LONDON — More than 800 million adults have diabetes worldwide – almost twice as many as previous estimates have suggested — and more than half of those aged over 30 who have the condition are not receiving treatment, according to a new study.

In 2022, there were around 828 million people aged 18 years and older with type 1 and type 2 diabetes worldwide, the study published in The Lancet found. Among adults aged 30 years and older, 445 million, or 59% of them, were not receiving treatment, the authors said.

The World Health Organization (WHO) has previously estimated that around 422 million people have diabetes, a chronic metabolic disease involving blood sugar levels, which can damage the heart, blood vessels, nerves and other organs if untreated.

The global diabetes rate has doubled since 1990 from around 7% to 14%, the study suggested, driven largely by rising cases in low- and middle-income countries. But although there are far more cases, treatment rates in those regions have barely increased, the authors said, while things have improved in some higher-income countries — leading to a widening treatment gap.

In parts of sub-Saharan Africa, for example, only 5-10% of those estimated to have diabetes were getting treatment, said Jean Claude Mbanya, professor at the University of Yaounde I in Cameroon. Treating diabetes, either with insulin or drugs, can be expensive.

“A huge number [are] at risk of serious health complications,” he said.

The study was done by the NCD Risk Factor Collaboration and the WHO, and is the first global analysis to include rates and treatment estimates for all countries, the authors said. It is based on more than 1,000 studies involving more than 140 million people.

Diabetes was defined as having high fasting plasma glucose levels and high glycated hemoglobin, both common diagnostic criteria for the condition, or taking medication for diabetes. The authors said both tests were used to avoid underestimating rates in parts of the world, particularly South Asia, where using fasting plasma glucose alone missed cases.

While the study could not separate out type 1 and type 2 cases, previous evidence has suggested that most diabetes in adults is type 2, which is linked to obesity and poor diet, the authors said. — Reuters

After a scare earlier this year that the U.S. labor market might be cooling too fast, some Federal Reserve policymakers are shifting their attention back to inflation risks as they weigh when, and how fast and far, to cut interest rates.

Government data released on Wednesday showed consumer prices rose 2.6% in the 12 months through October, above the U.S. central bank’s 2% goal but in line with economists’ expectations. 

Traders in financial markets piled into bets that the Fed’s policy-setting Federal Open Market Committee, fresh from last week’s quarter-percentage-point rate cut, will go ahead with another reduction in borrowing costs at its Dec. 17-18 meeting. 

It’s not clear if Fed Chair Jerome Powell will ratify that market view when he provides an update on his economic outlook to business leaders in Dallas on Thursday, just over a week after voters decided to send Donald Trump back to the White House. Powell has said that the Republican president-elect’s pledges of tax cuts and increased tariffs on imports would have no “near-term” impact on U.S. monetary policy. 

Fed policymakers on Wednesday held open the door to a go-slower approach, in the face of data showing the labor market remains healthy, even as price pressures remain. 

“In my baseline scenario, based on current information, I expect inflation to converge toward 2% over the medium term,” St Louis Fed President Alberto Musalem said at an Economic Club of Memphis luncheon, allowing the central bank to “judiciously and patiently” evaluate data in considering further rate cuts. 

But he also said, while the risk of unwelcome deterioration in the labor market may have fallen, recent data shows “the risk of inflation ceasing to converge toward 2%, or moving higher, has risen.” 

Dallas Fed President Lorie Logan struck a similar tone in remarks to an energy conference at her regional bank. 

“I anticipate the FOMC will most likely need more rate cuts to finish the journey” of bringing inflation toward the Fed’s goal.

But, she added, it’s “best to proceed with caution,” noting that “if we cut too far, past neutral, inflation could reaccelerate and the FOMC could need to reverse direction.” 

Kansas City Fed President Jeffrey Schmid, speaking at the same conference, said “it remains to be seen how much further interest rates will decline or where they might eventually settle.”

The Fed cut its policy rate by half a percentage point in September after a sharp slowdown in job growth and a rise in the unemployment rate raised concerns about a potential recession. Subsequent stronger labor market data suggested those fears were overblown, and with inflation continuing to fall – by the Fed’s targeted measure it registered 2.1% in September – the central bank cut its benchmark overnight interest rate by a quarter of a percentage point last week. 

The policy rate is now in the 4.50%-4.75% range. And that, Dallas Fed’s Logan said, is now “right at the top” of the estimated range of the neutral rate of interest where the cost of money acts neither as a headwind nor a tailwind for economic growth.

Logan did not speak directly to her view on the appropriateness of a rate cut at the Fed’s meeting next month, but her remarks suggest she is among the policymakers who would prefer to slow down on cuts sooner rather than later.

She noted upside risks to inflation, including from a possible post-election surge in business investment, as well as from consumer spending. Logan said she feels the labor market, with an unemployment rate of 4.1%, is cooling but not deteriorating materially. 

