The dynamics of the diabetes epidemic are changing rapidly. Once a disease of the West, type-2 diabetes has now spread to every country in the world. Once “a disease of affluence,” it is now increasingly common among the poor. Once an adult-onset disease almost unheard of in children, rising rates of childhood obesity have rendered it more common in the pediatric population, especially in certain ethnic groups. According to the International Diabetes Federation, diabetes affects at least 285 million people worldwide, and that number is expected to reach 438 million by the year 2030, with two-thirds of all diabetes cases occurring in low- to middle-income countries. The number of adults with impaired glucose tolerance will rise from 344 million in 2010 to an estimated 472 million by 2030.
Globally, it was estimated that diabetes accounted for 12% of health expenditures in 2010, or at least $376 billion—a figure expected to hit $490 billion in 2030. Its increasing prevalence and associated health complications threaten to reverse economic gains in developing countries. With limited infrastructures for diabetes care, many countries are ill-equipped to manage this epidemic.