MB Civic

WASHINGTON, June 10 —­ The number of people around the world suffering from diabetes has skyrocketed in the last two decades, from 30 million to 230 million, claiming millions of lives and severely taxing the ability of health care systemsto deal with the epidemic, according to data released Saturday by the International Diabetes Federation.

While the growing problem of diabetes in the affluent United States has been well documented, the federation’s data shows that 7 of the 10 countries with the highest number of diabetics are in the developing world.

China now has the largest number of diabetics over age 20, around 39 million people or about 2.7 percent of the adult population, according to the federation. The groups says India has the second largest number of cases with an estimated 30 million people, or about 6 percent of the adult population.

Other countries have higher rates of diabetes than either China or India, but the federation’s experts say rising diabetes rates in the large, rapidly industrializing nations are especially worrisome because of the size of their populations. In some countries in the Caribbean the Middle East, the percentage of diabetic people ranged from 12 to 20 percent; the highest rate was posted in Nauru, an island in the South Pacific.

In some of the world’s poorest nations, the disease is a quick death sentence. While Americans can live for many years with the disease, a person in Mozambique who requires injections of insulin can expect to live just a year; in Mali, such people survive about 30 months.

There are many factors driving the growth in diabetes worldwide, but most experts agree that changes in lifestyle and diet are the chief culprits, in addition to genetic predisposition. As developing countries rapidly industrialize, people tend to do work involving less physical activity. At the same time, the availability of food that is cheap but high in calories becomes more common.

The combination causes weight gain, which leads to greater risk of developing Type 2 diabetes, the most common form of the disease.

The other form, Type 1, is responsible for only 5 percent to 10 percent of cases, and is not associated with behavior, but rather is believed to stem almost entirely from genetic factors. In either form, diabetes is characterized by high blood sugar levels that result from the body’s inability to make or use insulin, which can lead to a host of complications that include kidney failure and blindness.

“Diabetes is one of the biggest health catastrophes the world has ever seen,” said Dr. Martin Silink, the president-elect of the International Diabetes Federation.

“The diabetes epidemic will overwhelm health care resources everywhere if governments do not wake up now and take action.”

To help stem the tide of the disease, the International Diabetes Federation is seeking a United Nations resolution to recognize the seriousness of the problem. If that effort is successful, it would be the first of its kind for a noncommunicable disease.

There is little debate among experts that the epidemic is getting worse. Measuring the rate of growth, though, is more problematic. The latest estimates are well above figures published in 2003, when the federation estimated that 194 million people had diabetes. Still, part of the increase is likely due to better detection efforts.

While Type 2 was traditionally thought of as affecting older people, in recent years people have been found to have the disease at younger and younger ages.

The data was released at the American Diabetes Association’s 66th Scientific Sessions. The federation studied only people over 20 years old.

“The largest number of people affected by diabetes are now between the ages of 40 and 59,” said Delice Gan, an editor at The Diabetes Atlas, which will publish the new figures.

“The trend has been that the ages have been dropping so that people are getting sick in the prime of their life, when they are their most productive.”

The federation estimates that within 20 years, the number of diabetics could grow to 350 million. Already, each year some 3 million deaths are tied directly to diabetes, with death rates expected to rise 25 percent over the next decade.