Global Burden of Diabetes, 1995-2025 - Diabetes Care

E p i d e m i o I o g y / H e a 11 h S e r v i c e s / P s y c h o s o c i a I R e s e a r c hN A L A R T I C L E

Global Burden of Diabetes, 1995-2025Prevalence, numerical estimates, and projections

HILARY KING, MD, DSC

RONALD E. AUBERT, PHD

WILLIAM H. HERMAN, MD, MPH

OBJECTIVE — To estimate the prevalence of diabetes and the number of people with dia-betes who are ^20 years of age in all countries of the world for three points in time, i.e., theyears 1995, 2000, and 2025, and to calculate additional parameters, such as sex ratio, urban-rural ratio, and the age structure of the diabetic population.

RESEARCH DESIGN AND METHODS — Age-specific diabetes prevalence estimateswere applied to United Nations population estimates and projections for the number of adultsaged 5:20 years in all countries of the world. For developing countries, urban and rural pop-ulations were considered separately.

RESULTS — Prevalence of diabetes in adults worldwide was estimated to be 4.0% in 1995and to rise to 5.4% by the year 2025. It is higher in developed than in developing countries.The number of adults with diabetes in the world will rise from 135 million in 1995 to 300 mil-lion in the year 2025. The major part of this numerical increase will occur in developing coun-tries. There will be a 42% increase, from 51 to 72 million, in the developed countries and a170% increase, from 84 to 228 million, in the developing countries. Thus, by the year 2025,>75% of people with diabetes will reside in developing countries, as compared with 62% in1995. The countries with the largest number of people with diabetes are, and will be in the year2025, India, China, and the U.S. In developing countries, the majority of people with diabetesare in the age range of 45-64 years. In the developed countries, the majority of people with dia-betes are aged ^65 years. This pattern will be accentuated by the year 2025. There are morewomen than men with diabetes, especially in developed countries. In the future, diabetes willbe increasingly concentrated in urban areas.

CONCLUSIONS — This report supports earlier predictions of the epidemic nature of dia-betes in the world during the first quarter of the 21st century. It also provides a provisional pic-ture of the characteristics of the epidemic. Worldwide surveillance of diabetes is a necessaryfirst step toward its prevention and control, which is now recognized as an urgent priority.

Diabetes Care 21:1414-1431,1998

I n 1993, the World Health Organization(WHO) Ad Hoc Diabetes Reporting Grouppublished standardized global estimates

for the prevalence of diabetes and impairedglucose tolerance in adults, based on datafrom 75 communities in 32 countries (1).

These estimates provided, for the firsttime, comparable information on theprevalence of abnormal glucose tolerancefrom many populations worldwide. How-ever, they did not meet the needs of thosewho frequently refer to the WHO diabetes

From the Division of Noncommunicable Diseases (H.K.), World Health Organization, Geneva, Switzerland;the Prudential Center for Health Care Research (R.E.A.), Atlanta, Georgia; and the Division of Endocrinologyand Metabolism (W.H.H.), Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.

Address correspondence and reprint requests to Dr. Hilary King, Division of Noncommunicable Dis-eases/DIA, 1211 Geneva 27, Switzerland. E-mail: [email protected].

Received for publication 24 December 1997 and accepted in revised form 5 May 1998.Abbreviations: EME, established market economies; FSE, former socialist economies of Europe; LAC,

Latin America and the Caribbean; MEC, Middle Eastern crescent; OAI, other Asia and islands; SSA, sub-Saha-ran Africa; WHO, World Health Organization.

A table elsewhere in this issue shows conventional and Systeme International (SI) units and conversionfactors for many substances.

program for information on the number ofpeople with diabetes in a particular coun-try/community, nor did they take accountof future trends in the burden of diabetes.

Therefore, a further study has nowbeen undertaken that links data from theglobal database collected by WHO withdemographic estimates and projectionsissued by the United Nations to estimatethe number of people with diabetes in allcountries of the world for three points intime, i.e., the years 1995, 2000, and 2025.In addition, the data have been analyzed interms of certain additional parameters,such as sex ratio, urban-rural ratio, and theage structure of the diabetic population.

The principal purpose of the projectwas to assemble numerical estimates andprojections for the frequency of diabetes inall countries as a primary source of infor-mation and as an aid to planning healthcare and public health interventions inWHO's member states.

RESEARCH DESIGN ANDMETHODS — This study is based on aset of 5-year age- and sex-specific estimatesof diabetes prevalence from rural and urbanareas of various countries. Criteria for inclu-sion were 1) a valid and apparently unbi-ased population sample and 2) a diagnosisof diabetes made according to the recom-mendations of recent WHO expert groups(2,3), i.e., a venous plasma glucose concen-tration of ^ 11.1 mmol/1 (or its equivalent)2 h after a 75-g oral glucose challenge. Stud-ies using only fasting blood glucose testingwere excluded. The estimates were drawnfrom the studies listed in the earlier report(1) with the addition of new survey datafrom China (4), Indonesia (5), Japan (6),Pakistan (7), and Uzbekistan (8). Thesedata were then applied to demographic esti-mates for the world's population issued bythe United Nations Population Division (9).

In accordance with United Nationsconvention, Europe (including the formersocialist economies), North America, Aus-tralia, New Zealand, and Japan were con-sidered "developed" countries, with allother countries designated as "developing"countries. For regional groupings, theaggregations proposed by the World Devel-opment Report 1993 were adopted (10).

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King, Aubert, and Herman

Because the great majority of peoplewith diabetes are adults, the study wasrestricted to subjects aged ^20 years. For thedeveloped countries, risk factors were notconsidered to differ markedly in rural andurban areas, and estimates were appliednationally. However, for developing coun-tries, rural and urban areas were consideredseparately, since prevalence is known to dif-fer markedly with differences in diet, physi-cal exercise, and other socioeconomic factors.Estimates for present and future urbanizationpatterns are also available from the UnitedNations Population Division (11,12). Wheneither rural or urban prevalence data wereunavailable, the urban rate was generallyassumed to be twice the available rural esti-mate, or the rural estimate was taken as one-half the available urban estimate. That thisrelation holds for most populations in devel-oping countries is evident from rural-urbancomparisons of the age-standardized esti-mates presented in the earlier report (1). Forcountries lacking valid prevalence estimates,extrapolation from the nearest or socioeco-nomically and ethnically most similar coun-try was performed. A listing of the dataapplied to each country's demographic esti-mates is given in APPENDIX l.

The assumption underlying the studymethodology was that, in addition to eth-nicity the size, sex distribution, age struc-ture, and degree of urbanization determinethe present and future frequency of diabetesin countries. Thus, for estimations for 1995,2000, and 2025, the baseline age- and sex-specific prevalence estimates within ruraland urban areas were maintained as a con-stant (i.e., inclusion in the models of popu-lation growth, aging, and urbanization wasconsidered sufficient to capture present andfuture trends in diabetes frequency).

Not all data sets included the full agerange under consideration (^20 years).Therefore, for each source of data, a logisticregression analysis was performed to esti-mate the relationship of age to the probabil-ity of having diabetes. The predictedprobability was then used as an estimate ofthe missing age-specific prevalence(s) so thatall the age-groups of interest, from 20-24years to ^80 years, could contribute to themodels. This method also resulted in a sta-bilization of rates when numbers from theraw data were quite sparse.

In certain cases, combinations of datawere made. For Novosibirsk, data for malesand females were combined because ofsmall numbers. For Israel, data from foursurveys were combined to give national

Developed Developing World

B1,200

1,000

800

•1 600 • -t

400 •-

200 •-

:slablished

Market

Economies

Formerly

socialists

economies

of Europe

Middle

Eastern

cresenl

India China Other Asia

and Islands

Latin

America

and the

Caribbean

Sub-

Saharan

Africa

Figure 1—Size of the adult population (aged ^20 years) by year and region. A: Developed and devel-oping countries and world total B: Major geographic areas. 53,1995; H,2000; • , 2025.

estimates. For China, data from the 1994National Diabetes Survey of 250,000 sub-jects in 16 provinces were aggregated intorural and urban estimates. For the U.K.,two surveys were combined. For the U.S.,National Health and Nutrition Examina-tion Survey II data were used for ages20-74 years, and Rancho Bernardo datawere used for older subjects.

