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Review
. 2023 Oct;23(10):277-291.
doi: 10.1007/s11892-023-01520-4. Epub 2023 Aug 23.

The T1D Index: Implications of Initial Results, Data Limitations, and Future Development

Graham D Ogle  1   2 , Gabriel A Gregory  3   4   5 , Fei Wang  4 , Thomas Ig Robinson  4 , Jayanthi Maniam  3   6 , Dianna J Magliano  7   8 , Trevor John Orchard  9
Affiliations
Review

The T1D Index: Implications of Initial Results, Data Limitations, and Future Development

Graham D Ogle et al. Curr Diab Rep. 2023 Oct.

Erratum in

Abstract

Purpose of the review: Current global information on incidence, prevalence, and mortality of type 1 diabetes (T1D) is limited, particularly in low- and middle-income countries. To address this gap in evidence, JDRF, Life for a Child, International Society for Pediatric and Adolescent Diabetes, and International Diabetes Federation have developed the T1D Index, which uses a Markov mathematical model, and machine learning and all available data to provide global estimates of the burden on T1D. This review assesses the methodology, limitations, current findings, and future directions of the Index.

Recent findings: Global prevalence was estimated at 8.4 million in 2021, with 1.5 million <20 years (y). T1D prevalence varied from 1.5 to 534 per 100,000, with T1D accounting for <0.1-17.8% of all diabetes in different countries. A total of 35,000 young people <25 y are estimated to have died at clinical onset of T1D from non-diagnosis. An estimated 435,000 people <25 y were receiving "minimal care." Health-adjusted life years (HALYs) lost for individuals diagnosed with T1D at age 10 y in 2021 ranged from 14 to 55 y. These results show that interventions to reduce deaths from non-diagnosis, and improve access to at least an intermediate care level, are needed to reduce projected life years lost. The results have significant uncertainties due to incomplete data across the required inputs. Obtaining recent incidence, prevalence, and mortality data, as well as addressing data quality issues, misdiagnoses, and the lack of adult data, is essential for maintaining and improving accuracy. The index will be updated regularly as new data become available.

Keywords: Diabetes-related mortality; Epidemiology; Healthy life years; Incidence; Prevalence; Type 1 diabetes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Type 1 diabetes prevalence per 100,000 population (all ages), by A world region and B income level, 2021. LIC, lower-income countries; LMIC, lower-middle-income countries; UMIC, upper-middle-income countries; HIC, higher-income countries
Fig. 2
Fig. 2
Percentage of all diabetes 20–79 years that is type 1 diabetes, 2021, by A world region and B income level. LIC, lower-income countries; LMIC, lower-middle-income countries; UMIC, upper-middle-income countries; HIC, higher-income countries
Fig. 3
Fig. 3
Modelled frequency of selected complications at 30 years after diagnosis of type 1 diabetes. Data from Gregory et al. (2020) [24]
Fig. 4
Fig. 4
Projected healthy life years lost for an individual with type 1 diabetes diagnosed at age 10 years in 2021
Fig. 5
Fig. 5
Projected healthy life years lost for an individual with type 1 diabetes diagnosed at age 10 years for 12 representative countries
See this image and copyright information in PMC

References

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