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Diabetes Care, Vol 21, Issue 9 1414-1431, Copyright © 1998 by American Diabetes Association
Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections
H King, RE Aubert and WH Herman
Division of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland. kingh@who.ch
OBJECTIVE: To estimate the prevalence of diabetes and the number of people
with diabetes who are > or =20 years of age in 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 population. RESEARCH DESIGN AND
METHODS: Age-specific diabetes prevalence estimates were applied to United
Nations population estimates and projections for the number of adults aged
> or =20 years in all countries of the world. For developing countries,
urban and rural populations were considered separately RESULTS: Prevalence
of diabetes in adults worldwide was estimated to be 4.0% in 1995 and to
rise to 5.4% by the year 2025. It is higher in developed than in developing
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 major part of this
numerical increase will occur in developing countries. There will be a 42%
increase, from 51 to 72 million, in the developed countries and a 170%
increase, from 84 to 228 million, in the developing countries. Thus, by the
year 2025, >75% of people with diabetes will reside in developing
countries, as compared with 62% in 1995. The countries with the largest
number of people with diabetes are, and will be in the year 2025, India,
China, and the U.S. In developing countries, the majority of people with
diabetes are in the age range of 45-64 years. In the developed countries,
the majority of people with diabetes are aged > or =65 years. This
pattern will be accentuated by the year 2025. There are more women than men
with diabetes, especially in developed countries. In the future, diabetes
will be increasingly concentrated in urban areas. CONCLUSIONS: This report
supports 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 prevention
and control, which is now recognized as an urgent priority.

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