Diabetes Atlas

The IDF Diabetes Atlas, fourth edition, therefore aims to highlight the evidence base needed for governments, civil society, international health organizations and the health community to make informed decisions on prevention and care strategies. It also aims to stimulate action on the gaps in knowledge about diabetes and the extent of its impact in low- and middle-income countries, where most people with diabetes live. Pressing issues that require immediate attention from governments are also highlighted in this edition.

• The diabetes epidemic is here and threatens to overwhelm health systems if left unchecked.
• The majority of type 2 diabetes cases can be prevented — prevention costs governments far less than treating diabetes and its complications.
• The non-preventable forms of diabetes can be treated — lives can be saved but people in low-and middle-income countries need access to essential diabetes medicines.
• Diagnosis, treatment, management and prevention of diabetes and other non-communicable diseases require integrated health systems, delivery of care down to primary care level, and supportive policies outside the health sector.
• Diabetes is a development issue — the epicentres of the epidemic are in low- and middle-income countries and it is a threat to the health and economic prosperity of nations.

This publication is a concise version of the IDF Diabetes Atlas, fourth edition, which summarizes the main issues in each of the topics addressed. A summary table of country estimates of the key data is provided in Appendix 1. Background papers on which the summaries have been based are available in the accompanying CD-ROM and in the download section of the website. Tables with more detailed estimates of the prevalence of diabetes and impaired glucose tolerance (IGT), mortality and healthcare expenditure are also available on the electronic media.

Chapter 1 defines diabetes mellitus and briefly describes the different types of diabetes and related major chronic complications.

The continuing escalation of diabetes prevalence worldwide and the burden it imposes on the individual, society and economy is captured in Chapter 2. This chapter looks at the extent of the diabetes epidemic and its bearing on morbidity and mortality as well as the economic impact of the disease. Chapter 2 also highlights the challenges of diabetes in the young, and the issue of diabetes and depression, which requires greater attention than it has received so far.

The global figures on the prevalence of diabetes and IGT in Chapter 2 are based on estimates for 216 countries and territories for 2010 and 2030. The estimates of diabetes-related mortality show that the number of deaths is considerable and of a similar or greater magnitude to that caused by several infectious diseases that receive considerably more attention from policy makers, researchers, donors and the public. At the same time, the projections for health expenditures for each person with diabetes show that there is a wide variation of spending between countries, and that more resources should be invested in cost-effective interventions, particularly in the low- and middle-income countries where the great majority of persons with diabetes live.

Chapter 3 provides an overview of the diabetes situation in each of the seven IDF Regions. The overviews show that the burden of diabetes will continue to be greatest in the economically developing countries, and that much remains to be done to lift them out of the epidemic.

Chapter 4 emphasizes the urgent need for governments to make investments in prevention programmes and in healthcare systems to improve the well-being of the millions affected by diabetes. It discusses some of the evidence that confirms that there are effective strategies for the prevention and management of type 2 diabetes. It also looks at the need for further investment in diabetes education, a cornerstone of effective self-management.

Chapter 5 reviews the response of policy-makers and health systems to the challenges of the diabetes epidemic. It summarizes the results of a survey of IDF member associations on national diabetes programmes (NDPs), and examines the broader picture of providing optimal care for people who require insulin by looking at results from assessments in a number of low-income countries. Chapter 5 also looks at global efforts to monitor the quality of diabetes care and identifies the issues that hinder such monitoring.

Chapter 6 highlights action taken at the international level to assist countries to strengthen their healthcare systems to tackle the growing problem of diabetes and other non-communicable diseases (NCDs). This chapter also specifies the direction that the International Diabetes Federation (IDF) will take to win the battle against diabetes. It emphasizes the Federation's call to the international community to fund essential medicines and technology, and to meet requests from low- and middle-income countries to improve their healthcare systems.

Chapter 7 provides useful resources and web links, and includes a list of the International Diabetes Federation’s position statements on topical issues.

Estimates of key data on the prevalence of diabetes and IGT, incidence rate of type 1 diabetes in children, mortality, national diabetes programmes and mean health expenditure are provided in Appendix 1. Two sets of prevalence figures, national and comparative, for diabetes and IGT are provided. The national, or crude, prevalence indicates the percentage of each country’s population that has diabetes, and is appropriate for assessing the burden of diabetes for each country. The comparative prevalence has been calculated by assuming that every country has the same age profile (the age profile of the world population has been used), which makes this figure appropriate for making comparisons.