And while she said a recent rise in Treasury yields could slow the economy more than the Fed intends, posing a downside risk to employment, Logan also said that because the neutral rate has likely risen in recent years, U.S. monetary policy may not be braking the economy as much as it might appear.

RIGHT DIRECTION
Minneapolis Fed President Neel Kashkari, in an interview with Bloomberg TV, likewise noted the possibility that the neutral rate has risen, which suggests the Fed will not need to cut rates as much as it otherwise would.

The consumer price index data released on Wednesday, he said, seems to show that inflation is headed in the right direction. 

“I’ve got confidence about that, but we need to wait,” he added. “We’ve got another month or six weeks of data to analyze before we make any decisions.” 

Kashkari earlier this week said it would be unlikely that the labor market could weaken enough to affect the Fed’s policy decision at its next meeting. Opting to hold rates steady instead of cutting at that meeting, he said, would hinge on inflation data. 

Analysts saw the latest inflation data as no barrier to a rate cut in December, particularly because some of the strength in prices came from housing inflation, which Fed officials, pointing to a continuing decline in new leases, have expressed confidence will ebb. 

The Fed will get one more CPI reading before the December meeting. — Reuters

BANDAR SERI BEGAWAN, Brunei – Asia-Pacific travel demand has recovered from the pandemic, but earnings at the region’s airlines are under pressure from supply chain problems disrupting operations and exposing them to strengthening consumer protection rules, industry executives say.

A shortage of parts, labour and new planes as the aviation industry emerged from the pandemic has coincided with higher-than-expected repairs needed on the latest-generation engines.

“The supply chain issue is the biggest challenge the industry is facing,” Subhas Menon, the director general of the Association of Asia Pacific Airlines (AAPA) said at the trade body’s annual meeting in Brunei this week.

Turnaround times for engine maintenance are at record lengths, with airlines having to cut flights, move parts around and lease stop-gap engines or planes to keep operations ticking.

Thai Airways CEO Chai Eamsiri said servicing the Rolls-Royce RR.L engines on its Boeing 787 jets used to take around three months, but that has blown out to about six.

“We have to stretch the aircraft. We used to operate 12.5 hours a day, now we have to stretch it to 13 plus,” he told Reuters on the sidelines of the gathering.

SUPPLY CHAIN FRUSTRATION
The heads of major carriers including Thai Airways, Singapore Airlines, Malaysia Airlines and Kazakhstan’s Air Astana expressed frustration with maintenance times and said governments trying to improve consumer protections should stop placing the blame on airlines for delays.

“The root cause is coming from the supply chain…But we are the one facing the customer,” Eamsiri told the meeting.

Malaysia, Australia, Thailand and the Philippines are among the countries beefing up airline consumer protections to require refund options in the case of delays and cancellations, as is the United States, though the rules are not as onerous as EU regulations requiring payments to affected passengers.

Aviation manufacturers “have to get their act together”, Air Astana CEO Peter Foster said.

Amid a shortage of planes, labour and parts, Malaysia Airlines suffered a string of service disruptions this year and cut its network capacity by 20% from September.

Malaysia’s civil aviation regulator cut the duration of the carrier’s air operator certificate to one year from three years after an investigation.

“All airlines are wringing the neck of our suppliers,” Malaysia Airlines CEO Izham Ismail told attendees.

Engine servicing used to take around 55 days before the pandemic, but now it needs 100 or more, Ismail said.

Representatives of Airbus and Rolls-Royce said separately they were working to resolve supply chain snags, including improving suppliers’ access to financing.

AIRFARES FALLING
Travel in the Asia-Pacific region, which accounts for around 32% of global passenger traffic, recovered later than other parts of the world due to a belated lifting of pandemic travel restrictions, particularly in China.

In September, passenger volumes for 40 Asia-Pacific based carriers averaged 97.5% of the corresponding month in 2019, according to AAPA data.

Airlines globally have been seeing stable demand but airfares are declining as a post-pandemic travel boom abates and most planes are back in the skies.

Singapore Airlines, seen as a bellwether for the region, last week posted a 48.5% plunge in interim net profit, reflecting stiff competition, and flagged its earnings would stay under pressure despite robust travel demand. — Reuters

U.S. President-elect Donald Trump chose loyalists with little experience for several key cabinet positions on Wednesday, stunning some allies and making clear that he is serious about reshaping – and in some cases testing – America’s institutions.

Mr. Trump’s choice of congressman Matt Gaetz, 42, for U.S. attorney general, America’s top law enforcement officer, was a surprising pick. The former attorney has never worked in the Justice Department, or as a prosecutor, and was investigated by the Justice Department over sex trafficking allegations. His office said in 2023 that he had been told by prosecutors he would not face criminal charges.

