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Diabetes Prevention
Doing More with What We Already Know—
Prevention and Improved Coverage of Healthcare for Diabetes
David Whiting, PhD
Epidemiologist and Public Health Specialist, International Diabetes Federation (IDF)
Abstract
Diabetes now affects 285 million people, representing 6.6% of the world’s adult population. It disproportionately affects the developing
world, with four of five people with diabetes living in low- and middle-income countries (LMCs). Diabetes is expected to cost the world at
least $376 billion (11.6% of total healthcare expenditure) in 2010, according to the IDF Diabetes Atlas. This means that LMCs will also bear
the economic brunt of the disease, which affects far more people of working age than previously believed. In many of these countries,
essentials for good basic care for diabetes are scarce. The International Diabetes Federation (IDF) believes that where care for diabetes is
scarce or limited, improving the coverage of prevention measures and basic care for diabetes will improve outcomes and quality of life.
Good basic care can be highly cost-effective or even cost-saving. Even if costs are higher, the number of people affected by diabetes is
now so large that it is no longer acceptable to ignore it.
Keywords
Diabetes, public health, low- and middle-income countries, therapies, care, health expenditure
Disclosure: The author has no conflicts of interest to declare.
Received: November 5, 2009 Accepted: November 30, 2009
Correspondence: David Whiting, PhD, International Diabetes Federation (IDF), Chaussée de la Hulpe 166, B-1170 Brussels, Belgium. E: david.whiting@idf.org
The International Diabetes Federation (IDF) launched the fourth education, and technologies. A tremendous amount of money is spent
edition of the IDF Diabetes Atlas at its 20th World Diabetes Congress on what are often incremental improvements in care. In poorer
in Montreal, Canada in October 2009.
1
Based on conservative countries the picture is very different. In many low- and middle-
modeling assumptions, this edition estimates that the global income countries, essentials for good basic care for diabetes are
prevalence of diabetes in 2010 has risen to 285 million people, scarce. Many people with diabetes are undiagnosed, and many of
representing 6.6% of the world's adult population. Far from being a those who do know that they have diabetes do not attend a clinic
condition of higher-income countries, 70% of those with diabetes live regularly. Clinic-based studies and audits, from Africa for example,
2
in low- and middle-income countries. In most low- and middle-income tend to show that the quality of care in those who do attend a clinic
countries the majority of people with diabetes are 40–59 years of is poor. However, poor access to care is not limited to developing
age—the age at which they should be economically productive. countries. In some higher-income countries, health policies can
exclude large numbers of disadvantaged people with diabetes,
Mortality attributable to diabetes in 2010 is estimated at 4 million leading to poorer outcomes.
(6.8%) deaths in the 20–79-year-old age group. This is larger than the
number of people who die from AIDS or malaria each year. Where care for diabetes is scarce or limited, improving the coverage
of prevention measures and basic care for diabetes will improve
Global healthcare expenditure on diabetes is expected to account for outcomes and quality of life. Good basic care can be highly cost-
at least $376 billion (11.6% of total healthcare expenditure) in 2010. effective or even cost-saving. Even if costs are higher, the number of
Approximately 80% of the countries covered in the IDF Diabetes Atlas people affected by diabetes is now so large that it is no longer
report on the economic costs of diabetes are predicted to spend acceptable to ignore it.
between 5 and 13% of their total healthcare dollars on diabetes. It is
clear that diabetes is a global problem that has become a major IDF is working to raise the profile of diabetes with international
health challenge for the 21st century. organizations to ensure that at the very least good basic care is
available to all people with diabetes. At the recent IDF 20th World
In many high-income countries diabetes care can include Diabetes Congress, Professor Jean Claude Mbanya took over as
breakthrough improvements in care such as the latest therapies, President and will lead a dynamic campaign to ensure that care
26 © TOUCH BRIEFINGS 2009
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