RESULTS — The detailed numerical esti-mates and other parameters of interest arepresented for all countries and regions for theyears 1995,2000, and 2025 in APPENDIX 2.

DemographyThe size of the world's adult population(aged ^20 years) is shown by year andregion in Fig. 1. It can be seen that for thedeveloped countries, total population sizewill remain relatively stable, with an 11%increase from 1995 to 2025 of ~ 1 billion.

For the developing countries, the increasewill be around 80%, from ~2.5 billion in1995 to >4 billion in 2025. It is thisincrease that will determine the ~60%growth of the world's adult population as awhole over these 30 years, from >3 billionto >5 billion.

The rise in adult population size will bemodest in the former socialist economies ofEurope (FSE) (5%) and the establishedmarket economies (EME) (11%); moderatein China (39%); -80% in India, other Asiaand islands (OAI), and Latin America andthe Caribbean (LAC); and >100% in sub-Saharan Africa (SSA) and the Middle East-ern crescent (MEC).

Prevalence of diabetesThe prevalence of diabetes in adults aged^20 years is shown by year and region inFig. 2. Between 1995 and 2025 there willbe a 35% increase in the worldwide preva-

DIABETES CARE, VOLUME 21, NUMBER 9, SEPTEMBER 1998 1415

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Global burden of diabetes


B

Formerly Middle

socialists Eastern

economies of cresem

Europe

Other Asia Latin America Sub-Saharan

and Islands and the Africa

Caribbean

Figure 2—Prevalence oj diabetes in the adult population (aged ^-20 years) by year and region. A:Developed and developing countries and world total. B: Major geographic areas. H, 1995; H, 2000;M, 2025.

lence of diabetes, from 4.0 to 5.4%. Preva-lence is higher in developed than in devel-oping countries and will remain so in 2025.However, the proportional increase will begreater in the developing countries. Indeveloped countries, the increase in preva-lence will be 27%, from 6.0 to 7.6%. Indeveloping countries, the increase will be48%, from 3.3 to 4.9%.

The highest increases in prevalencebetween 1995 and 2025 will be for China(68%) and India (59%). LAC and OAI willboth experience a 41% increase, and MECwill experience a 30% increase. The increasewill be lowest in FSE (26%) and EME (28%).

Numerical estimatesThe number of adult people with diabetesis shown by year and region in Fig. 3. Thenumber of adults with diabetes in theworld is estimated to increase by 122%,from 135 million in 1995 to 300 million in2025. There will be a 42% increase, from51 million to 72 million, in the developedcountries. In the developing countries,

there will be a 170% increase, from 84 mil-lion to 228 million. Thus, by the year 2025,over 75% of all people with diabetes will bein the developing countries, as comparedwith 62% in 1995.

The greatest increases will be seen inIndia (195%, from 19 million to 57 mil-lion), MEC (193%, from 18 million to 54million), and SSA (185%, from 3 million to8 million). The increase will be over 150%in OAI (from 12 million to 32 million) andLAC (from 15 million to 39 million). InChina there will be a 134% increase (from16 million to 38 million). The smallestincreases will occur in FSE (33%, from 17million to 22 million) and EME (46%, from34 million to 50 million).

The "Top 10" countries of the world, interms of the number of people with diabetes,are shown for 1995 and 2025 in Table 1. Atboth points in time, the three countries withthe largest number of people with diabetesare India, China, and the U.S. For 1995, oth-ers in the Top 10 are the Russian Federation,Japan, Brazil, Indonesia, Pakistan, Mexico,

and the Ukraine. For 2025, the others in theTop 10 are Pakistan, Indonesia, Russian Fed-eration, Mexico, Brazil, Egypt, and Japan.Thus, there will be a tendency for certaindeveloping countries to move up the list andfor certain industrialized countries to movedown it. In both time periods, the Top 10countries will account for approximatelytwo-thirds of all diabetes in the world.

Age structure of the diabeticpopulationThe number of diabetic subjects in three ageranges, i.e., 20-44 years, 45-64 years, and^65 years, is shown by region of the worldfor the years 1995 and 2025 in Fig. 4.

The age structure of the diabetic pop-ulations of developed and developingcountries are markedly different. For thedeveloped countries, the oldest age-grouphas the largest number of people with dia-betes in 1995 and will experience the great-est increase in numbers by the year 2025.However, for the developing countries, the45- to 64-year-old age-group contained thelargest number of people with diabetes in1995, and this tendency will be furtheraccentuated by the year 2025. The agestructure of the world total follows thetrend for developing countries.

Regionally, three distinct patternsemerge. For SSA, the greatest numbersand the greatest increases are in the twoyounger age-groups, with only a small pro-portion of subjects in the oldest age range.For LAC, MEC, China, India, and OAI, themajority of people with diabetes are andwill be in the middle age range. For EMEand FSE, there are relatively few youngpeople with diabetes, and the majority ofpeople with diabetes are presently, and willbe in 2025, over 65 years of age.

Male/female diabetes ratioThe ratio of the number of adult male andfemale people with diabetes is shown byyear and region in Fig. 5. For 1995 for theworld as a whole, there were more womenthan men with diabetes (73 vs. 62 million).The female excess is pronounced in thedeveloped countries (31 vs. 20 million),but in the developing countries, there areequal numbers of men and women withdiabetes (42 million in each case). Region-ally, there is a marked female excess in FSE(12 million vs. 5 million) and LAC (9 vs. 6million). There is a moderate female excessin EME (20 vs. 15 million) and China (9 vs.7 million). There is approximate parity inthe ratio in MEC (9 million in each case)


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350

300

250

200

150

100

50


B70

60

50

40

30 --*

20 --S

10 --/1I

I -\

n-

- 1 r- 1 TTTIEstablished

Market

Economies

Formerly

socialists

economies

ol Europe

Middle

Eastern

cresent

India China Other Asia

and Islands Am

Ci

Lalin

erica and

thesribbean

Sub-

Saharan

Africa

Figure 3—Number of people with diabetes in the adult population (aged ^20 years) by year andregion. A: Developed and developing countries and world total. B: Major geographic areas. S3, 1995;m, 2000; S, 2025.

and OAI (6 million in each case). There is amale excess in India (11 vs. 8 million) andinSSA(1.8vs. 1.1 million).

By the year 2025, the worldwidefemale/male excess is estimated to bereduced somewhat (to 159 vs. 141 million).The female excess will decrease in FSE andEME but increase slightly in China, LAC,and MEC. The male excess will decrease inIndia, but it will increase in SSA.

Urban/rural diabetes ratioFor developing regions of the world, thestudy design permitted the calculation ofthe ratio of the frequency of diabetes inurban and rural areas (Fig. 6). Apart fromChina and SSA, all regions had at least asmany cases in urban as in rural areas in1995. By 2025, there will be a considerableexcess of diabetes in the urban areas. Themost extreme example is LAC (with a 12-fold excess), followed by MEC (with a 4-

fold excess) and India (with a 3-foldexcess). For developing countries as awhole, the urban/rural ratio in diabetes fre-

quency is predicted to rise from 1.6 in1995 to 3.3 in 2025.

CONCLUSIONS — The results of thisstudy suggest that for the world as a whole,between the years 1995 and 2025, theadult population will increase by 64%,prevalence of diabetes in adults willincrease by 35%, and the number of peo-ple with diabetes will increase by 122%.For the developed countries, there will bean 11% increase in the adult population, a27% increase in the prevalence of adultdiabetes, and a 42% increase in the num-ber of people with diabetes. For the devel-oping countries, there will be an 82%increase in the adult population, a 48%increase in the prevalence of adult dia-betes, and a 170% increase in the numberof people with diabetes.

Because of a lack of suitable survey data,many extrapolations were necessary in thisstudy (all of SSA was estimated based on thedata from Tanzania). Even when a survey ina particular country was available, its find-ings may not necessarily have been nation-ally representative (it is unlikely that thereare three times as many men as women withdiabetes in Australia and New Zealand; thisresult was due to a relatively high number ofelderly diabetic men being identified in theonly available Australian study).

