with those from the year 2000. Predominance of infectious causes has shifted to chronic degenerative diseases. >70 60-64 50-54 40-44 30-34 20-24 10-14 0-4 >70 60-64 50-54 40-44 30-34 20-24 10-14 0-4 6,000,000 4,000,000 0 2,000,000 2,000,000 4,000,000 6,000,000 15,000,000 10,000,000 5,000,000 0 5,000,000 10,000,000 15,000,000 Inhabitants Inhabitants Male Female Male Female Age (years) Total population year 2000: 102,375,643 Age (years) Estimated population year 2050: 131,574,027 A B Source: CONAPO: Proyected population of México, 1996-2050 Fig. 2. (A) Population pyramid of Mexico for the year 2000. Data obtained from the 2000 National Census. (B) Estimation of the shape of the population pyramid of Mexico for the year 2005. Data calculated by the National Population Council of Mexico. communicable infectious diseases and an increase in the incidence and prevalence of chronic degenerative noncommunicable diseases. This complex and continuous evolving process has modified the scenario and required an urgent modification of health policies. Of particular relevance is the change of the burden of disease usually present in younger groups to the adult population, particularly the elderly. Additionally, the disease processes in infectious illnesses, which were usually short and evolved either to cure or death, have changed to what is observed in chronic diseases, which is usually longstanding and may require continuous medical care and treatment for years or even decades [1, 2, 6, 7]. In addition, other demographic phenomena have contributed to a shift to the current complex scenario, in which chronic maladies predominate as responsible for a high percentage of the health budget of the developing world. Industrialization and development have favored Correa-Rotter and Gonzalez-Michaca: Diabetic nephropathy prevention in Mexico ´ S-71 the migration of extensive rural populations to urban and suburban areas. Accelerated urbanization has been characterized in the emerging world by the appearance of extensive areas of irregular settlements located in the outskirts of major cities, which lack adequate urban sanitary and general services and medical care facilities. Two of the most relevant features of the marginality in which these suburban communities develop are extensive poverty and lack of access to medical care. Massive industrialization and development have favored almost universal changes in lifestyle and dietary habits, with a predominance of some unhealthy ones such as sedentary life, high fat and high carbohydrate diets, high sodium consumption, and smoking, among others. Highly developed and industrialized nations have been able to progressively establish some educational and regulatory strategies to counterbalance the commercial forces that promote these unhealthy habits, therefore conditioning a loss of consumers and advocates. In contrast, poorer nations have become the target of advertising and promotion of corporations that visualize these regions of the world as unregulated, uneducated, and highly attractive markets for consumption of unhealthy products such as the ones previously mentioned. For example, during the last couple of decades, tobacco smoking has become significantly higher in the underdeveloped world, a situation that has been accompanied by aggressive and poorly regulated advertising. This factor has imposed an additional burden on the health system of societies, which already have extremely high growth rates of chronic pathologic conditions such as cardiovascular diseases, diabetes mellitus, obesity, chronic renal diseases, or cancer; these conditions are negatively impacted by such dietary and lifestyle habits [6–12]. The continuous increase in metabolic, cardiovascular, and neoplastic chronic diseases is already generating devastating public health and financial and social consequences in most emerging nations that cannot cope with the cost burden of technology-driven medical interventions and drugs needed to treat these diseases. To make matters worse, the near future foresees a continued increase in the incidence of these diseases as a consequence of increased life expectancy, and this is particularly true for Mexico. It is therefore clear that preventive strategies may play a central role in modifying the expected public health scenario, given the actual trends of increase of chronic diseases. Growth of type 2 diabetes mellitus Of particular relevance among chronic degenerative diseases and major contributors to excess morbidity and mortality present in Mexico are non-insulin–dependent or type 2 diabetes mellitus and its chronic complications, particularly cardiovascular disease and diabetic nephropathy. Mortality of the patient with diabetes is, in most instances, related to cardiovascular and renal complications that require costly medical procedures and which may impose an even larger financial burden to the system [13]. Indeed, type 2 diabetes mellitus may well be the largest health problem we face in Mexico during the 21st century. This is similar to what is happening in most other latitudes of the planet, yet to a larger extent, given the very high prevalence of the disease and its complications [12]. Growth of type 2 diabetes mellitus prevalence is expected to happen worldwide;