Press Release WHO/63 14 September 1998 GLOBAL BURDEN OF DIABETES WHO Projects a 170% Growth in the Number of People with Diabetes in Developing Countries by 2025 Between 1995 and 2025 the number of the adult population affected by diabetes mellitus in developing countries is projected to grow by 170%, from 84 to 228 million people. By 2025, these countries will be home to 76% of all persons with diabetes, as compared with 62% in 1995. In the same period, the developed world will see a 41% increase, from 51 to 72 million people. Worldwide, a 122% rise is projected, from the total of 135 to 300 million. This more than twofold global increase will occur because of population ageing and growth, as well as from obesity, unhealthy diets and a sedentary lifestyle. These latter factors are closely associated with urbanization and industrialization. A study containing these estimates was published by Diabetes Care, a most authoritative professional publication on the subject. The study has been undertaken by the World Health Organization (WHO) in cooperation with the US-based Prudential Center for Health Care Research in Atlanta (Georgia) and the University of Michigan (Ann Arbor). The study linked data from a WHO-developed global database on diabetes with UN demographic projections in order to estimate the number of people with diabetes in all countries of the world for three points in time – the years 1995, 2000 and 2025. In 1995, the countries with the largest number of people with diabetes were, and are projected to be in the year 2025, India (19 and 57 million respectively), China (16 and 38 million) and the U.S.A. (14 and 22 million). The greatest increase between 1995 and 2025 is expected to occur in India (195%). For 1995, others in the "top 10" countries were the Russian Federation (9 million), Japan (6 million), Brazil (5 million), Indonesia (5 million), Pakistan (4 million), Mexico (4 million) and the Ukraine (4 million). For 2025, the others in the top 10, if current demographic projections hold, would include Pakistan (15 million), Indonesia (12 million), the Russian Federation (12 million), Mexico (12 million), Brazil (around 11 million), Egypt (9 million) and Japan (around 9 million). The projections for the Russian Federation are complicated by the continuing social change there. The WHO study also contains estimates of sex ratio, urban-rural ratio and the age structure of the diabetic population. In 1995, for the world as a whole, there were more women than men with diabetes (73 million vs. 62 million). The female excess was pronounced in the developed countries (31 million vs. 20 million), but for the developing countries, these figures are surprisingly equal (42 million in each case). WHO estimates that by 2025 the worldwide female/male excess will decrease (159 million vs. 141 million). For developing countries as a whole, a considerable excess of people affected with diabetes in the urban areas is predicted. Of special interest to health economists and planners are WHO's projections of the age structure of the diabetic population. If the present trends persist, by 2025 most people with diabetes in developed countries will be aged 65 years or more, while the majority of diabetic persons in developing countries will be in the 45-64 year age group. This means that some 170 million men and women, who will reside in the developing regions of the world in less than 30 years from now, will be suffering from diabetes in their most productive years of life. "These estimates and projections will undoubtedly become a powerful tool for planning evidence-based health care and public health interventions in our Member States", commented WHO's Director-General Dr Gro Harlem Brundtland. "They are yet another scientific testimony of a transition the world is experiencing at the moment, the transition from communicable to noncommunicable diseases. In the 21st century, the impact of this transition on the public health and economic sectors will be especially noticeable in developing countries." "As was requested in May 1998 by the World Health Assembly, WHO is currently developing a strategy, which could help reduce the toll of premature morbidity and mortality from major noncommunicable diseases, including diabetes, and prepare developing countries for such a transition", said Dr Brundtland. Diabetes mellitus is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by ineffectiveness of the insulin produced. Complications include diabetic retinopathy, renal failure, heart disease, diabetic neuropathy and foot ulceration and amputation. As a major noncommunicable disease, diabetes mellitus alone claims on the average around 8% of total health budgets in developed countries.

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