Additional caution should be expressedover the fact that some of the studies wereconducted in the 1980s and therefore maynot reflect the current situation. Somerecent reports have suggested quite sub-stantial increases in prevalences in countriessuch as India (13) and Korea (14). A recentreport from Nigeria (15), as well as clinicalobservation, also suggests that diabetes is

Table 1—Top ten countries for estimated number of adults with diabetes, 1995 and 2025

Rank1234567

8910

Country

IndiaChinaU.S.Russian FederationJapanBrazilIndonesiaPakistanMexicoUkraine

All other countriesTotal

1995 (millions)

19.416.013.98.96.34.94.5

4.33.83.6

49.7135.3

Country

IndiaChinaU.S.PakistanIndonesiaRussian FederationMexicoBrazilEgyptJapan

2025 (millions)

57.237.621.914.512.412.211.711.68.88.5

103.6300.0


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Developed countries

1 20

45-64

age group (years)

Developing countries

120

100

80

I 60

40

-

7777,

WA V//A45-64

age group (years)

World

n n45-64

age group (years)

Figure 4—Number of people with diabetes by age-group, year, and region, ffl, 1995; M, 2025.

now more common in SSA than was previ-ously thought. Therefore, both national andregional figures for SSA may be underesti-mated.

For all of these reasons, too muchemphasis should not be placed on the fig-ures for individual countries. However,they do provide a useful starting point fornational situational analysis.

Three previous studies have estimatedthe number of people with diabetes in theworld. Although they used different sourcesof demographic data, they drew to a largeextent on the same prevalence data as thepresent project, and estimates of currentprevalence are quite comparable. It shouldbe noted that all four studies have relied onfield survey data for the estimation of preva-lence. Therefore, the numerical estimatesderived therefrom represent all people withdiabetes in the community, including bothknown and undiagnosed cases.

As compared with our global estimate of

135 million adults with diabetes for 1995,Murray and Lopez (16) estimated 118 mil-lion cases at all ages for 1990. McCarty andZimmet (17) estimated 110 million cases atall ages for 1994. Most recently, Amos et al.(18)—in a revision of the earlier McCartyand Zimmet report—estimated 118 millioncases at all ages for 1995. Comparing the1995 and 2000 country estimates of Amoset al. and the present study, in most casesthere is good agreement, although there area small number of important differences thatbear further examination.

McCarty and Zimmet, and subse-quently Amos et al., also attempted to makeprojections of diabetes frequency into thefuture. However, they did not incorporateprojected changes in patterns of urbaniza-tion directly into their models, as was donein the present study Instead, they hypothe-sized that in general, populations wouldmove toward progressively higher preva-lences of diabetes in the future. They first

examined all available prevalence rates for anethnic group, and then for each country,they selected the "most appropriate" higherrate based on predicted future gross nationalproduct and urbanization of each country.The higher age-specific prevalence estimateswere then applied to a projected national agedistribution. Using this procedure, Amos etal. estimated a world total of 147 millioncases for the year 2000 (as compared withour estimate of 154 million) and 221 millioncases for the year 2010. Thus, the projec-tions of Amos et al. yield an average annualincrement to the worlds diabetic populationof 5.8 million people for the years1995-1999 and of 7.4 million people for theyears 2000-2010. Our apparently moreconservative approach yields an averageannual growth of the worlds diabetic popu-lation of 3.8 million people for the years1995-1999 (starting from a higher 1995baseline figure) and of 5.8 million people forthe years 2000-2025. These alternatives,essentially the result of adopting "pes-simistic" or "optimistic" scenarios, probablyform useful boundaries for the likely burdenof diabetes during the first years of the 21stcentury Thus, they may be viewed as com-plementary to one another.

The failure to include subjects <20years of age in the present study should notbe taken as ignoring the importance andseverity of diabetes in childhood and ado-lescence. It is simply a reflection of the factthat their inclusion would have had littleeffect on the numerical estimates. Of the 118million cases estimated by Murray andLopez for 1990, only 214,000, or 0.2%,were <15 years of age. This suggests thatfrequency of diabetes in adults is a close andefficient proxy for global frequency of dia-betes at all ages.

The division of countries into "devel-oped" and "developing" groups is some-what arbitrary and is unduly simplistic,given that many developing countries havecomplex infrastructures and considerableeconomic potential. However, it does serveto differentiate those countries that havebeen industrialized for some time from thenewly emerging economies and those yet toexperience such changes. Clearly, there areclose links between socioeconomic transi-tion and epidemiological transition.

The much greater predicted number ofmiddle-aged (45-64 years) than elderly(^65 years) people with diabetes in thedeveloping countries is important. Suchsubjects will have to endure the conditionduring some of the most productive years


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1.2

1.0

0.8

o1 0.6

0.4

0.2

0.0 IDeveloped Developing World

B1.8

1.6

1.4

1.2

o 1.0S 0.8

0.60.40.20.0

y" /

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i

- -\

-

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-

Established Formerly MiddeMarket socialists Eastern

Economics economies cresenlof Europe

Other Asia Latin Sub-and Istand3 America and Saharan

the AfricaCaribbean

Figure 5—Male/female ratio oj number of people with diabetes by year and region. A: Developed anddeveloping countries and world total. B: Major geographic areas. 0 ,1995; E3, 2000; • , 2025.

3.5

3.0

2.5

o 2.0

2 1.5

1.0

0.5

0.0

mB

14.0

12.0

10.0

8.0

6.0

4.0

2.0

0.0 1 n i c^rflMiddle Eastern India

cresenlChina Other Asia and

Islands

Latin America

andlneCaribbean

Sub-Sahara

Africa

Figure 6—Urban/rural ratio oj number of people with diabetes by year and region. A: Developingcountries. B: Major geographic areas. 0 , 1995; M, 2000; M, 2025.

of their lives. They will also have moreyears of life to develop the chronic compli-cations of diabetes than will the generallyelderly diabetic population of the industri-alized countries. This will have majorimplications with respect to health careneeds, resource utilization, and cost.

The fact that there are more womenthan men with diabetes in many countries isalso notable. For the developed countries, alikely explanation is the greater longevity ofwomen. However, in the developing coun-tries, diabetes is more common in the mid-dle-aged than the elderly (Fig. 4), underwhich circumstances the previous explana-tion is less likely In this case, it may be dif-ferential distribution of risk factors—especially diet, physical inactivity, and cen-tral obesity—in men and women that maydetermine the male/female ratio. If so, theratio may have public health, as well ashealth planning, significance.

The increasing concentration of dia-betes in urban areas of developing coun-tries, which may be largely accounted forby the rapid growth in size of the majorurban conglomerates of developing coun-tries, as well as by the aging of their popu-lations, should also be borne in mind whenplanning future health care systems.

In summary, this report supports ear-lier predictions of the epidemic nature ofdiabetes in the world during the first quar-ter of the 21st century. It also provides aprovisional picture of the characteristics ofthe epidemic. The database is a contribu-tion to an ongoing process of worldwidesurveillance of diabetes, its complications,and related disorders, which recently ledthe WHO to recommend prevalence ofdiabetes as one of the "basic health indica-tors" for its member states (19). Such sur-veillance is a first step toward the integratedprevention and control of diabetes andother noncommunicable diseases, whichis now recognized as an urgent priority fornational and international health authori-ties (20).

Acknowledgments— This project was con-ceived as a joint collaboration between theWHO diabetes program and the Division ofDiabetes Translation, Centers for Disease Con-trol and Prevention, Atlanta, Georgia, during theperiod of employment of R.E.A. and W.H.H. inthe Division of Diabetes Translation, Centersfor Disease Control and Prevention.

The authors thank the members of theWHO Ad Hoc Diabetes Reporting Group whosupplied the survey data used in this study.


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Appendix 1—Description of survey data used for the calculation of country estimates

Country

EMEAustraliaAustriaBelgiumCanadaDenmarkFinlandFranceGermanyGreeceIrelandItalyJapanNetherlandsNew ZealandNorwayPortugalSpainSwedenSwitzerlandU.K.U.S.

