World health report

Conquering suffering, enriching humanity

Diabetes mellitus

This disease is one of the most daunting challenges posed by chronic diseases. The number of sufferers is currently estimated to be about 135 million; this number is expected to rise to almost 300 million by the year 2025. The main reasons are population ageing, unhealthy diets, obesity and a sedentary lifestyle. While the rise in cases will exceed 40% in developed countries, it will be in the order of 170% in developing countries.

Diabetes mellitus is a hereditary disease with two major forms: insulin-dependent (IDDM) and non-insulin-dependent (NIDDM). These terms are currently under review. In IDDM, the pancreas fails to produce the insulin which is essential for survival. This form develops most frequently in children and adolescents but is being increasingly recognized later in life; sufferers are dependent on daily injections of insulin. Much more common, NIDDM accounts for about 90% of all cases and occurs principally in adults; in this form, the body is unable to respond properly to the action of insulin produced by the pancreas.

Diabetes is closely linked with heart disease, kidney failure and blindness; it adversely affects the outcome of pregnancy; and it can give rise to foot lesions which may progress to gangrene and limb amputations. Recent research provides clear evidence of the potential for adequate treatment to delay or even prevent these long-term complications of the disease.