GLOBAL BURDEN OF DIABETES, 1995-2025 - PREVALENCE, NUMERICAL ESTIMATES, AND PROJECTIONS

OBJECTIVE - To estimate the prevalence of diabetes and the number of p eople with diabetes who are greater than or equal to 20 years of age i n all countries of the world for three points in time, i.e., the years 1995, 2000, and 2025, and to calculate additional parameters, such as sex ratio, urban-rural ratio, and the age structure of the diabetic p opulation. RESEARCH DESIGN AND METHODS - Age-specific diabetes prevale nce estimates were applied to United Nations population estimates and projections for the number of adults aged greater than or equal to 20 years in all countries of the world. For developing countries, urban a nd rural populations were considered separately. RESULTS - Prevalence of diabetes in adults worldwide was estimated to be 4.0% in 1995 and t o rise to 5.4% by the year 2025. It is higher in developed than in dwe loping countries. The number of adults with diabetes in the world will rise from 135 million in 1995 to 300 million in the year 2025. The ma jor part of this numerical increase will occur in developing countries . There will be a 42% increase, from 51 to 72 million, in the develope d countries and a 170% increase, from 84 to 228 million, in the develo ping countries. Thus, by the year 2025, >75% of people with diabetes w ill reside in developing countries, as compared with 62% in 1995. The countries with the largest number of people with diabetes are, and wil l be in the year 2025, India, China, and the U.S. In developing countr ies, the majority of people with diabetes are in the age range of 45-6 4 years. In the developed countries, the majority of people with diabe tes are aged greater than or equal to 65 years. This pattern will be a ccentuated by the year 2025. There are more women than men with diabet es, especially in developed countries. In the future, diabetes will be increasingly concentrated in urban areas. CONCLUSIONS - This report s upports earlier predictions of the epidemic nature of diabetes in the world during the first quarter of the 21st century It also provides a provisional picture of the characteristics of the epidemic. Worldwide surveillance of diabetes is a necessary first step toward its preventi on and control, which is now recognized as an urgent priority.