FSEAlbaniaBelarusBulgariaCzech RepublicHungaryLithuaniaPolandRepublic ofMoldova

RomaniaRussian

FederationSlovakiaUkraineYugoslavia

MECAfghanistanAlgeriaArmeniaAzerbaijanBahrainCyprus

EgyptGeorgiaIran,

IslamicRepublic of

IraqIsraelJordanKazakhstan

KuwaitKyrgyzstan

LebanonLibyan ArabJamahiriya

MoroccoOmanPakistanQatarSaudi ArabiaSyriaTajikistan

TunisiaTurkeyTurkmenistan

Urbanprevalence

AustraliaU.K.U.K.Hanes: U.S.FinlandFinlandU.K.U.K.Sanza, ItalyU.K.Sanza, ItalyJapanU.K.AustraliaFinlandSanza, ItalySanza, ItalyFinlandU.K.U.K.Hanes: U.S.

WroclawNovosibirskWroclawWroclawWroclawWroclawWroclawWroclaw

WroclawNovosibirsk

WroclawNovosibirskWroclaw

Cairo X 0.5TunisiaCairo X 0.5Cairo X 0.5OmanCairoCairoCairo x 0.5Cairo X 0.5

Cairo x 0.5IsraelCairoUzbekistan

X 1.5OmanUzbekistan

X 1.5CairoTunisia

TunisiaOmanPakistanOmanOmanCairoUzbekistan

x 1.5TunisiaTunisiaUzbekistan

X 1.5

Ruralprevalence

AustraliaU.K.U.K.Hanes: U.S.FinlandFinlandU.K.U.K.Sanza, ItalyU.K.Sanza, ItalyJapanU.K.AustraliaFinlandSanza, ItalySanza, ItalyFinlandU.K.U.K.Hanes: U.S.

WroclawNovosibirskWroclawWroclawWroclawWroclawWroclawWroclaw

WroclawNovosibirsk

WroclawNovosibirskWroclaw

Baluchistan X 0.5Tunisia x 0.5Baluchistan X 0.5Baluchistan X 0.5Oman X 0.5KaliubiaKaliubiaBaluchistan X 0.5Kaliubia X 0.5

Kaliubia X 0.5IsraelKaliubiaUzbekistan

Oman X 0.5Uzbekistan

x 0.5KaliubiaTunisia x 0.5

Tunisia x 0.5Oman X 0.5Pakistan x 0.5Oman x 0.5Oman X 0.KaliubiaUzbekistan

X 0.5Tunisia X 0.5Tunisia X 0.5Uzbekistan

Ref.

21

22,2322,2324,252626

22,2322,2327

22,23276

22,232126272726

22,2322,2324,25

28*282828282828

28*

28*28

29,73029,729,7312929

29,729

2932298

318

2930

303173131298

30308

Country

United ArabEmirates

Uzbekistan

YemenIndiaChinaOAI

BangladeshBhutanBruneiDarussalam

CambodiaCook IslandsDemocratic

Urbanprevalence

Oman

UzbekistanX 1.5

Cairo X 0.5India, urbanChina, urban

BangkokBangkokBangkok

BangkokFijiBangkok

Peoples Republicof Korea

East TimorFijiHong KongIndonesiaKiribatiLao Peopled

DemocraticRepublic

MalaysiaMaldivesMarshall IslandsMicronesiaMongoliaMyanmarNauruNepalNiuePalauPapuaNew Guinea

PhilippinesRepublic of

KoreaSamoaSingaporeSolomon IslandsSri LankaThailandTongaTuvaluVanuatuVietnam

LACAntigua

and BarbudaArgentinaBahamasBarbadosBelizeBoliviaBrazilChileColombiaCosta RicaCubaDominicaDominican

RepublicEcuadorEl SalvadorGrenadaGuadeloupeGuatemalaGuyanaHaitiHonduras

BangkokFijiBangkokIndonesiaFijiBangkok

BangkokBangkokFijiFijiBangkokBangkokFijiBangkokFijiFijiFiji

BangkokBangkok

FijiBangkokFijiBangkokBangkokFijiFijiFijiBangkok

St. James

BogotaSt. JamesSt. JamesBogotaBogotaSao PauloBogotaBogotaBogotaSt. JamesSt. JamesSt. James

BogotaBogotaSt. JamesSt. JamesBogotaSt. JamesSt. JamesSt. James

Ruralprevalence

Oman x 0.5

Uzbekistan

Kaliubia x 0.5India, ruralChina, rural

Bangkok X 0.5Bangkok X 0.5Bangkok X 0.5

Bangkok x 0.5Fiji X 0.5Bangkok x 0.5

Bangkok x 0.5Fiji X 0.5Bangkok X 0.5Indonesia X 0.5Fiji x 0.5Bangkok X 0.5

Bangkok X 0.5Bangkok x 0.5Fiji x 0.5Fiji X 0.5Bangkok X 0.5Bangkok X 0.5Fiji X 0.5Bangkok X 0.5Fiji X 0.5Fiji X 0.5Fiji x 0.5

Bangkok x 0.5Bangkok X 0.5

Fiji X 0.5Bangkok X 0.5Fiji x 0.5Bangkok x 0.5Bangkok x 0.5Fiji X 0.5Fiji x 0.5Fiji x 0.5Bangkok x 0.5

St. James x 0.5

Bogota X 0.5St. James X 0.5St. James x 0.5Bogota X 0.5Bogota X 0.5Sao Paulo X 0.5Bogota x 0.5Bogota x 0.5Bogota x 0.5St. James x 0.5St. James X 0.5St. James X 0.5

Bogota X 0.5Bogota x 0.5St. James X 0.5St. James x 0.5Bogota x 0.5St. James x 0.6St. James X 0.5St. James x 0.5

Ref.

31

8

29334

343434

343534

34353453534

3434353534343534353535

3434

353435343435353534

36

373636373738373737363636

3737363637363636

Country

JamaicaMartiniqueMexicoNeth. AntillesNicaraguaPanamaParaguayPeruPuerto RicoSt. Kitts

and NevisSt. LuciaSt. Vincent and

the GrenadinesSurinameTrinidad andTobago

UruguayVenezuela

SSAAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral AfricanRepublic

ChadComorosCongoC6te d'lvoireDjiboutiEquatorial

GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauKenyaLesothoLiberiaMadagascarMalawiMaliMauritaniaMauritiusMozambiqueNamibiaNigerNigeriaReunionRwandaSao Tome and

PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTogoUgandaUnited Republic

of TanzaniaZaireZambiaZimbabwe

Urbanprevalence

St. JamesSt. JamesMexico CitySt. JamesBogotaBogotaBogotaBogotaSt. JamesSt. James

St. JamesSt. James

St. JamesSt. James

BogotaBogota

Dar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-Salaam

Dar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-Salaam

Dar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-Salaam

Dar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-SalaamDar-es-Salaam

Dar-es-SalaamDar-es-SalaamDar-es-Salaam

Ruralprevalence

St. James x 0.5St. James X 0.5Mexico City X 0.5St. James X 0.5Bogota X 0.5Bogota X 0.5Bogota X 0.5Bogota X 0.5St. James x 0.5St. James X 0.5

St. James X 0.5St. James X 0.5

St. James X 0.5St. James X 0.5

Bogota x 0.5Bogota x 0.5

WaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguru

WaluguruWaluguruWaluguruWaluguruWaluguruWaluguru

WaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguru

WaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguruWaluguru

WaluguruWaluguruWaluguru

Ref.

36363936373737373636

3636

3636

3737

4040404040404040

404040404040

40404040404040404040404040404040404040404040

40404040404040404040

404040

Personally communicated data: *E. Shubnikov.


