The amount of insulin needed to effectively treat type 2 diabetes will rise by more than 20% worldwide over the next 12 years, but without major improvements in access, insulin will be beyond the reach of around half of the 79 million adults with type 2 diabetes who will need it in 2030, according to a new modelling study published in The Lancet Diabetes & Endocrinology journal.

The findings are of particular concern for the African, Asian, and Oceania regions which the study predicts will have the largest unmet insulin need in 2030 if access remains at current levels.

Results showed that worldwide, the number of adults with type 2 diabetes is expected rise by more than a fifth from 406 million in 2018 to 511 million in 2030, with over half living in just three countries — China (130 million), India (98 million), and the USA (32 million).

At the same time, global insulin use is projected to rise from 526 million 1000-unit vials in 2018 to 634 million in 2030, and will be highest in Asia (322 million vials in 2030) and lowest in Oceania (4 million).

The study also predicts that using a higher glucose target of 8% in the over 75s could halve insulin use and prevent more disability by cutting severe hypoglycaemic events (more common among older adults) by 44%, with only a 20% increase in diabetes-related harms from eye, kidney, and nerve complications.