Diabetes is a chronic disease characterised by high levels of glucose in the blood. It occurs either because the pancreas stops producing the insulin hormone (Type 1 diabetes), or because the cells of the body do not respond properly to the insulin produced (Type 2 diabetes). People with diabetes are at greater risk of developing cardiovascular diseases such as heart attack and stroke if the disease is left undiagnosed or poorly controlled. They also have higher risks of sight loss, foot and leg amputation, and renal failure.
About 32.7 million adults were diabetics in the European Union in 2017, up from an estimated 18.2 million adults in 2000. In addition, some 12.8 million people were estimated to have undiagnosed diabetes in 2017. The number of men with diagnosed diabetes has increased particularly rapidly since 2000, more than doubling from around 8 million in 2000 to 17.1 million in 2017. But the number of women with diabetes has also gone up substantially, rising from 10.3 million in 2000 to 15.6 million in 2017, an increase of over 50% ( 3.30).
Diabetes is more common among older people: 19.3 million people aged 60-79 have diabetes across EU countries, compared with 11.7 million people aged 40-59 and only 1.8 million aged 20-39 ( 3.31). While more men than women have diabetes in middle-age (between 40 and 59 years old), a greater number of women have diabetes after age 70 mainly because they live longer.
The age-standardised prevalence rate of diabetes among adults was 6% on average in EU countries in 2017. The rates varied from 9% or more in Portugal, Romania and Malta to 4% or less in Ireland, Lithuania and Estonia ( 3.32).
Age-standardised rates of diabetes prevalence have stabilised in many European countries in recent years, especially in Nordic countries, but they have gone up slightly in Southern Europe countries and in Central and Eastern Europe countries. These upward trends are partly due to the rise in obesity and physical inactivity, and their interactions with population ageing (NCD Risk Factor Collaboration, 2016).
Based on self-reported data on the prevalence of diabetes from the second wave of the European Health Interview Survey conducted in 2014, adults with the lowest level of education are more than twice as likely to report having diabetes than those with the highest level of education, on average across EU countries. This may partly be due to a higher proportion of low-educated people in older population groups and to the risk of diabetes increasing with age. But the prevalence of important risk factors for diabetes including obesity is much higher among people with a lower level of education (see the indicator “Obesity among adults” in Chapter 4).
The economic burden of diabetes is substantial. The health expenditure allocated to treat diabetes and prevent complications are estimated at about EUR 150 billion in 2017 in the European Union, with the average expenditure per diabetic adult estimated at about EUR 4 600 per year (IDF, 2017).
Type 2 diabetes is largely preventable. A number of risk factors, such as overweight and obesity, nutrition and physical inactivity, are modifiable. However, the prevalence of overweight and obesity is increasing in most countries (see the indicator “Overweight and obesity among adults” in Chapter 4). These reinforce the need for effective preventive strategies.