Dow



Appendix 2—Population size, prevalence of diabetes, and number of people with diabetes in adults aged 20 years and over—1995,2000, and 2025

Countryand year

World199520002025

Developed countries199520002025

Developing countries199520002025

Established market economies199520002025

Andorra199520002025

Australia199520002025

Austria199520002025

Belgium199520002025

Canada199520002025

Denmark199520002025

Finland199520002025

France199520002025

Germany199520002025

Greece199520002025

Iceland199520002025

Ireland199520002025

Italy199520002025

Japan199520002025

Luxembourg199520002025

Malta199520002025

Monaco199520002025

Population(000)

3,397,6043,719,5515,572,260

856,952883,442953,703

2,540,6522,836,1094,618,557

612,477633,575697,518

444647

12,93913,85818,374

6,0856,2306,523

7,6887,8378,077

21,39122,60928,551

3,9723,9993,963

3,8053,8994,082

42,75044,02747,154

63,97464,59563,008

7,9638,2918,069

183197248

2,3452,4882,842

44,86345,88543,757

96,16399,63198,404

314329341

259272314

242526

Prevalence(%)

4.04.25.4

5.96.27.6

3.33.54.9

5.65.87.1

7.17.17.0

2.52.73.3

2.02.12.7

2.12.22.7

7.27.59.2

8.38.410.8

7.98.311.1

2.12.12.6

2.12.22.8

7.67.89.6

7.07.29.3

1.81.82.3

7.57.810.0

6.56.98.7

2.02.12.7

1.81.92.5

2.12.12.1

Rural

———

———

33,05136,21553,176

———

———

——

———

—

—

——

———

—

—

———

———

——

——

———

——

_——

——

—

—

Urban

———

———

51,22063,320174,472

———

———

———

———

———

——

———

———

———

———

———

———

———

——

——

——

—

—

——

Male

62,13071,470141,936

19,88021,54429,765

42,25049,925112,171

14,50715,66921,752

1.51.61.6

241269466

545988

7579105

651723

1,154

141144188

118130193

399425569

610661856

262276317

6.26.411

212232

1,4141,4891,747

2,6842,9493,601

2.93.14.4

2.22.53.8

0.20.20.2

Number of people (000)

Female

73,15682,922158,037

31,09433,26642,484

42,06249,657115,554

19,54621,07428,075

1.61.71.7

8898144

697191

8892116

882978

1,464

189191240

182192261

482510665

749773914

345374455

6.67.812

222434

1,9562,1032,618

3,5853,9564,942

3.43.64.9

2.52.84.0

0.30.30.3

20-44

28,64232,60853,874

4,7944,8784,420

23,84827,73049,454

3,8303,9413,568

———

474953

6.26.95.2

8.18.36.4

239248238

10107.9

11108.9

464640

646951

677056

0.60.60.6

333

377399265

465442375

0.30.40.3

0.30.30.3

——

Age (years)45-64

58,74767,899141,418

17,63919,14923,378

41,10848,749118,041

13,66314,98618,699

———

122142219

495474

656784

651753

1,039

8190103

808994

347366464

585613734

239238276

3.13.55.7

182028

1,2911,3111,595

2,8172,9552,837

2.72.93.7

2.22.42.9

——

>65

47,85153,832104,599

28,53630,77744,445

19,31523,05560,154

16,55517,81127,554

———

161176339

686999

9095130

643701

1,341

238235318

210222350

488524731

710752986

300342440

9.11017

222336

1,7021,8822,505

2,9873,5085,331

3.23.55.3

2.32.64.5

———

Total

135,286154,392299,974

50,97454,81072,248

84,31399,582

227,725

34,05436,74349,826

3.13.33.3

330367610

123130178

164171221

1,5321,7012,618

329335428

300322454

881935

1,234

1,3591,4341,770

607650772

131423

434666

3,3693,5924,365

6,2696,9058,543

6.26.89.3

4.85.37.7

0.50.50.5


Dow



Appendix 2 (continued)


Countryand year

Netherlands199520002025

New Zealand199520002025

Norway199520002025

Portugal199520002025

San Marino199520002025

Spain199520002025

Sweden199520002025

Switzerland199520002025

U.K.199520002025

U.S.199520002025

Formerly socialist econom199520002025

Albania199520002025

Belarus199520002025

Population(000)

11,73012,08512,898

2,4762,6193,227

3,2253,2693,550

7,1987,3987,630

202120

29,95431,37431,213

6,6086,6837,380

5,5325,7186,105

43,36543,78446,756

187,607196,407244,959

lies of Europe244,475249,867256,185

2,0402,2153,323

7,2167,3137,509

Bosnia and Herzegovina199520002025

Bulgaria199520002025

Croatia199520002025

Czech Republic199520002025

Estonia199520002025

Hungary199520002025

Latvia199520002025

Lithuania199520002025

2,4373,1383,474

6,5096,5326,150

3,3233,3413,269

7,4247,6417,936

1,1061,1011,087

7,4597,5157,141

1,8591,8211,771

2,6312,6582,802

Prevalence(%)

1.92.02.7

2.52.63.2

8.68.610.2

7.17.38.8

7.67.67.6

7.27.39.5

9.39.411.2

2.02.12.8

2.12.12.5

7.47.68.9

6.97.28.8

2.82.93.9

8.99.511.4

3.43.65.0

4.44.45.0

4.44.55.1

4.14.14.7

4.44.45.0

4.44.44.9

4.54.65.0

4.24.34.9

Age (years)Rural Urban Male Female 20-44 45-64 >65 Total

104115172

465078

117119160

213222280

0.60.60.6

9149701,244

265272372

505584

419434564

5,6976,1929,462

5,3735,8758,013

232653

209233311

314264

102101103

515255

105112129

151517

107107111

252527

343543

119127182

171925

159161203

300316394

0.90.90.9

1,2421,3331,709

350360456

596386

493500622

8,1568,81712,430

11,54712,19214,409

343978

432463543

5171109

183190207

9498112

202202244

343437

220223241

585962

767993

131310.0

8.89.39.1

8.78.97.5

646856

262285205

161716

5.96.44.6

434640

2,0662,1262,112

964937852

7.48.611

303027

9.51210

201917

11109.4

252322

3.73.63.4

252219

6.06.05.5

8.69.18.4

94106141

232638

596687

194198266

8048081163

134150168

465068

359380491

5,5996,4968,720

3,9754,1634,679

313571

104101120

455984

139136140

727173

146160178

232324

152155155

393839

525162

116123203

313356

209205269

255272352

—

1,0911,2101,584

464465644

586198

510508655

6,1886,38711,060

11,98012,96616,892

192249

507564707

284378

127136153

626985

136131174

222327

150152178

384045

495467

222242354

6368103

276280363

513538674

1.51.61.5

2,1562,3032,952

614631827

109118170

912934

1,186

13,85315,00921,892

16,92018,06722,422

5865131

641696854

82114172

286290311

145150167

307314373

494955

326329352

838489

110115137


Dow




Countryand year

Poland199520002025

Republic of Moldova199520002025

Romania199520002025

Russian Federation199520002025

Slovakia199520002025

Slovenia199520002025

Population(000)

26,40327,49830,483

2,8933,0133,645

16,23916,74216,992

105,326106,994107,169

3,6563,8544,399

1,4391,4861,457

The Former Yugoslav Republic of Macedonia199520002025

Ukraine199520002025

Yugoslavia199520002025

The Middle Eastern Crescent199520002025

Afghanistan199520002025

Algeria199520002025

Armenia199520002025

Azerbaijan199520002025

Bahrain199520002025

Cyprus199520002025

Egypt199520002025

Georgia199520002025

Iraq199520002025

Islamic Republic of Iran199520002025

Israel199520002025

1,4571,5611,894

37,42337,77737,234

7,6357,6678,450

290,043335,553653,472

9,99313,61925,134

13,92316,55730,966

2,2292,4223,361

4,4734,8817,168

339383658

495521678

32,65537,25566,125

3,7453,8514,464

9,39411,14024,677

30,66934,96676,814

3,4863,8435,564

Prevalence(%)

