Assessing and projecting the burden of diabetes mellitus in the European Union by 2030

BACKGROUND: Although the upward trend in diabetes mellitus (DM) is known in many countries, there are considerable uncertainties in the forecasts. This study provides valuable insights into the potential development of DM in the European Union (EU) member states through past trends and future projections. METHODS: European Health Interview Survey (EHIS) 2015 and 2019 microdata from 27 EU countries were used. Finite mix model (fmm) was applied to identify subgroups within the population and obtain probability of risk factors within each group. Time indicator as interaction was added to obtain the developing trend of heterogeneous effects with socioeconomic and lifestyle risk factors that were included in the model. Forecasting was used to project probability of risk factors within each group up to 2030. RESULTS: Data included 500,840 participants (274,016 from 2015 and 226,824 from 2019). Fmm and forecasting results showed DM prevalence was 7.4% in 2015 and 8.4% in 2019 and expected to increase to 11.15% in 2030. High- and low-risk subgroups were identified. Most risk factors and lifestyle categories increased in the high-risk group in comparison to the low-risk group between 2015 and 2019. However, within the high risk group, the probability of living rural areas has decreased 2.7% 2015 vs. 2019 and is expected to further decrease by 10.2% up to 2030. Additionally, within the high-risk group, the likelihood of living in towns and suburbs, having a tertiary education and eating fruit and vegetables 1-6 times a week have increased by (3%, 5%, 1.7%, 4.4%) compared to other categories for each risk factor and are expected to be higher in 2030 by (11.6%, 18.6%, 5%, 16.3%). CONCLUSIONS: According to EHIS data, from 2015 to 2030, the number of people with diabetes in the EU will change and increase by 3.8 %. This increase will vary by subgroup.More data on risk factors are needed to obtain more accurate estimates. KEY MESSAGES: • The future health and economic burden of diabetes on society, health systems and the national economy is expected to increase in the EU. • Implementing effective prevention strategies on a large scale can reduce the future burden of diabetes.