The Numbers and Questions Around Kazakhstan’s Diabetes Data

Kazakhstan’s latest diabetes figures look encouraging at first glance: in the first quarter of 2026, the ministry of health reported an incidence of 308.7 cases per 100,000 population, compared with 313.5 during the same period in 2025.This comes on the back of more monitoring, after healthcare institutions expanded the use of glycated haemoglobin, or HbA1c, testing.In 2025, 261,500 people with type 2 diabetes underwent such tests, equivalent to 49.9% of registered patients with the condition.These are meaningful developments.Diabetes requires early detection and sustained follow-up, and HbA1c is one of the main clinical measures used to assess glycaemic control over time.Better monitoring can help physicians adjust treatment and identify patients at risk of complications.But these figures also illustrate a problem that extends well beyond diabetes.The indicators most readily available to a health system often describe what the system does: how many patients are registered, how many tests are performed, and how many consultations take place.What they do not necessarily show is what eventually happens to the people behind those numbers.That distinction became increasingly important during my research on the burden of diabetes in Kazakhstan.Together with colleagues, I analyzed national data covering 1.9 million registered diabetes cases and 20,605 registered deaths between 2018 and 2021.Over that period, registered prevalence rose from 2,142.2 to 3,743.9 cases per 100,000 population.The rate of newly registered cases increased from 207.2 to 392.3 per 100,000, while mortality rose from 22.3 to 34.1 per 100,000.The study, published in 2023, is available in open access here.Those figures appear to tell a simple story of a rapidly growing disease burden.In reality, they are more difficult to interpret.The Pandemic and the DiseaseThe largest increases occurred in 2020 and 2021 during the COVID-19 pandemic, during which time healthcare access changed, screening patterns changed, routine care was disrupted, and people changed the way they used medical services.Here, it is worth stating explicitly that the data do not establish that the pandemic caused the increase.Registration practices and diagnostic activity can influence administrative statistics alongside changes in underlying diseases themselves.So, while a rising prevalence rate can mean that more people are developing diabetes, it can also mean that a health system has become better at finding people who were previously undiagnosed.Conversely, a fall in registered cases does not automatically mean that fewer people are becoming ill.It can also reflect reduced screening or poorer access to healthcare.The numbers themselves are therefore only the beginning of the question.For diabetes, this is particularly important because being included into a register is the beginning of long-term care. A person may then live with the disease for decades, moving between primary care, laboratory monitoring, specialist services and, in some cases, hospital care for serious complications.If we want to understand the burden of a chronic disease, we need to know more than how many people have had their cases recorded.Studying MortalityIn a similar vein, conventional mortality statistics count deaths, which is essential.They do not, however, fully capture the difference between a death late in life and a death that occurs decades earlier than expected.In another study, published in 2025, we used diabetes mortality data to examine years of potential life lost, or YPLL.This statistic differs from mortality rates by estimating how much of an expected lifetime has been lost, rather than merely counting how many deaths have occurred.We found that between 2018 and 2021, registered deaths from diabetes in Kazakhstan represented approximately 105,036 years of potential life lost.In my subsequent doctoral research, the greatest losses I found were concentrated among people aged 50 to 69.This gives mortality a different meaning. A death in this age range can represent years of expected life, employment, family responsibility and social participation that have disappeared with that person’s passing.Once we begin looking at diabetes in this way, another limitation of routine statistics becomes apparent.Not all of the burden is visible through death or hospitalization – much of it is lived every day.Kazakhstan’s ministry of health routinely collects information on diagnoses, laboratory tests, prescriptions, consultations and hospital admissions.Far less is known systematically about whether people with chronic disease can move without difficulty, carry out ordinary activities, continue working, maintain independence or live without persistent pain and emotional distress.To properly evaluate clinical outcomes, however, this information is also vital.That is why, in a separate study published in 2025, my colleagues and I sought to assess health-related quality of life among 54 hospitalized patients with type 2 diabetes in Almaty using the EQ-5D-5L instrument.Our sample was small and consisted specifically of hospitalised patients, so it should not be interpreted as representative of everyone living with diabetes in Kazakhstan.Within that group, however, the findings were striking.Pain or discomfort was reported by 77.8% of participants, problems with mobility by 64.8%, and anxiety or depression by 53.7%.