Diabetes has become a development issue. In LMCs, it threatens health and economic prosperity. IDF predicts that diabetes will cost the world economy at least US$376 billion in 2010, or 11.6% of total world healthcare expenditure. By 2030, this number is projected to exceed US$490 billion. More than 80% of diabetes spending is in the world's richest countries and not in the poorer countries, where over 70 percent of people with diabetes now live.

The United States accounts for $198 billion or 52.7% of total diabetes spending worldwide. India, which has the largest diabetes population, spends US$2.8 billion or 1% of the global total. In most LMCs, people with diabetes must pay for their care out of their own pocket because public medical services and insurance are lacking. The diagnosis of diabetes in a low or middle-income country can often drag entire families into poverty.

"The world needs to invest in integrated health systems that can diagnose, treat, manage and prevent diabetes," said Professor Nigel Unwin, who leads the team of experts behind the IDF Diabetes Atlas. "Governments also need to invest in actions outside the formal health sector, particularly in promoting healthier diets and physical activity, to reduce obesity and the risk of type 2 diabetes. Without effective prevention diabetes will overwhelm health systems and hinder economic growth."

Integrating plans for the prevention of diabetes into national health systems and policy frameworks is an important part of the response. IDF warns that many health systems worldwide are not yet equipped to handle the extent of the diabetes threat, and that failure to take action will have serious consequences.

"The epidemic represents nothing short of a global health emergency," said IDF President Mbanya. "It is alarming that world leaders stand by while the diabetes fuse slowly burns. The serious impact on families, countries and economies continues with little resistance. Governments, aid agencies and the international community must take concerted action to defuse the threat now, before the diabetes time bomb explodes."

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