3.94.04.7

3.73.74.2

4.04.04.8

8.49.011.4

3.83.84.6

4.34.45.3

3.43.64.6

9.610.111.8

4.14.24.6

6.36.58.2

4.14.15.3

4.34.66.3

6.97.38.9

6.46.78.7

8.49.612.8

13.114.217.4

9.910.213.3

7.88.19.3

6.06.17.0

5.55.76.8

8.58.510.2

Rural

———

———

———

———

———

———

———

———

——

5,7256,3179,999

276364575

173165295

353637

656777

2.32.84.2

161716

9621,0811,592

666351

5864104

318324543

171619

Urban

———

———

———

———

———

———

———

———

——

12,57515,64843,550

136196748

433599

1,642

120141261

220259549

263480

4858102

2,2782,7207,211

227247363

504614

1,635

1,3741,6534,672

280310547

Male

353375472

363752

238238292

2,6933,0134,407

464968

212225

202232

1,1461,2541,612

117117139

9,33211,24526,703

200272596

330424993

6172

111

112132234

172246

252944

1,4281,6793,756

105113147

246297739

739858

2,221

151168296


Female

688729953

7175102

416437526

6,2016,5667,832

9298134

404352

303455

2,4302,5482,778

194203252

8,96810,72026,845

212287727

276340944

94105187

173194392

111538

404574

1,8112,1225,046

188197267

315381

1,001

9531,1192,994

145159270

20-44

1009497

111112

545250

456443381

131313

4.84.64.0

5.45.55.8

148147131

262425

6,6807,89916,247

174257456

207265474

495568

100116147

131417

182024

1,2831,4482,706

717682

228271605

668780

1,843

262737

Age (years)45-64

493525614

525572

328324393

1,4691,5511,715

657194

303134

273042

546591591

161156179

8,41310,20126,782

183230659

273344

1,041

6674

135

120127309

121841

313654

1,4421,7444,229

130134189

248302820

706809

2,352

124143243

>65

449484714

434670

272299375

6,9697,58610,144

606495

263038

172139

2,8813,0633,667

124141187

3,2073,86410,520

5572

208

125154422

394895

6482170

3.54.527

161840

5156091867

91101144

85105314

318388

1,020

147157286

Total

1,0411,1031,425

107113154

654675817

8,8949,57912,240

138148202

616577

505687

3,5763,8014,389

311320391

18,30021,96453,549

412559

1,323

606764

1,937

155177298

285325627

293784

6574118

3,2403,8018,802

293310414

561678

1,739

1,6921,9775,215

297327566


Dow




Countryand year

Jordan199520002025

Kazakhstan199520002025

Kuwait199520002025

Kyrgyzstan199520002025

Lebanon199520002025

Libyan Arab Jamahiriya199520002025

Morocco199520002025

Oman199520002025

Pakistan199520002025

Qatar199520002025

Saudi Arabia199520002025

Syria199520002025

Tajikistan199520002025

Tunisia199520002025

Turkey199520002025

Turkmenistan199520002025

United Arab Emirates199520002025

Uzbekistan199520002025

Yemen199520002025

India199520002025

China199520002025

Population(000)

2,4722,9866,842

10,46311,17615,408

7659921,912

2,5282,8104,853

1,6901,8953,086

2,3892,8556,783

14,23316,59928,183

9201,1142,918

64,49475,111166,975

362397551

8,51710,37423,162

6,1227,44418,733

2,8733,3407,164

4,8465,5759,240

35,16039,35563,457

2,0682,3704,441

1,1771,3022,021

11,43113,12425,016

6,1327,29617,118

515,361577,814957,337

800,890859,0861,116,209

Prevalence(%)

11.011.313.8

4.74.85.8

8.08.712.4

4.24.24.9

13.713.818.0

5.35.45.7

4.34.46.2

6.56.77.4

6.77.18.7

9.411.113.6

8.79.110.1

9.59.612.0

3.83.74.3

4.74.96.8

5.25.67.2

3.63.64.7

9.210.812.9

3.73.74.7

3.74.05.2

3.84.06.0

2.02.23.4

Rural

333663

194196220

5.06.712

7478113

131214

111117

211238383

293359

2,1592,4734,229

2.63.43.8

8085131

135156315

7482144

566187

358320356

303151

101217

171179285

92103185

8,1359,08614,094

9,38210,06813,047

Urban

239302881

292338681

5680226

3340126

219251541

115142368

3974911,364

3042158

2,1792,83710,294

314071

6648592,203

4445621,938

3442162

173211544

1,4831,8964,195

4555157

98129243

257312884

138188705

11,26213,79343,149

6,6348,56924,509

Male

118149401

241265462

2842115

5359127

88100205

7792212

323387866

3139108

2,6283,2088,669

253347

4375591,244

249312972

5765169

122145314

1,0031,1942,277

3945114

80103159

222255641

96126417

11,15213,12331,514

7,0148,17615,984


Female

154189543

246268439

3244123

5459111

144163350

4961173

285342881

2835109

1,7102,1025,853

8.51128

3073851,090

3304061,281

5160137

107127317

8381,0232,274

364193

2938101

207237528

134165473

8,2459,75525,729

9,00210,46121,571

20-44

in146324

677287

273455

161829

8193138

4249121

205246403

212574

1,8352,1785,236

151413

286319676

243319870

172244

7590138

571663979

131627

474451

7187154

100136369

5,0795,97111,914

3,0123,2603,655

Age (years)45-64

121139472

261292483

2744117

5559135

99110295

6477183

275335929

293898

2,0792,6257,635

172730

3524881,085

2432851,047

5863180

103120336

8701,0322,355

4045124

5586102

227254687

102120418

10,02011,76531,112

8,4849,98720,643

>65

4153148

159169330

6.38.566

364074

5260122

212781

128148416

9.91245

4255071,652

1.43.132

106137573

93115336

334083

5162157

3995211,217

222556

6.711108

131151328

2835103

4,2985,14214,217

4,5205,39013,257

Total

272338944

487533901

6186237

107118239

232262555

126153385

6087291,747

5975217

4,3385,31014,523

344475

7459442,334

5797182,253

108125307

229272631

18412,2174,551

7586208

109141260

4294921,169

230291890

19,39722,87857,243

16,01618,63737,555


Dow




Countryand year

Other Asia and islands199520002025

Bangladesh199520002025

Bhutan199520002025

Brunei Darussalam199520002025

Cambodia199520002025

Cook Islands199520002025

Population(000)

401,050453,613739,466

59,31769,579131,442

799903

1,739

162186301

4,7865,33511,240

91017

Democratic Peopled Republic of Korea199520002025

East Timor199520002025

Fiji199520002025

Hong Kong199520002025

Indonesia199520002025

Kiribati199520002025

15,03216,37723,986

405439770

424486803

4,3224,5604,941

111,372125,873192,239

343964

Lao People's Democratic Republic199520002025

Malaysia199520002025

Maldives199520002025

Marshall Islands199520002025

Micronesia199520002025

Mongolia199520002025

Myanmar199520002025

Nauru199520002025

Nepal199520002025

2,2162,5325,457

10,67112,05521,629

107128313

172033

485590

1,2321,4392,573

24,44927,54248,860

2.42.84.5

10,28911,89924,112

Prevalence(%)

