Type 2 Diabetes: An Epidemic Requiring Global Attention and Urgent Action

Abstract

Decades ago, the global epidemic of type 2 diabetes was predicted by epidemiologists who observed large and rapid increases in the prevalence of type 2 diabetes among indigenous peoples who adopted Western lifestyles (1–4). Subsequent epidemiological studies demonstrated that essentially all non-Europid populations who escape the ravages of communicable diseases, enjoy abundant food and less physically demanding lifestyles and survive to middle and old age are at increased risk for type 2 diabetes, its complications, and comorbidities. The global epidemic of type 2 diabetes has been documented in a series of progressively more precise, refined, and sobering projections (5). In 1993, King et al. (6) assembled estimates of the prevalence of diabetes for adults around the world. In 1997, Amos et al. (7) first used age-specific prevalence rates for type 2 diabetes from different countries and current and projected age distributions of the world population to estimate the present and future numbers of people with diabetes worldwide. Using similar methods but incorporating additional age- and sex-specific and rural- and urban-specific diabetes prevalence rates, King et al. (8), Wild et al. (9), and Shaw et al. (10) repeated these analyses. In general, these studies projected that the number of adults with diabetes in the world will more than double between 2000 and 2030, with most of the increase occurring in developing countries, particularly in Asia. Not surprisingly, countries with the largest populations have and will have the greatest number of individuals with diabetes. Accordingly, India and China top the lists. The most recent studies have projected that by 2030, India will have 79–87 million and China 42–63 million adults with diabetes (9,10). The latter projection did not account for the rapid change in lifestyle occurring in China and …