Raised fasting blood glucose
Situation and trends
Raised blood glucose was estimated to result in 3.4 million deaths in 2004, equivalent to 5.8% of all deaths. Impaired glucose tolerance and impaired fasting glycaemia are risk categories for future development of diabetes and cardiovascular disease. In some age groups, people with diabetes have a twofold increase in the risk of stroke. Diabetes is the leading cause of renal failure in many populations in both developed and developing countries. Lower limb amputations are at least 10 times more common in people with diabetes than in non-diabetic individuals in developed countries; more than half of all non-traumatic lower limb amputations are due to diabetes. Diabetes is one of the leading causes of visual impairment and blindness in developed countries. People with diabetes require at least 2-3 times the health care resources compared to people who do not have diabetes, and diabetes care may account for up to 15% of national healthcare budgets.
The prevalence of hyperglycaemia depends on the diagnostic criteria used in epidemiological surveys. Defined as a fasting plasma glucose value ≥ 7.0 mmol/L (126 mg/dl) or on medication for raised blood glucose), the global prevalence of diabetes in 2008 was estimated to be 9%.
There was little variation in prevalence rates across WHO regions. The prevalence of diabetes was highest in the Eastern Mediterranean Region (11% for both sexes) and lowest in the WHO European Region (7% for both sexes). The magnitude of diabetes and other abnormalities of glucose tolerance will be considerably higher than the above estimates if the categories of "impaired fasting" and "impaired glucose tolerance" are included.
The prevalence of diabetes was relatively consistent across the income groupings of countries. The high income countries showed the lowest prevalence rate (7% for both sexes), possibly reflecting better dietary and other nonmedical interventions. The lower middle income countries showed the highest prevalence rate (10% for both sexes).