3.03.24.3

2.22.23.1

2.12.12.3

3.13.24.1

2.02.12.5

8.18.18.1

2.93.24.3

2.12.22.8

10.110.614.8

4.24.55.5

4.14.36.5

7.07.07.0

2.32.42.8

2.83.03.7

2.52.53.0

7.07.07.0

7.07.07.0

3.03.13.9

2.42.53.2

24.024.024.0

2.22.22.6

Rural

6,0446,6789,866

856969

1,652

151729

1.41.62.0

7687161

———

103111141

6.47.311

141521

4.54.33.6

2,4642,6893,836

———

333657

107117159

1.41.52.7

———

——

8.89.613

341376554

———

172190320

Urban

6,0947,676

21,776

429595

2,381

1.72.310

3.64.510

2027122

——

340416897

2.02.610

293698

179201268

2,0822,7078,591

———

182493

193245648

1.31.76.6

——

——

293687

247305995

———

5373

318

Male

6,4977,65816,552

755922

2,253

9.11022

2.93.56.5

4756152

0.30.30.5

241284515

4.95.612

212558

102112140

2,3322,7576,406

1.11.22.0

273281

166197427

1.61.95.4

0.60.71.2

1.71.93.1

212553

318369812

0.30.30.5

125147359


Female

5,6546,71115,114

530642

1,779

7.58.517

2.12.65.7

4858131

0.40.50.8

202243523

3.54.39.4

222660

8193132

2,2142,6386,021

1.31.52.5

242869

134165380

1.11.33.8

0.60.71.1

1.71.93.2

172047

270312737

0.30.40.6

100116279

20-44

4,3205,0958,120

583725

1,448

6.67.616

2.32.43.5

4451119

———

198231260

4.04.58.7

101120

676846

1,1381,3552,109

——

212563

129150272

1.21.54.2

——

——

161934

241285531

———

91108259

Age (years)45-64

5,6516,65016,501

567676

2,086

8.19.119

2.32.96.0

4253132

———

196237599

3.74.59.9

242965

8397141

2,1692,5486,315

——

242970

136171405

1.21.34.0

——

——

172152

273306809

———

107124304

>65

2,1682,6097,022

136163497

1.82.24.6

0.50.72.7

9.11032

———

5059178

0.70.82.7

8.41133

343984

1,2391,4924,003

——

6718

3541131

0.30.41.0

—

——

4.05.014

7489

208

——

273276

Total

12,15114,36931,666

1,2851,5644,032

171939

5.06.012

96114283

0.70.81.4

443527

1,038

8.49.921

4352119

183205271

4,5465,39612,427

2.42.74.5

5160150

300362807

2.73.29.2

1.21.42.3

3.33.86.3

3745101

588681

1,549

0.60.71.1

225263638


Dow




Countryand year

Niue199520002025

Palau199520002025

Papua New Guinea199520002025

Philippines199520002025

Republic of Korea199520002025

Samoa199520002025

Singapore199520002025

Solomon Islands199520002025

Sri Lanka199520002025

Thailand199520002025

Tonga199520002025

Tuvalu199520002025

Vanuatu199520002025

Vietnam199520002025

Population(000)

1.41.52.6

8.09.215

2,1462,4494,572

34,59939,55469,467

30,43132,90840,664

6982199

2,0062,1222,586

167207475

10,91412,13117,760

36,08839,98152,660

434981

6.06.79.5

7692195

38,80344,56180,166

Latin America and the Caribbean199520002025

Antigua and Barbuda199520002025

Argentina199520002025

Bahamas199520002025

Barbados199520002025

Belize199520002025

Bolivia199520002025

270,259305,400486,097

687487

21,32123,33432,427

169189272

183187233

101120255

3,6234,1678,058

Prevalence{ 0/ \\ (0 J

9.69.69.5

7.07.07.0

7.27.49.9

2.72.93.6

3.63.84.8

4.84.59.4

4.24.65.3

6.97.39.4

2.52.63.5

2.42.53.7

8.08.08.0

4.04.14.8

7.07.69.7

2.22.33.1

5.76.08.1

4.54.76.7

7.47.38.1

4.14.57.3

4.54.67.4

4.14.15.6

4.44.55.6

Rural

———

106116193

349376520

138148150

2.32.47.9

0.00.00.0

7.99.719

171190243

514563674

—

———

3.74.58.1

549636

1,088

2,0432,1673,005

——

888786

1.21.31.9

2.62.63.0

1.31.52.6

545780

Urban

———4865

261

592761

1,999

9611,1081,809

1.01.311

8598136

3.65.426

104128374

349454

1,248

——

———

1.72.511

321379

1,366

13,43516,08536,279

———

1,4901,6272,555

5.87.218

5.66.114

2.83.512

105130368

Male

0.10.10.1

0.30.30.5

7992

236

519626

1,339

584660976

1.51.49.9

465171

5.97.823

147167313

472550964

1.41.72.7

0.00.10.1

2.83.79.0

459543

1,297

6,4347,57216,054

1.51.72.8

742805

1,260

3.44.510

4.24.39.3

2.12.67.2

7689219


Female

0.10.10.1

0.30.40.6

7589

218

423511

1,180

515596982

1.82.38.8

394666

5.67.222

128151304

391467959

2.02.33.8

0.20.20.4

2.63.310

411471

1,157

9,06810,70623,275

1.61.83.0

836909

1,380

3.54.19.6

4.04.47.9

2.12.47.2

8398

230

I

20-44

—

———

38 •4599

414488862

431479422

0.91.54.7

343427

2.93.810

103115169

368422494

———

———

1.41.74.4

377460834

3,4253,9415,838

———

262280395

1.11.41.7

1.11.21.2

1.01.33.1

404799

ige (years)45-64

—

———88103269

428528

1,283

541618

1,120

1.30.912

405070

6.48.225

131156325

3894651084

———

———

3.03.910

368408

1,285

7,4048,81419,618

———

743804

1,221

4.15.212

3.84.49.7

1.72.07.7

8194

228

>65

——

———283286

100122375

127159416

1.11.31.8

111340

2.23.19.4

4047122

106130345

———

———

0.91.34.3

125147336

4,6495,49713,828

———

573630

1,024

1.62.06.2

3.33.06.4

1.41.63.5

3846121

Total

0.10.10.2

0.60.61.1

154181453

9421,1372,519

1,0991,2561,958

3.33.719

8598136

121545

275318617

8631,0171,923

3.43.96.5

0.20.30.5

5.37.019

8701,0152,454

15,50118,27939,329

3.03.55.8

1,5781,7142,641

6.98.620

8.28.717

4.25.014

159187449


Dow




Countryand year

Brazil

1995

2000

2025

Chile

1995

2000

2025

Colombia

1995

2000

2025

Costa Rica

1995

2000

2025

Cuba

19952000

2025

Dominica

1995

2000

2025

Dominican Republic

1995

2000

2025

Ecuador

1995

2000

2025

El Salvador

1995

2000

2025

Grenada

1995

2000

2025

Guadeloupe

1995

2000

2025

Guatemala

1995

2000

2025

Guyana

1995

2000

2025

Haiti

1995

2000

2025

Honduras

1995

20002025

Jamaica

1995

2000

2025

Martinique

1995

2000

2025

Mexico

1995

2000

2025

Netherlands Antilles

1995

2000

2025

Nicaragua

1995

2000

2025

Panama

1995

2000

2025

Population(000)

93,349

105,098

161,442

8,834

9,655

13,944

19,919

22,492

34,421

1,895

2,171

3,733

7,752

8,070

9,562

717882

4,276

4,850

7,695

6,040

7,034

12,154

2,718

3,224

6,153

92101113

280308417

4,744

5,634

12,422

488535804

3,554

3,957

7,138

2,555

3,063

6,630

1,451

1,585

2,360

258275347

50,178

57,649

94,977

133138180

1,892

2,324

5,415

1,494

1,688

2,657

Prevalence(%)

5.25.57.2

6.16.58.3

4.95.27.5

4.64.96.9

5.45.88.3

4.54.76.7

3.94.26.4

4.64.86.5

4.44.45.6

4.54.76.7

4.85.07.2

4.14.25.2

3.03.36.0

3.23.24.0

3.33.44.6

3.63.86.6

5.35.67.7

7.78.112.3

5.25.57.6

4.54.55.5

4.85.07.3

Rural

523532638

424453

150164235

252840

505154

———

374059

7176130

394263

———

2.32.42.9

7281119

6.37.112

646898

303360

181827

2.32.42.5

529578891

1.21.21.3

171833

192127

Urban

4,376

5,256

10,965

4965801,101

8271,006

2,345

6380217

366419743

———

128162432

206262660

8299284

———

111327

123154521

8.31137

4859187

5471246

3542128

111324

3,318

4,076

10,793

5.76.412

6787264

5364167

Male

1,962

2,325

4,669

251292553

4635541,236

4252127

226253430

1.51.82.6

90110267

136166377

5565158

2.02.33.6

6.97.815

96116307

7.59.124

5664143

4555163

283283

7.07.814

1,185

1,436

3,513

3.43.87.2

3949137

364296


Female

2,937

3,463

6,934

287332601

5146171,345

4656129

190216367

1.61.92.9

7592224

141172413

6577189

2.12.43.9

6.57.715

99120333

7.18.624

5664142

3949143

242872

6.87.513

2,661

3,218

8,172

3.53.86.5

4657160

364398

20-44

1,407

1,594

2,172

121137164

270312416

222642

495550

———

283551

7487151

273273

———

1.82.12.3

4959150

2.73.44.7

182142

151846

8.41115

1.61.81.9

5726901,092

0.81.01.1

232873

182030

Age (years)45-64

2,285

2,754

5,705

257302564

4555681,350

4252125

237273480

———

97119298

130161392

6068181

——

7.48.919

94111319

8.51031

6877178

4960184

2832101

7.68.416

1,803

2,176

5,679

4.34.57.8

4051148

344197

>65

1,207

1,440

3,726

161185427

252291815

242990

129142267

——

4049142

7389248

344293

4.24.59.3

5266171

3.44.212

273065

202676

161740

4.75.19.3

1,472

1,787

4,913

1.82.14.8

222776

202467

Total

4,899

5,788

11,603

5396241,154

9771,171

2,581

88107257

416470797

3.23.75.5

165202491

277338791

120142347

4.14.77.6

131630

195235640

151848

112128285

84104306

5360155

141527

3,847

4,654

1,1684

6.97.614

84106297

7285194


Dow




Countryand year

Paraguay199520002025

Peru199520002025

Puerto Rico199520002025

Saint Kitts and Nevis199520002025

Saint Lucia199520002025

Population(000)

