. Weaknesses
- Model-based; sparse mortality data (37 countries)
- Diagnosis rates from expert survey
- Funder involvement
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Modelling study; estimates depend on assumptions and sparse input data.
9. Assessment of the statistical interpretation
Large differences in life expectancy by income level are consistent with unequal access to insulin and care; the exact figures carry model uncertainty.
10. Relevance to the specific claim
Shows that T1D is a real, common disease with high premature mortality where diagnosis, insulin and care are lacking; undiagnosed people die within a year of symptom onset.
11. Independent contrary findings
12. Transferability to Germany and Europe
Directly applicable; same biology and clinical standards in Europe.
13. Overall methodological judgement
Best available global estimate; supports insulin access as life-saving.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- There is no such thing as type 1 diabetes; 'type 1' is a state of high sugar seen mainly in athletes with high needs; type 1 patients do not develop complications; insulin before puberty is a catastrophe (short stature, thyroid problems, cysts). – Studies contradicting or limiting the claim
- People with diabetes can stop insulin and diabetes medication by following the Tayebat system ('zero medicine'), as shown by followers who stopped insulin and are 'perfectly fine'. – Studies contradicting or limiting the claim