Diabetes - a common, growing, serious, costly, and potentially preventablepublic health problem

An estimated 135 million people worldwide had diagnosed diabetes in 1995, a nd this number is expected to rise to at least 300 million by 2025. The num ber of people with diabetes will increase by 42% (from 51 to 72 million) in industrialized countries between 1995 and 2025 and by 170% (from 84 to 228 million) in industrializing countries. Several potentially modifiable risk factors are related to diabetes, including insulin resistance, obesity, ph ysical inactivity and dietary factors. Diabetes may be preventable in high- risk groups, but results of ongoing clinical trials are pending. Several ef ficacious and economically acceptable treatment strategies are currently av ailable (control of glycemia, blood pressure, lipids; early detection and t reatment of retinopathy, nephropathy, foot-disease; use of aspirin and ACE inhibitors) to reduce the burden of diabetes complications. Diabetes is a m ajor public health problem and is emerging as a pandemic. While prevention of diabetes may become possible in the future, there is considerable potent ial now to better utilize existing treatments to reduce diabetes complicati ons. Many countries could benefit from research aimed at better understandi ng the reasons why existing treatments are under-used and how this can be c hanged, (C) 2000 Published by Elsevier Science Ireland Ltd.