Epidemiology of Diabetes

Diabetes is a growing health problem throughout the world; more than 170 million people are estimated to have diabetes worldwide, the majority of whom have type 2 diabetes (DM-2). Largely unknown early in the 20th century, DM-2 is now the fifth leading cause of death in the USA. Conservative estimates suggest that by 2025 the diabetic population will more than double to over 366 million [1]. From a global perspective, Asia is expected to be the region most heavily impacted by diabetes, with an anticipated 2- to 3-fold increase in prevalence. Factors contributing to the rise in diabetes prevalence are the declining mortality from communicable diseases and infant and maternal mortality in less developed countries, aging and urbanization of the population, and, most importantly, the striking increase in obesity. The parallel rise in the prevalence of obesity and DM-2 has been appropriately labeled 'diabe-sity' [2].

The complications of diabetes, which include limb amputations, blindness, nerve damage, kidney failure requiring hemodialysis, and cardiovascular disease (CVD), pose the threat of enormous human and economic costs. A prospective study of more than 15,000 persons followed for 25 years confirms that the risk of cardiovascular death in patients with diabetes without previous coronary heart disease (CHD) is equal to that of patients with CHD without diabetes, with the risk in women being higher [3]. Direct healthcare expenditures and the costs of lost productivity attributable to diabetes in the USA were estimated at USD 132 billion in 2002 [4].

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