Warning over mysterious explosion in type 1 diabetes – experts predict 30% rise by 2050…and it’s not because we’re getting fatter

Britain is in the midst of an explosion of type 1 diabetes, with cases set to surge by a third over the next two decades, experts have warned. 

Researchers estimate more than 100,000 more Britons will be blighted by the deadly disease over the coming years – reaching a total of 420,500 by 2049.

Cases have already risen by some 25 per cent since the early 2000s, official figures show.

Unlike type 2 diabetes, the condition is not caused by obesity, lack of exercise and poor diet. 

Rather, type 1 is an autoimmune problem that typically develops during childhood.

It occurs when the body makes little or no insulin – the hormone responsible for converting sugars in food into energy.

While scientists are yet to identify a single cause for the rise, they believe a combination of environmental triggers could be to blame, including viral infections during childhood, air pollution and forever chemicals. 

‘This increase is happening too quickly to be explained by changes in our genes alone,’ Dr Rosiered Brownson-Smith, an expert from King’s College London, told the Daily Mail. 

‘Instead, researchers think that changes in our environment and early-life exposures may be interacting with genetic susceptibility. 

‘A number of factors are being investigated – including childhood obesity, viral infections, changes in the gut microbiome and reduced exposure to microbes early in life, air pollution and certain chemicals.

However, she added, experts still don’t know what exactly is driving the surge. 

‘It is unlikely that there is one single environmental factor responsible,’ she explained. 

‘The more likely explanation is that several different factors may work together in people who are genetically susceptible to type 1 diabetes.’

Researchers have explored a number of possible triggers, including viral infections in childhood, changes in gut bacteria, the widespread use of antibiotics and even early exposure to cow’s milk.

Other studies have suggested that air pollution may influence the risk of developing autoimmune diseases, though the evidence remains inconclusive.

The latest research – due to be presented at the annual meeting of the European Association for the Study of Diabetes in Milan – also predicts a sharp rise in the global burden of the disease. 

It is estimated that the number of new worldwide cases per year will increase by 14 per cent per year, from around 530,000 to more than 605,000.

The projections were generated using a modelling tool that estimates rates of type 1 diabetes around the world, taking into consideration treatment availability and survival. 

The international team, led by experts at the University Hospital of Southern Denmark, said one of the key reasons type 1 diabetes is becoming more common is that more people are surviving and living longer with the condition thanks to improvements in diabetes care. 

‘The number of people living with type 1 diabetes is expected to increase for a few different reasons,’ Dr Brownson-Smith said.

‘The main reason for this difference is likely that people with type 1 diabetes are living longer.’

The disease can increase the risk of kidney disease, stroke, blindness and nerve damage. 

But decades of advances in insulin therapy, blood glucose monitoring and specialist diabetes care have dramatically improved outcomes for patients.

While early studies suggested that people with type 1 diabetes tend to live 15 to 20 years fewer than their healthy peers, more recent studies put this figure closer to 11 years, indicating survival gains over recent decades.

‘With access to specialist diabetes care (insulin, glucose monitoring), many people diagnosed when they are young will live with the condition for decades,’ Dr Brownson-Smith said. 

Diabetes treatment involves daily injections of insulin – which allows sugar from the bloodstream to enter the body’s cells where it can be used for energy.

Without enough insulin, glucose builds up in the bloodstream to dangerous levels.

This can lead to a life-threatening condition called diabetic ketoacidosis (DKA), in which the body begins breaking down fat for energy, causing harmful acids known as ketones to build up in the blood. 

Symptoms include severe thirst, vomiting, abdominal pain, confusion, breathing difficulties and, in severe cases, coma and death if left untreated. 

The rise in prevalence is expected to be particularly pronounced in poorer countries, where access to treatment is limited. 

The US, meanwhile, is expected to record one of the largest increases in the number of people living with the condition, with cases rising from almost 1.5 million today to more than 2 million by 2049, the researchers predict.

The team has urged policy makers to ensure that the rising tide of patients will be able to access the treatment they need. 

Dr Brownson-Smith said the findings should serve as a warning to health services to prepare for a growing number of patients requiring lifelong support.

‘The main implication is that the NHS needs to plan for more people living with type 1 diabetes over the long term,’ she said.

‘People with type 1 diabetes need lifelong access to care, including insulin, blood glucose monitoring and specialist support to manage their condition.

‘As the number of people living with the disease increases, this will create greater demand for diabetes services.’

This is anticipated to include increased pressure on specialist diabetes teams, glucose-monitoring technology, diabetes education programmes and services that support patients throughout childhood and into later life. 

‘The NHS needs to think about how many people might be diagnosed next year and how many people will need diabetes care over the next decades,’ she added.

Symptoms of type 1 diabetes usually appear quickly, within a few weeks, beginning with severe thirst, frequent urination and unexplained weight loss. 

Later symptoms include fatigue, blurred vision, itching and slower-than-normal healing of wounds. 

People with the autoimmune disease need either insulin injections or an insulin pump, which administers small amounts of insulin throughout the day and nights. 

Patients also require regular tests and check-ups with their diabetes care team. 

Despite this, nearly 450 million people with diabetes go untreated, according to a recent study published in The Lancet. This is three-and-a-half times the number in 1990. 

In the UK, routine testing for type 1 diabetes is not yet available on the NHS.

Instead, people are likely to learn they are at risk through blood tests carried out for other medical reasons or because the condition runs in their family.

 But, given that most of those diagnosed have no close family history, experts believe environmental factors may also play an important role.