hensive packages that meet the needs of all members of the community, and that address the disease at all stages and in all its manifestations.”

The burden of disease associated with diabetes is substantial: at least one in 20 deaths worldwide is attributable to diabetes. In financial terms, direct health care costs range from 2.5% to 15% of annual health care budgets, and indirect costs such as loss of production may be five times this number.

Diabetes is a chronic disease characterized by having too much glucose in the blood because the body is not producing insulin or not using insulin properly. Some 90% of the world’s estimated 171 million people with diabetes have type 2 diabetes. This used to be considered a disease of older people and rich countries, but the majority of people with diabetes in Africa are between 45 and 64 years.

“All over the world, peoples lifestyles are changing,” said Dr Le Galès-Camus. “We are less active than our parents and grandparents, and we eat food with higher concentrations of sugars and fats, often with the result that we are putting on weight, and increasing the risk of diabetes. Add to this the fact that populations are ageing, and it is easy to see why diseases such as diabetes are on the increase.”

China provides a graphic example. Diabetes is already a substantial concern, with 21 million cases in the year 2000, or one in every 60 people. Obesity is on the rise – a recent study showed that even among Chinese pre-school children, obesity rates increased tenfold to affect one in every 10 children over an eight-year period. This extra weight increases their risk of diabetes as they grow oder.


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