By 2030, about half of the 79 million adults around the globe predicted to have type 2 diabetes won’t have access to insulin, a study said.

A modeling study published in The Lancet Diabetes & Endocrinology focused on the price and dwindling supply of the life-saving drug that also helps people with types 1 and 2 diabetes stave off amputation, blindness, kidney failure and stroke.

Researchers from Stanford University projected type 2 diabetes numbers in 221 countries from 2018 and 2030, with half of that group living in China, India and the United States.

During that time, the biggest spike in need could come from Africa, where experts predict the number of people with type 2 diabetes will jump from 700,000 to over 5 million.

Climbing global rates of type 2 diabetes and growing numbers of people living with the disease continue to drive up demand and prices for insulin. The drug can cost as much as $900 per month for people without insurance.

Only three companies currently produce insulin: Novo Nordisk, Sanofi and Lilly. In 2017, diabetes patients sued those companies for driving up insulin prices.

In 2016 an article in the Journal of the American Medical Association reported that the drug’s price almost tripled between 2002 and 2013.

“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,” Basu said. “Unless governments begin initiatives to make insulin available and affordable, then its use is always going to be far from optimal.”

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