Diabetes in developing countries: its importance for public health

The insulin dependent (IDDM) and non-insulin dependent (NIDDM)forms of diabetes mellitus were previously considered to berare in most developing countries, but recent evidence showsthat the frequency of NIDDM has risen rapidly in some developingcountry populations, particularly in Asia and the Western Pacific.Studies on the indirect and direct costs of diabetes, mainlyfrom the USA, suggest that the economic burden due to the diseaseand its complications is very large, but equivalent studiesfrom developing countries are virtually non-existent. Althoughthere is some evidence that the incidence of NIDDM could bereduced, the prevention of diabetes in developing countriesdoes not appear to be a viable policy option. The priority lieswith a broad approach to the prevention of a range of non-communicablediseases, including diabetes, and to improved case diagnosisand management. The direct costs in case management in manydeveloping countries will be dominated by the relatively highcosts of insulin and oral hypoglycaemic drugs. A major priorityis for further research on the incidence, aetiology and preventionof IDDM and NIDDM in developing countries, particularly Africaand Latin America.