Abstract
Background: Rates of diabetes have been increasing in Aotearoa New Zealand by approximately 7% per year and are three times higher among Māori and Pacific peoples than Europeans. The depth of the diabetes epidemic, and the expansive breadth of services required for its management, elevate the need for updated evidence on the projected future burden of this complex disease.
Methods: We have projected the prevalence of diabetes (type 1 and type 2 combined) out to 2040–2044 using Virtual Diabetes Register data on diabetes prevalence trends (2006 to 2019) by age group, calendar period and birth cohort. We then used age-period-cohort (APC) modelling to project diabetes prevalence from 2020 to 2044 (overall, and by gender and ethnicity).
Results: New Zealand will experience a substantial increase in the absolute numbers of people with prevalent diabetes, rising to more than 500,000 by 2044 (approximately 90% increase from 2015–2019). The age-standardised prevalence rate will increase from 3.9% to 5.0%. Both the rate and number of new cases will increase most dramatically for Pacific peoples, especially Pacific females for whom diabetes prevalence is projected to increase to 17% by 2044.
Conclusions: Increased numbers of people living with diabetes in New Zealand will be driven both by population growth (including our ageing population) as well as increases in prevalence of diabetes in specific groups. These projected increases are likely to stretch our health system to breaking point, if not beyond; and as such, immediate and bold action is required to stem the tide of diabetes and other obesity-related illnesses.