There exists a great diversity of populations and affluence among the 53 countries and territories in the European Region, with gross domestic product (GDP) varying from over US$60,000 per capita for Luxembourg to less than US$2,000 for several of the former socialist republics 1 .
At a glance
|
2007 |
2025 |
|
| Total population (millions) |
883 |
891 |
| Adult population (age 20-79, millions) |
634 |
653 |
|
|
||
| Diabetes (20-79 age group) | ||
| Regional prevalence (%) |
8.4 |
9.8 |
| Comparative prevalence (%) |
6.6 |
7.8 |
| Number of people with diabetes (millions) |
53.2 |
64.1 |
| Impaired Glucose Tolerance (IGT) (20- 79 age group) | ||
| Regional prevalence (%) |
10.3 |
10.9 |
| Comparative prevalence (%) |
9.1 |
9.6 |
| Number of people with IGT (millions) |
65.3 |
71.2 |
Diabetes and IGT prevalence
The number of people with diabetes in this vast region was estimated to reach 53.2 million, or 8.4% of the adult population in 2007. National prevalence rates for diabetes show a wide variation from 2.0% in Iceland to 11.8% in Germany (see Table 1). Abnormal glucose tolerance in this region shows little association with affluence, and there was no evidence that any difference in urban/rural prevalence existed except in Turkey 2 , and the Central Asian Republics of Kazakhstan, Kyrgyzstan, Tajikistan and Turkmenistan (for which data were extrapolated from neighbouring Uzbekistan 3 ).
The lack of data from several of the former socialist republics required that data for many countries be extrapolated from two studies from Poland — urban Krakow 4 , and the urban and rural areas near Lublin 5 . These data suggested high levels of diabetes currently, and such high levels of IGT that the diabetes prevalence will almost certainly increase by 2025 to levels above those indicated in Table 2, as these took no account of the higher incidence of diabetes among those with IGT.
Surprisingly there is a paucity of good data from many of the more affluent western countries of the region. Much of the data for Europe is based on surveys establishing the prevalence of ‘known diabetes’. This applied to reports from France 6 , Germany 7 8 9 , Israel 10 , Italy 11 , Netherlands 12 and Norway 13 . The prevalence rates of these reports were doubled to estimated total diabetes, based on other European data 14 15 16 17 .
In comparison with the second edition of the Diabetes Atlas, national data from several countries — Albania, Cyprus, Denmark, France and Norway — have been used, which has reduced the need to extrapolate from other countries. Nonetheless, there remains a marked lack of data for eastern Europe, so that survey results from Poland were used for 12 other countries.
To a large degree the high prevalence of abnormal glucose tolerance is a consequence of the relatively old population of the European Region, such that currently a third of the population is over 50 years of age, and is expected to increase to over 40% by 2025. Thus the number of persons with diabetes and IGT will increase, although the total regional population will have decreased. This will place an increasing financial burden on the declining working-age population to provide resources for the health consequences of rising diabetes prevalence in the older population. The region has the resources to be at the forefront of efforts to amend lifestyle factors contributing to the prevalence of diabetes.
1.Central Intelligence Agency The World Factbook.CIA..Accessed 0 2005
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3.King,H. Ashworth,L. Abdullaev,B. Djumaeva,S. Glucose intolerence and related factors in the Fregana Valley, Uzbekistan (Abstract). In International Diabetes Epidemiology Group Symposium, Savonlinna, Finland, 1997
4.Szurkowska,M. Szybinski,Z. Nazim,A. Szafraniec,K. Jedrychowski,W. [Prevalence of type II diabetes mellitus in population of Krakow]. Pol Arch Med Wewn.2001; 106(3): 771-779
5.Lopatynski,J. Mardarowicz,G. Nicer,T. Szczesniak,G. Krol,H. Matej,A. Szydlowski,W. Paszkowski,J. Dabek,K. Zmurowska,B. Szyprowska-Grzegorczyk,E. [The prevalence of type 2 diabetes mellitus in rural urban population over 35 years of age in Lublin region (Eastern Poland)]. Pol Arch Med Wewn.2001; 106(3): 781-786
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14.Gourdy,P. Ruidavets,J.B. Ferrieres,J. Ducimetiere,P. Amouyel,P. Arveiler,D. Cottel,D. Lamamy,N. Bingham,A. Hanaire-Broutin,H. Prevalence of type 2 diabetes and impaired fasting glucose in the middle-aged population of three French regions - The MONICA study 1995-97. Diabetes Metab.2001; 27(3): 347-358
15.Rathmann,W. Haastert,B. Icks,A. Lowel,H. Meisinger,C. Holle,R. Giani,G. High prevalence of undiagnosed diabetes mellitus in Southern Germany: target populations for efficient screening. The KORA survey 2000. Diabetologia.2003; 46(2): 182-189
16.Mooy,JM Grootenhuis,PA de Vries,H. Valkenburg,HA Bouter,LM Kostense,PJ Heine,RJ Prevalence and determinants of glucose intolerance in a Dutch Caucasian population. The Hoorn study.. Diabetes Care.1995; 18: 1270-1273
17.Eliasson,M. Lindahl,B. Lundberg,V. Stegmayr,B. Diabetes and obesity in Northern Sweden: occurrence and risk factors for stroke and myocardial infarction. Scand J Public Health Suppl.2003; 61: 70-77
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