The International Diabetes Federation (IDF) is an umbrella organization of over 200 national diabetes associations in over 160 countries. Besides promoting diabetes care and prevention, the IDF tracks statistics on diabetes and diabetics on a worldwide basis. The Federation publishes the Diabetes Atlas, a collection of statistics and comments on diabetes which is issued from time-to-time. The Atlas is based on data supplied by its members. As these are national associations, the facts and figures published by the IDF are considered quite reliable. According to the 6th edition of the IDF Diabetes Atlas, which was published in 2013, the total population of the world is 7.2 billion. This is expected to have risen to 8.7 billion by 2035, ie in 22 years time. This total population includes 4.6 billion adults and these has been projected to reach 5.9 billion by 2035. The IDF defines an adult as a person aged 20-79 years, the most likely age range for the development of type 2 diabetes. According to the Diabetes Atlas, 382 million people around the world or 8.3% of all 4.6 million adults (20-79 years) are estimated to be suffering from diabetes. Almost half of all adults with diabetes are aged 40-59 years, the age range during which people are at their most productive phase in life. The number of people with type 2 diabetes is increasing in every country. If current trends continue, the IDF expects that there will be more than 592 million diabetics by 2035, a rise of 55%, when one adult in ten will be diabetic. Undiagnosed diabetes Type 2 diabetes may be undiagnosed for several reasons. There are few symptoms in the early years of the disease. In addition, the complications vary so widely that, even when symptoms do exist, diabetes may not be recognised as the cause. The IDF figure for 382 million diabetics in 2013 includes 175 million who are undiagnosed. I must admit I was astounded when I first read that 46% of diabetics are undiagnosed. How can you count something if you don't know it exists? Estimating the number of undiagnosed diabetics, I discovered, is relatively easy. All the IDF had to do was to arrange tests for a sample of people living in a particular area. The tests, which are carried out by the IDF's national associates, identify both known and unknown cases of diabetes, and it is a simple mathematical exercise to extrapolate to the population as a whole with a high degree of accuracy. Many (but not all) persons who know they have the disease will be making some attempts to beat their diabetes. The problem with undiagnosed diabetes is that these diabetics will not be managing their blood glucose levels and may be developing complications, such as kidney disease, heart failure, retinopathy and neuropathy, unbeknownst to themselves.
Regional differences The Diabetes Atlas provides statistics for 219 countries which the IDF have grouped into seven regions: Africa, Europe, the Middle East & North Africa, North America & the Caribbean, South & Central America, South-east Asia, and the Western Pacific. The IDF estimates that 80% of diabetics live in low- and middle-income countries where the disease is increasing very fast and posing a threat to development. The prevalence of diabetes, however, varies widely from region to region and country to country. It also varies widely within regions... to an extent that suggests that the grouping of countries into regions by the IDF needs revising. While about 8% of adults (aged 20-79) in the Western Pacific have diabetes, in certain countries in that region the proportion of adult diabetics is much higher. In Tokelau, for example, 37.5% of adults are diabetic. The figure for the Federated States of Micronesia is 35%. In the Middle East and North Africa, nearly 11% of adults have diabetes. However this is an average for the entire region and the figures for the Arabian Gulf states are much higher, more than double the average, with 24% of adults in Saudi Arabia, 23.1% in Kuwait and 22.9% in Qatar being diabetic. Undiagnosed diabetes also varies from region to region. In some countries in sub-Saharan Africa up to 90% of diabetics are undiagnosed, mainly due to a lack of resources and priorities. By contrast, in high-income countries about one-third of the people with diabetes have not been diagnosed. In most countries diabetes is increasing in tandem with rapid economic development, which is leading to changes in diets, ageing populations, increasing urbanisation, reduced physical activity and unhealthy behaviour. Many governments, however, seem to be unaware of the growing crisis and the likelihood of serious consequences that could stifle their countries' development. Impaired glucose tolerance (IGT) The IDF estimates that about 316 million people or 6.9% of adults (20-79) have impaired glucose tolerance (IGT). By 2035 this number is expected to have risen to 471 million (8.0% of the w