OBJECTIVE -The goal of this study was to estimate the prevalence of diabetes and the number of people of all ages with diabetes for years 2000 and 2030.RESEARCH DESIGN AND METHODS -Data on diabetes prevalence by age and sex from a limited number of countries were extrapolated to all 191 World Health Organization member states and applied to United Nations' population estimates for 2000 and 2030. Urban and rural populations were considered separately for developing countries.RESULTS -The prevalence of diabetes for all age-groups worldwide was estimated to be 2.8% in 2000 and 4.4% in 2030. The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. The prevalence of diabetes is higher in men than women, but there are more women with diabetes than men. The urban population in developing countries is projected to double between 2000 and 2030. The most important demographic change to diabetes prevalence across the world appears to be the increase in the proportion of people Ͼ65 years of age.CONCLUSIONS -These findings indicate that the "diabetes epidemic" will continue even if levels of obesity remain constant. Given the increasing prevalence of obesity, it is likely that these figures provide an underestimate of future diabetes prevalence.

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OBJECTIVE -To estimate the global number of excess deaths due to diabetes in the year 2000.RESEARCH DESIGN AND METHODS -We used a computerized generic formal disease model (DisMod II), used by the World Health Organization to assess disease burden through modeling the relationships between incidence, prevalence, and disease-specific mortality. Baseline input data included population structure, age-and sex-specific estimates of diabetes prevalence, and available published estimates of relative risk of death for people with diabetes compared with people without diabetes. The results were validated with population-based observations and independent estimates of relative risk of death.RESULTS -The excess global mortality attributable to diabetes in the year 2000 was estimated to be 2.9 million deaths, equivalent to 5.2% of all deaths. Excess mortality attributable to diabetes accounted for 2-3% of deaths in poorest countries and over 8% in the U.S., Canada, and the Middle East. In people 35-64 years old, 6 -27% of deaths were attributable to diabetes.CONCLUSIONS -These are the first global estimates of mortality attributable to diabetes. Globally, diabetes is likely to be the fifth leading cause of death. Diabetes Care 28:2130 -2135, 2005D iabetes is a serious illness with multiple complications and premature mortality, accounting for at least 10% of total health care expenditure in many countries (1). However, routinely reported statistics based on death certification seriously underestimate mortality from diabetes (2), because individuals with diabetes most often die of cardiovascular and renal disease and not from a cause uniquely related to diabetes, such as ketoacidosis or hypoglycemia (3).Most international mortality statistics, including those published by the World Health Organization (WHO), are based solely on the "underlying cause of death" as recorded on the death certificate, even in the presence of other information. Complex methods have been developed for estimating cause-specific mortality for some conditions (AIDS, tuberculosis) but not for diabetes (4).Based on routine statistics, recent World Health Reports estimated mortality from diabetes in the world as 987,000 deaths for the year 2002 (5), which was 1.7% of total world mortality. There were estimated to be at least 170 million people with diabetes in the world in the year 2000 (6); therefore, mortality attributable to diabetes could be expected to be much higher, since diabetes is a serious and chronic condition. The aim of this study was to provide a more realistic estimate of the number of deaths attributable to diabetes. RESEARCH DESIGN AND METHODS Model and dataTo estimate the number of deaths attributable to diabetes in the year 2000, we used a software program, DisMod II, developed for the Global Burden of Disease 2000 study (7,8) and routinely used by WHO for disease estimates. The DisMod II disease model is that of a multistate life table that describes a single disease. There are two causes of death, from the disease and from "all othe...