The 21st
Adrian R. Scott MD, FRCP 3 century will see diabetes emerge as the world’s commonest chronic
disease. Whilst the bulk of this will be type 2 diabetes (90%) the incidence has been rising in both types. The direct and indirect costs of diabetes and its complications, plus the associated reduction in quality and quantity of life, will have considerable economic consequences. This effect will be most noticeable in developing countries which are going to see a disproportionate increase in the prevalence of diabetes over the next few decades. It has been estimated that the worldwide prevalence of diabetes will double between 1990 and 2010. Epidemiological studies in the USA have shown that the number of people with diabetes has increased from around 1.5 million in 1958 to 10.5 million in 1998. Most states in the US report a prevalence of over 8% and this fails
to take into account those people with undiagnosed diabetes. Most screening studies indicate that at least 50% of people found to have diabetes were silently undiagnosed for sometime.