Diabetes: Quick facts 13/7/04. By Giles Newton The burden of disease in the UK, USA and worldwide.

The disease

• Diabetes mellitus arises when insufficient insulin is produced, or when the available insulin does not function correctly.
• Without insulin, the amount of glucose in the bloodstream is abnormally high, causing unquenchable thirst and frequent urination. The body's inability to store or use glucose causes hunger and weight loss.
• Insulin-dependent diabetes – type 1 diabetes – is caused by the destruction of most or all of the beta cells in the islets of Langerhans in the pancrease.
• Type 1 diabetes usually appears before the age of 35, and most often between the ages of 10 and 16.
• Non-insulin-dependent diabetes – type 2 diabetes – occurs when the body does not produce enough insulin, and the insulin that is produced becomes less effective. Regular insulin injections are required to survive.
• Type 2 diabetes usually appears in people over the age of 40, and tends to have a more gradual onset. In most cases, glucose levels in the blood can be controlled by diet, or diet and tablets, although sometimes insulin injections may be needed. About 90 per cent of diabetics are non-insulin dependent.

Diabetes in the UK

• An estimated 1.4 million people in the UK are known to have diabetes, with possibly up to a million more undiagnosed.
• An estimate of the costs of insulin-dependent diabetes mellitus (type 1 diabetes) in England and Wales in 1992 put the direct costs at £96 million and the indirect costs at £113 million.
• Overall, estimates suggest that diabetes costs the NHS at least £2 billion every year - 8 per cent of total hospital expenditure. More than half of this sum is spent treating the complications of the disease, and 10 per cent of hospital beds are occupied by people with diabetes.

…in the USA

• The USA had 14 million people with diabetes in 1995; by 2025, this figure is expected to rise to 22 million.
• The total annual economic cost of diabetes in the USA in 1997 was estimated to be US$98 billion - US$44.1 billion in direct medical and treatment costs, and US$54 billion for indirect costs attributed to disability and mortality.
• In 1998, the US National Institutes of Health spent US$415 million on diabetes-related research.

…and worldwide

• Diabetes is the fourth leading cause of death in most developed countries.
• Between 1995 and 2025 the number of the adult population affected by diabetes mellitus in developing countries is projected to grow by 170 per cent, from 84 to 228 million people. By 2025, these countries will be home to 76 per cent of all persons with diabetes, as compared with 62 per cent in 1995. The greatest increase between 1995 and 2025 is expected to occur in India – from 19 million to 57 million (195 per cent).
• In the same period, the developed world will see a 41 per cent increase, from 51 to 72 million.
• Worldwide, a 122 per cent rise is projected, from the total of 135 to 300 million. This more than twofold growth increase will occur because of population ageing and growth, as well as from obesity, unhealthy diets high in saturated fats and a sedentary lifestyle.
• If the present trend persists, by 2025 most people with diabetes in developed countries will be aged 65 years or more, while the majority of diabetic persons in developing countries will be in the 45- to 64-year-old age group. This means that some 170 million men and women, who will reside in the developing regions of the world in less than 30 years from now, will be suffering from diabetes in their most productive years of life.