High Fasting Glucose

High Fasting Glucose is one of the modifiable risk factors tracked by the IHME Global Burden of Disease Study. The attributable deaths shown here represent the estimated number of deaths that could be prevented if exposure to this risk factor were eliminated or reduced to optimal levels. Understanding risk factor contributions helps prioritize public health interventions and policy decisions.

Risk factor attribution uses comparative risk assessment methodology. A single death may be partially attributed to multiple risk factors, so attributable death counts should not be summed across risk factors. Data covers 204 countries from 1990 to the latest available year.

High fasting plasma glucose — the metabolic state underlying diabetes and pre-diabetes — contributes to approximately 6.7 million deaths annually through direct diabetic complications (ketoacidosis, hyperosmolar states), cardiovascular disease, chronic kidney disease, and increased susceptibility to infections including tuberculosis. The global prevalence of diabetes has quadrupled since 1980, reaching 537 million adults by 2021, with a further 541 million having impaired glucose tolerance. The Middle East, North Africa, South Asia, and the Pacific Islands have the highest age-adjusted prevalence. Obesity and physical inactivity are the dominant modifiable drivers. Poorly controlled hyperglycaemia accelerates macrovascular (coronary, cerebrovascular, peripheral) and microvascular (retinal, renal, neural) disease. In many low- and middle-income countries, the majority of diabetics are undiagnosed, and access to insulin, glucose monitoring, and diabetes education remains severely limited.

High Fasting Glucose contributes to mortality from ischaemic heart disease, stroke, chronic kidney disease, peripheral neuropathy, and 1 other conditions. The magnitude of impact varies by country depending on exposure levels, population demographics, and the availability of preventive and treatment services.

Lifestyle modification — moderate weight loss (5-7%) and regular physical activity — reduces type 2 diabetes incidence by 58% in pre-diabetic populations. Population strategies include sugar-sweetened beverage taxation, food labelling, and promotion of healthy diets. Metformin, SGLT2 inhibitors, and GLP-1 receptor agonists provide glycaemic control with cardiovascular and renal co-benefits. Universal access to affordable insulin is a critical equity issue: insulin should cost less than $5 per month but remains unaffordable for millions. The WHO Global Diabetes Compact sets targets for diagnosis, treatment, and control coverage.