Diabetes is one of the most pressing global health issues of the 21st century. Approximately 450 million adults are estimated to have diabetes, and recent projections show that globally, the number of adults with diabetes will increase to 642 million in 2040 (1 in 10 adults). 1 Diabetes is currently the seventh leading cause of death in the United States and the World Health Organization anticipates that diabetes will be the seventh leading cause of death worldwide by 2030.23

Diabetes is diagnosed by high blood glucose. Long-term inadequate glucose control can lead to complications such as eye disease (retinopathy), kidney disease (nephropathy), nervous system disease (neuropathy) or accelerated risk of cardiovascular disease. The complications can progress to blindness, chronic kidney disease, lower limb amputation, heart attack, and stroke.456

There are two major types of diabetes. In type 1 diabetes (T1D), autoimmune destruction of the cells that make insulin (the beta-cells located in the pancreas) causes an absolute deficiency of insulin. Insulin is a hormone that allows glucose to pass from the bloodstream into the body’s cells to provide energy for all metabolic processes. Most causes of T1D are not fully understood, and replacement of insulin is essential to survival for T1D patients.

In type 2 diabetes (T2D), resistance to the biological actions of insulin (insulin resistance) leads to high blood sugar. T2D is a progressive disease and many patients require several different diabetes medications including insulin as control of their blood sugar worsens. T2D is much more common than T1D and accounts for more than 90% of all cases of diabetes. T2D is frequently associated with obesity and is a complex disease involving many organ systems (e.g. liver, muscle, kidneys, pancreas) contributing to high blood sugar levels. Until recently, T2D was observed almost exclusively in adults but is now increasingly common in adolescents as well.

Globally, the total economic burden of diabetes, including both direct and indirect costs, is anticipated to increase from $1.3 trillion in 2015 to more than $2.1 trillion by 2030.1 In a recent analysis of the burden of diabetes on the US healthcare system, $414 billion of the $1.7 trillion total projected healthcare expenditure for 2017 was incurred by people with diabetes, reflecting 24% of all healthcare dollars.2