Mr. Trump tapped Tulsi Gabbard as director of national intelligence. The former Democratic congresswoman-turned-Trump-ally has in the past spoken out against military intervention in the civil war in Syria under former President Barack Obama and implied that Russian President Vladimir Putin had valid grounds for invading Ukraine, America’s ally.

“I know Tulsi will bring the fearless spirit that has defined her illustrious career to our intelligence community, championing our constitutional rights and securing peace through strength,” Mr. Trump said in a statement.

Ms. Gabbard has little direct experience with intelligence work and had not been widely expected to be tapped for the post, which oversees 18 spy agencies.

She was deployed in Iraq from 2004 to 2005 as a major in the Hawaii National Guard and is now a lieutenant colonel in the U.S. Army Reserves.

On Tuesday, Mr. Trump chose Pete Hegseth, a Fox News commentator and veteran, to be his secretary of defense. Hegseth has opposed women in combat roles and questioned whether the top American general was promoted to his position because of his skin color. He also lobbied Mr. Trump during his 2017-2021 term to pardon servicemembers who allegedly committed war crimes.

Sprinkled in with those personnel choices were more conventional selections. Mr. Trump said on Wednesday he would nominate Senator Marco Rubio, who is a hardliner on China, as his new secretary of state.

But on the whole, his selections signal a radical shift in the way the U.S. government conducts its business and in the role America will play in the world over the next four years.

Mr. Trump has said he wants to end the “weaponization” of the Justice Department, which he said brought politically motivated criminal cases against him to hurt his presidential candidacy. The department says it acts without political bias.

LOYALTY
One common thread for Mr. Trump’s picks: He chose unfailingly loyal people who are unlikely to push back against his most controversial orders, analysts said.

Mr. Trump pledged on the campaign trail to go after his political enemies, including Democratic President Joe Biden, a pledge that Mr. Gaetz, his attorney general-designate, is unlikely to stand in the way of.

“Gaetz will do exactly as Trump says, which is why he was picked I guess,” said a source close to Mr. Trump, after Mr. Gaetz’s selection as was announced.

A half dozen sources close to Trump world, including donors, consultants and fundraisers, said privately that they were shocked by the choice of Gaetz because of his limited qualifications and past DOJ investigation into him.

“I was shocked that he has been nominated,” Republican senator Susan Collins, a moderate from Maine, told reporters about the Gaetz selection. “The president obviously has the right to nominate whomever he wants. But I think this is an example of why it’s so important that we have the advice and consent provisions in the Constitution.”

Some of Mr. Trump’s other nominees also lack any meaningful qualifications. Mr. Hegseth, while a decorated combat veteran, is best known in recent years as a media personality. He will now oversee the better part of 3 million employees and the world’s largest fighting force.

“Being secretary of defense is a very serious job, and putting someone as dangerously unqualified as Pete Hegseth into that role is something that should scare all of us,” said Tammy Duckworth, a Democratic senator from Illinois who sits on the armed services committee.

SENATE GUARDRAIL
Not only are Mr. Trump’s national security and foreign policy nominees universally skeptical of helping Ukraine fend off Russia’s invasion, some of their statements have been outright hostile toward Kyiv.

Ms. Gabbard, who will oversee America’s sprawling foreign and domestic intelligence apparatus, has portrayed Mr. Putin as a defender of his own nation’s vital national security interests. Ukraine, she has said, is a corrupt kleptocracy.

One potential guardrail that Mr. Trump and his nominees still face: the Senate.

While Mr. Trump’s Republicans control the Senate and most Republican lawmakers will support his nominees for top jobs, the slate the president-elect put forward will likely give the party’s remaining moderates pause and test just how loyal elected Republicans are to him and his vision.

The choice of Mr. Rubio as secretary of state could come as a relief to U.S. partners worried that the Trump administration could pull back from its global network of alliances, including NATO, given Trump’s “America First” emphasis during his campaign to return to the White House.

“He will be a strong Advocate for our Nation, a true friend to our Allies, and a fearless Warrior who will never back down to our adversaries,” Mr. Trump said of Rubio in a statement.

In additional to being a China hawk, Mr. Rubio, 53, is an outspoken critic of Cuba’s Communist government and strong backer of Israel.

He has in the past advocated for a more assertive U.S. foreign policy with respect to America’s geopolitical foes, although recently his views have aligned more closely with those of Trump’s approach to foreign policy.

Some analysts questioned whether Rubio would stand up to Trump, noting the president-elect’s inclination to make personal loyalty a central requirement for administration posts.

Aaron David Miller, a senior fellow at the Carnegie Endowment for International Peace, who served in both Democratic and Republican administrations, said it is essential for any president’s advisers to stand up to him when necessary, given the wide array of foreign policy challenges Mr. Trump will face.

“I’m trying to keep an open mind here,” Mr. Miller said, noting that Mr. Rubio, because of his experience in Congress, has a better grasp of foreign policy than any of Trump’s other appointees. — Reuters