Professor Diana Magliano (3:00)

Days or sometimes even up to two weeks. If you don't have insulin, you will die. So that's the one that people get mainly in childhood, but we also see that now in young adults and older adults. And type 2 diabetes is a bit different in the sense that the biggest feature is insulin resistance. They're resistant to their insulin and they need more and more to do the same job.

Tim Harford (3:22)

It's type 2 diabetes that generally hits the headlines as it makes up about 90% of all diabetes cases.

Professor Diana Magliano (3:30)

It's a disease in older people, although we are seeing it now in 20s and 30 year olds. There is more lifestyle driven. Lack of physical activity, smoking, hypertension. They're all drivers. But the biggest driver of type 2 diabetes is in fat. Obesity.

Tim Harford (3:47)

Obesity may be the biggest driver, but some obese people will never develop type 2 diabetes and some slimmer people will. This is because some people, and indeed some populations, are genetically predisposed to developing the condition.

Professor Diana Magliano (4:01)

Certain racial groups are more likely to get type 2 diabetes. The white people are protected, but people from Asia and India and Pakistan and indigenous people have got a much higher risk of type 2 diabetes and a stronger family history of type 2 diabetes as well.

Tim Harford (4:18)

Diana has been looking at global diabetes statistics for decades. In the Diabetes World Atlas, she used data from government health agencies and some extrapolation to calculate that 590 million people around the globe are currently living with diabetes. The majority of them have type 2 diabetes. This number is likely to be an underestimate due to some countries under diagnosing, but it is the best number we have. But wait a minute. If 590 million people have diabetes globally.

Ad Voice 3 (4:51)

And 20 years ago there was no diabetes in China. Today, 50% of the population is diabetic.

Tim Harford (4:57)

That would mean 700 million people in China have diabetes and that would mean that every single person diagnosed with diabetes is Chinese and in fact that the rest of the world has negative 100 million diabetics. Now, I'm not a doctor, but that doesn't seem very likely. So RFK Jr's 50% figure can't possibly be right?

Professor Diana Magliano (5:21)

No, it's at about 12%.

Tim Harford (5:23)

Ah.

Professor Diana Magliano (5:24)

Type 2 diabetes is always lower in the rural communities. We were still living on the land having their traditional diets, but in urbanised communities, where they're living in big urban cities with pollution and junk food and affluent life, diabetes is really taking a hold. And that's what's happening in China.

Tim Harford (5:42)

However, Diana says that RFK Jr. S claim about the numbers shooting up does reflect what she found when she was compiling her diabetes atlas, the birth atlas.

Professor Diana Magliano (5:52)

That we wrote in 2000. It was under 1% of people in China would have diabetes. And now in the 11th edition of the Atlas, 11.9% of Chinese adults aged 20 to 79 have diabetes.

Tim Harford (6:07)

That could partly be due to undercounting or under diagnosis. But it's also likely that lifestyle factors and urbanisation, plus genetic disposition and a rapidly aging population have made these numbers shoot up. However, the rise was from under 1% to just under 12%, not 50%.

Professor Diana Magliano (6:27)

There's no monkey that's got 50%. So the highest country is Pakistan was about 30, 31% and some of the Pacific islands got really high.

Tim Harford (6:36)

One such place that demonstrates how quickly incidence of diabetes can spread is Nauru, a small island in Micronesia to the northeast of Australia.

Professor Diana Magliano (6:46)

That was an island made of phosphate and they sold it their phosphate and got rich and stopped moving and didn't have to work and they got large and they got diabetes and they couldn't grow their food anymore because the land was destroyed from all the phosphate. So they had to buy all this food from New Zealand and Australia and was energy dense foods and they were living off junk food. So their diabetes prevalence hit 34% overall and it was 50% in some of the older age groups.

Tim Harford (7:13)

In Nauru, all that happened in the space of 30 years. Currently, the increase in incidence of diabetes is higher in certain areas than others.

Professor Diana Magliano (7:24)

Much higher burden of type 2 diabetes in middle income countries and high income countries. Even though the high income countries presented with it earlier and the low and middle income countries are still developing, the burden now for them is much higher because of their genetics and their ethnic group.

Tim Harford (7:40)

One of the important things to note when looking at the data around diabetes in countries such as the US and the UK is that although the percentage of people who have diabetes is growing, the rate of new cases is stabilising and in some places reducing.

Professor Diana Magliano (7:57)

Prevalence is generally rising everywhere because we're living longer with diabetes, because we're managing it so much better. European white populations, we actually think the incidence of type 2 might be starting to stabilise, in fact, but it doesn't mean that prevalence doesn't go up because people are still staying alive with it.

Tim Harford (8:14)

An alarming development in higher income countries is that people are being diagnosed with type 2 diabetes at a younger age.

Professor Diana Magliano (8:21)

So I looked at eight countries, it was certainly going up in Japan and Korea and it was going up less in the white European populations.

Tim Harford (8:32)

In the us, this problem extends to children.

Ad Voice 3 (8:35)

Today, one out of every three kids is prediabetic or diabetic.

Tim Harford (8:40)

The Health Secretary is right in that the Centres for Disease Control and Prevention, the CDC recently reported that 1 in 3American children aged between 12 and 17 are pre diabetic. However, the National Health and Examination Survey, which provided the data for the CDC report, also found that 70% of teenagers with prediabetes do not develop diabetes. So while that figure is alarming, it is fixable. But how many American children actually have type 2 diabetes?

Professor Diana Magliano (9:14)

It's really low. For type 2, it's 0.67 in 1000.

Tim Harford (9:18)

Children in kids under 20, that's 1 in 1500. Although we are better at treating diabetes, it still carries a high burden of disease, especially in middle and lower income countries countries. Despite this, Diana says there is a sliver of hope.

Professor Diana Magliano (9:36)

We can be cautiously optimistic that in at least high income countries we're managing to turn the tide. So the message of healthy life is.

Tim Harford (9:44)

Getting through eventually, thanks to Professor Diana Magliano. And that's all we have time for this week. If you see any suspicious stats, please email in to more or lessbc.com until next week. Goodbye.

Ad Voice 4 (10:07)

This is the Story of the One as head of maintenance at a concert hall, he knows the show must always go on. That's why he works behind the scenes, ensuring every light is working, the H Vac is humming, and his facility shines with Granger supplies and solutions for for every challenge he faces. Plus 24. 7 customer support, his venue never misses a beat. Call quickgranger.com or just stop by Grainger for the ones who get it done.

Ad Voice 1 (10:37)

This is the story of the One As a custodial supervisor at a high school, he knows that during cold and flu season, germs spread fast. It's why he partners with Granger to stay fully stocked on the products and supplies he needs, from tissues to disinfectants to floor scrubbers. Also, that he can help students, staff and teachers stay healthy and focused. Call 1-800-granger clickgranger.com or just stop by Granger for the ones who get it done.