THE GLOBAL BURDEN
It is now recognized that it is the low- and middle-income countries that face the greatest burden of diabetes. However, many governments and public health planners still remain largely unaware of the current magnitude, or, more importantly, the future potential for increases in diabetes and its serious complications in their own countries.
This section of the IDF Diabetes Atlas looks at the global burden of diabetes. It points out the consequences of inaction by revealing the mortality caused by diabetes as well as the mounting health expenditures in countries around the world.
The first part presents estimates of the prevalence of diabetes mellitus and impaired glucose tolerance (IGT) for 216 countries and territories for the years 2010 and 2030; it also looks at the global trends in diabetes in the young and provides estimates for type 1 diabetes in children and adolescents.
Diabetes can lead to complications, the consequences of which can include blindness, kidney damage, and foot ulcers that can result in amputation. There is no single definition for each type of complication (e.g. retinopathy, neuropathy or nephropathy) so studies of the occurrence of diabetes complications are often hard to compare. There have been relatively few studies and a review of most of these studies is available in the Diabetes Atlas, third edition 1 . However, this edition addresses depression, an important condition that is common in people with diabetes. A survey on national diabetes programmes, reported in National Diabetes Programmes, found that psychological and behavioural issues received less attention than other aspects of diabetes care. This section summarizes a review of studies of diabetes and depression, and shows the significance of depression in affecting both the quality of life of people with diabetes and how well diabetes is controlled.
Estimates of the mortality burden related to diabetes for 2010 are also presented in this section, deaths that are largely preventable through public health action directed at primary prevention of diabetes in the population and improvement of care for all people with diabetes.
In addition, this section examines the economic impact of diabetes and provides estimates of national health expenditures to treat and prevent diabetes and its complications for the years 2010 and 2030. The results show that more than 80% of expenditures for medical care for diabetes are made in the world’s economically richest countries, not in the low and middle-income countries where over 70% of people with diabetes live. In the world’s poorest countries, not enough is spent to provide even the least expensive life-saving diabetes drugs.
1: International Diabetes Federation. The Diabetes Atlas. Third Edition. Brussels: International Diabetes Federation; 2006.