Insulin is an indispensable medication for millions of people who suffer from diabetes, but experts are becoming concerned that we'll be unable to meet the demand for it over the coming decades. A new study led by Stanford scientists forewarns of massive gaps in access to the life-saving hormone as the diabetes epidemic continues to worsen. So much so, that half of those who need it simply might not be able to get it.

Diabetes rates have risen steadily over the past three decades, from affecting around five percent of adults around the globe in 1980 to roughly nine percent today. This brings with it a heightened risk of all the complications that both type 1 and type 2 diabetes can trigger, including kidney failure, stroke, nerve disease and blindness.

While not all sufferers of diabetes need insulin, for those that do current access is far from ideal. As the Stanford scientists point out, prices have skyrocketed since the turn of the century with manufacturing of the drug controlled by three major companies, all of which were sued in 2017, accused of conspiring to intentionally drive up prices.

A 2016 study published in the The Journal of the American Medical Association found that the price of insulin almost tripled between 2002 and 2013, despite no evidence of increasing costs associated with the development of the drug.

Stanford Assistant Professor of Medicine Sanjay Basu led a team of researchers in an effort to take stock of the current situation regarding insulin accessibility, and what it might look like if current trends continue. The researchers gathered data from the International Diabetes Federation accumulated through 14 cohort studies that involved more than 60 percent of type 2 diabetes sufferers around the world.

Based on this data, the team modeled the increasing prevalence of type 2 diabetes in 221 countries between 2018 and 2030, which led them to estimations around how the number of insulin users will rise, and how much insulin would be needed to serve their needs. Among the findings was a projected 20 percent rise in total type 2 diabetes sufferers, from 406 million in 2018 to 511 million in 2030. Half of those would come from China, India and the US.

In a perfect world with universal access to insulin, the scientists say 79 million of those sufferers would have access to life-saving insulin. But in reality, their modeling suggests only around half of those will be able to get their hands on it if current trends continue. This widening gap in accessibility is expected to be felt most in Africa and Asia.

"Despite the UN's commitment to treat noncommunicable diseases and ensure universal access to drugs for diabetes, across much of the world insulin is scarce and unnecessarily difficult for patients to access," says Basu."Unless governments begin initiatives to make insulin available and affordable, then its use is always going to be far from optimal."

The research was published in the journal The Lancet.