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Objective: To analyse the implications of using different methods to predict diabetes prevalence for the future. Approach: Different methods used to predict diabetes were compared and recommendations are made. Conclusion: We recommend that all projections take a conservative approach to diabetes prevalence prediction and present a 'base case' using the most robust, contemporary data available. We also recommend that uncertainty analyses be included in all analyses. Implications: Despite variation in assumptions and methodology used, all the published predictions demonstrate that diabetes is an escalating problem for Australia. We can safely assume that unless trends in diabetes incidence are reversed there will be at least 2 million Australian adults with diabetes by 2025. If obesity and diabetes incidence trends, continue upwards, and mortality continues to decline, up to 3 million people will have diabetes by 2025, with the figure closer to 3.5 million by 2033.The impact of this for Australia has not been measured. Key words: diabetes, prevalence, forecasting, projections, incidence. Aust NZ J Public Health. 2009; 33:540-43 doi: 10.1111/j.1753-6405.2009.00450.x

Increases in obesity, hypercholesterolemia, and diabetes may be under way in Europe. We have reported the only data available from the 1990s for continuous monitoring of chronic disease risk factors in random samples of a general European population. In random surveys (1993-2003) of 6164 men and 6107 women in Geneva, overweight and obesity combined increased in both men and women; hypercholesterolemia prevalence also rose; diabetes treatment increased in men. Only population-based interventions can prevent the impending epidemic of obesity-related disorders.

The San Antonio Heart Study--conducted from 1979 to 1996--and the Mexico City Diabetes Study--conducted from 1990 to 1999--both show significant secular increases in obesity as indicated by mean body mass index values and proportions of the populations who were obese or overweight. The increase in obesity accounts for an estimated 28% of the increase in the incidence of diabetes in San Antonio. This increase in the incidence of diabetes occurred across all age groups (25-34, 35-44, 45-54, and 55-64). Thus the generational acceleration of diabetes, expected as a result of the greater tendency for people whose mothers were diabetic when pregnant to become diabetic themselves, may not be as severe as would be expected had the increases in diabetes incidence occurred disproportionately more among women prior to or during their child-bearing years. Keywords: obesity, diabetes, trends

Boys born in the US in 2000 have a 33% lifetime risk of developing diabetes and girls born in 2000 have a 38% lifetime risk of developing diabetes. Diabetes will shorten the men's lives by about 12 years and the women's lives by about 14 years. It will also increase their risk of disability. Hispanic men and women have the highest lifetime risk of developing diabetes.

Objective To measure the economic burden associated with diabetes mellitus in Latin America and the Caribbean. Methods Prevalence estimates of diabetes for the year 2000 were used to calculated direct and indirect costs of diabetes mellitus. Direct costs included costs due to drugs, hospitalizations, consultations and management of complications. The human capital approach was used to calculate indirect costs and included calculations of forgone earnings due to premature mortality and disability attributed to diabetes mellitus. Mortality and disability attributed to causes other than diabetes were subtracted from estimates to consider only the excess burden due to diabetes. A 3% discount rate was used to convert future earnings to current value. Findings The annual number of deaths in 2000 caused by diabetes mellitus was estimated at 339 035. This represented a loss of 757 096 discounted years of productive life among persons younger than 65 years (>US$ 3 billion). Permanent disability caused a loss of 12 699 087 years and over US$ 50 billion, and temporary disability caused a loss of 136 701 years in the working population and over US$ 763 million. Costs associated with insulin and oral medications were US$ 4720 million, hospitalizations US$ 1012 million, consultations US$ 2508 million and care for complications US$ 2 480 million. The total annual cost associated with diabetes was estimated as US$ 65 216 million (direct US$ 10 721; indirect US$ 54 496). Conclusion Despite limitations of the data, diabetes imposes a high economic burden to individuals and society in all countries and to Latin American and the Caribbean as whole. Keywords Diabetes mellitus/economics/complications; Cost of illness; Health care costs; Disabled persons; Value of life//economics; Latin America; Caribbean region (source: MESH, MM). Mots cles Diabete/economie/complication; Cout maladie; Cout soins medicaux; HandicapS; Valeur de la vie/economie; Amerique latine; Caraibes (source: MESH, INSERM). Palabras clave Diabetes mellitus/economia/complicaciones; Costo de la enfermedad; Costos de la atencion en salud; Personas incapacitadas; Valor de la vida/economia; America Latina; Region del Caribe (fuente: DeCS, BIREME)., Introduction Diabetes mellitus presents a high burden for individuals and society. This burden is not only related to health care costs, but also to indirect costs caused by loss of [...]

Objectives. There is evidence from past decades that the number of diabetic patients has increased independently of changes in demography. A static model that takes into account only demographic changes is therefore unable to forecast the expected number of diabetic patients correctly. Methods. We developed a dynamic model in which actual incidence, prevalence, and life expectancy data are used and alternative assumptions about future trends in these parameters can be incorporated. Results. This dynamic model forecasts higher numbers of diabetic patients than the less sophisticated static model. According to the dynamic model, a 46% increase in the number of diabetic patients in The Netherlands can be expected, from 244 000 in 1990 to 355 000 in 2005 (about 2.5% annually). The static model forecasts a 22% increase. Conclusions. Diabetes mellitus will become a more serious public health problem than can be expected from demographic changes only. In planning future health care, monitoring of trends in incidence, prevalence, remission, and mortality or life expectancy is a necessary prerequisite. (Am J Public Health. 1993;83: 989-995), Health data from the 1980s reveals that the number of diabetic patients in the Netherlands has increased independently of changes in demography. A static model that takes into account only demographic changes is unable to forecast correctly the expected number of diabetic patients. In planning future health care a necessary prerequisite is monitoring of trends in incidence, prevalence, remission and mortality or life expectancy. When computing the projected number of diabetic patients, the dynamic model used was considered to be more valid than the static model. The dynamic model is most sensitive to variations in incidence and relatively insensitive to variations in prevalence. The dynamic model predicts an increase in diabetics in the Netherlands from 244,000 in 1990 to 355,000 by 2005, which is an annual increase of 2.5%.