Diabetes Mellitus is a chronic metabolic disease characterized by elevated blood glucose (hyperglycemia). It is associated with an absolute or relative deficiency in the secretion and/or action of insulin.
There are three main forms of diabetes: type 1, type 2, and gestational diabetes. Type 2 diabetes is the most common, accounting for approximately 85% to 90% of all cases. It is related to modifiable risk factors such as obesity or overweight, physical inactivity, and high-calorie diets of low nutritional value.
Intermediate hyperglycemia, is characterized by the presence of prediabetes in conjunction with one other cardiovascular disease (CVD) risk factor (hypertension, upper body obesity or dyslipidemia)
Recent estimates reveal that among Latin American and Caribbean countries, the highest prevalence of diabetes has been reported in Belize (12.4%) and Mexico (10.7%) with rates of 8% to 10% in Managua, Guatemala City, and Bogota. The most recent data from the United States reported a prevalence of diabetes of 9.3% while it was 15.7% along the US-Mexico border.
The burden of diabetes to an individual and to society is chiefly associated with increased disability and premature mortality due to complications. Diabetes complications and premature mortality are believed to be exacerbated by poor quality of care. In addition, the risk of dying from cardiovascular disease (CVD) is between two and three times higher among people with diabetes versus those without.
In a clinical study involving six Latin American countries, it was found that after 20 years of living with diabetes, the frequency of chronic complications was: 48% for retinopathy, 6.7% for blindness, 42% for neuropathy, 1.5% for kidney damage, 6.7% for myocardial infraction (heart attack), 3.3% for stroke and 7.3% for lower limb amputations.
Prevalence of Diabetes Mellitus, Overweight (BMI ≥25) and obesity (BMI≥30) by gender in selected countries
Some population groups are at greater risk for complications than others. For example, studies in Barbados demonstrated a high incidence of lower limb amputations (936 per 100,000) and a higher prevalence of retinopathy among blacks (28.5% of black diabetics).
While diabetes and its complications are largely preventable, lack of access to quality health care services and lack of knowledge of preventive measures are widespread.
The cost of health care for people affected by diabetes is between two and three times higher than their peers without diabetes. In 2000, the cost of diabetes in the Region was estimated at US$ 65.2 billion, of which $10.7 billion were direct costs and $54.5 billion, indirect costs. In 2006, the cost of diabetes in some countries was reported between 0.4% and 2.3% of GDP.