Diabetes: The 21st century epidemic.

The pandemic of type 2 diabetes is, inevitably, at the cross-roads of globalization and aging, and is intricately linked to contemporary lifestyles (e.g., inactivity, sedentary behaviors, dietary factors, urban stress). The disease is inter-related with all vascular risk factors (e.g., high blood pressure, abnormal lipids, obesity/adiposity, thrombogenesis, oxidative stresses, inflammation), and results in substantial morbidity, disability, loss of quality and quantity of life, and economic burden worldwide.

There are about 200 million people with diabetes worldwide, and by 2025, this number is projected to increase to at least 333 million, including approximately 80 million in India and 35 million in the US. The lifetime risk of diabetes in the US is 1 in 3, and a person diagnosed with diabetes at age 40, for example, can expect to live between 11 and 14 years less than he or she otherwise would have. The disease costs $132 billion annually.

The largest future increase in diabetes will be in the industrializing low- and middle-income countries, with India ranking first. Diabetes prevalence in urban India is already 16-20%, and the epidemic is spreading through semi-urban and rural areas, and across the socioeconomic divide.

The World Bank, WHO, NIH, CDC and other major organizations world-wide have urged strong partnerships between developed and developing countries in population-based basic and epidemiological research, development of low-cost interventions, translational sciences, and public health program and policy to stem the epidemic of diabetes.