2,4802,8685,675

12,83914,81424,915

2,4112,5913,303

414547

142155199

Saint Vincent and the Grenadines199520002025

Suriname199520002025

Trinidad and Tobago199520002025

Uruguay199520002025

Venezuela199520002025

Sub-Saharan Africa199520002025

Angola199520002025

Benin199520002025

Botswana199520002025

Burkina Faso199520002025

Burundi199520002025

Cameroon199520002025

Cape Verde199520002025

112123147

237252416

761833

1,269

2,1322,2362,645

11,66613,48323,503

263,048304,644665,976

4,7335,56112,861

2,3032,6545,980

679817

1,789

4,6725,23810,755

2,8013,2117,082

5,9877,005

15,421

182218454

Central African Republic199520002025

Chad199520002025

Comoros199520002025

1,5591,7623,436

2,9543,4216,814

268318818

Prevalence(%)

4.34.66.1

5.05.17.0

5.96.07.4

4.54.76.7

4.54.76.7

4.54.76.7

3.83.86.1

4.54.76.7

8.18.08.6

5.55.87.6

1.11.11.3

1.11.11.2

1.11.21.3

1.11.11.4

1.11.11.2

1.01.01.1

1.21.21.4

1.11.21.5

1.31.21.4

1.21.21.3

1.11.11.2

Rural

313455

109118170

171717

———

——

———

2.62.54.0

5.86.28.3

8.27.55.9

252327

1,7221,8993,166

343968

131422

4.04.58.4

374058

242858

363860

0.80.91.4

8.79.012

171926

1.82.03.7

Urban

7697

292

528643

1,571

124139226

———

——

6.37.121

283377

164171220

621761

1,749

1,2201,5505,209

172283

131753

3.24.718

131768

2.33.217

3646150

1.11.75.4

111335

192366

1.11.46.1

Male

5265174

314376867

7380125

0.91.01.5

3.13.56.4

2.42.84.7

4.54.913

182044

8083107

318386876

1,8232,1525,365

323898

161948

4.55.917

303481

151846

4554137

1.01.44.3

121329

232760

1.82.16.5


Female

5466173

323385874

6977118

0.91.11.6

3.33.86.9

2.63.05.1

4.44.712

161941

9295119

328398899

1,1251,3033,018

202353

101227

2.73.38.7

202246

111329

273173

0.91.12.5

7.98.818

131532

1.11.33.3

20-44

313570

164192312

151620

———

———

———

1.31.72.9

5.16.19.2

252631

173198317

1,3331,5653,679

232870

121434

3.74.710

222559

141635

303687

0.91.32.6

7.88.919

151838

1.31.64.6

Age (years)45-64

4864168

319378902

8090136

———

——

———

5.25.216

202351

7879108

315391887

1,1361,3313,385

202360

111230

2.63.412

192248

8.31028

293489

0.60.63.3

7.99.020

151740

1.11.34.0

>65

2732109

154191528

465087

———

———

———

2.52.85.8

9.31025

697388

159194572

473553

1,311

8.29.622

4.24.911

0.91.24.2

8.29.619

4.85.213

131534

0.50.60.9

3.84.28.0

5.86.714

0.40.51.3

Total

106131347

637761

1,741

141156243

1.82.13.2

6.37.313

5.05.89.9

8.99.625

343986

172179226

646784

1,775

2,9473,4558,383

5161151

263175

7.29.226

5057126

273175

7285

210

1.92.56.8

192247

364292

2.93.49.8


Dow




Countryand year

Congo199520002025

COte d'lvoire199520002025

Djibouti199520002025

Equatorial Guinea199520002025

Eritrea199520002025

Ethiopia199520002025

Gabon199520002025

Gambia199520002025

Ghana199520002025

Guinea199520002025

Guinea—Bissau199520002025

Kenya199520002025

Lesotho199520002025

Liberia199520002025

Madagascar199520002025

Malawi199520002025

Mali199520002025

Mauritania199520002025

Mauritius199520002025

Mozambique199520002025

Namibia199520002025

Population(000)

1,1381,2982,837

5,7986,70816,654

274317593

191210420

1,6171,8593,892

23,90427,65762,378

692760

1,412

550633

1,175

7,7819,079

20,232

2,8543,3107,373

520578

1,050

11,50313,66833,240

9701,1272,335

1,3331,5563,613

6,4247,59317,940

4,7625,23711,190

4,5635,31712,110

1,0491,2212,468

695763

1,059

7,2208,54517,900

734850

1,735

Prevalence(%)

1.11.11.2

1.21.11.2

1.41.41.6

1.21.21.2

1.01.01.2

1.01.01.1

1.41.41.4

1.11.11.3

1.11.21.3

1.11.11.2

1.21.21.3

1.11.11.3

1.11.11.3

1.21.31.3

1.11.11.2

1.01.01.0

1.01.11.2

1.21.31.4

1.31.41.8

1.11.21.3

1.21.21.4

Rural

7.07.411

353862

0.50.50.6

1.41.52.2

131528

200227429

4.75.06.2

3.74.15.7

475387

192133

3.94.15.1

7481136

7.68.413

7.48.113

455190

394288

313559

4.94.97.4

4.04.45.2

535173

4.95.38.3

Urban

6.07.424

3238133

3.44.18.8

0.81.03.0

2.93.817

4456255

4.85.613

2.33.19.9

4253182

121556

2.32.98.4

4965

307

3.34.518

9.21135

2432131

8.91126

162285

7.91128

5.36.213

2648155

3.84.916

Male

8.09.323

4551133

2.63.06.1

1.31.53.3

9.81127

147172427

5.86.412

3.74.49.5

5667171

192359

3.74.28.4

7894

307

6.47.619

111231

4251139

293269

293592

8.11023

5.66.310

4862147

5.46.415


Female

5.05.612

222662

1.41.53.3

0.91.01.9

6.67.718

97111257

3.84.27.2

2.32.86.1

333998

121331

2.42.85.1

4552136

4.65.312

5.97.017

273281

192145

192252

4.75.512

3.74.28.5

313881

3.33.88.7

20-44

5.86.716

3035100

1.61.83.6

0.91.02.3

7.58.719

113132315

3.43.77.8

2.83.26.0

4048113

151741

2.42.85.7

6073

211

4.55.312

7.08.321

323898

232555

232765

5.87.114

3.94.14.7

3544102

3.74.49.5

Age (years)45-64

5.05.614

273071

1.82.14.4

0.80.92.1

6.37.217

90104256

4.14.57.2

2.52.96.9

3542111

121436

2.62.85.5

4148177

4.35.113

6.57.519

263189

181941

182158

5.06.115

3.54.38.7

313992

3.44.010

>65

2.32.54.9

9.61124

0.50.61.4

0.50.50.9

2.63.28.2

4147114

2.12.44.1

0.81.02.7

141745

4.55.312

1.11.32.3

212454

2.12.56.2

3.13.78.3

111335

7.78.519

7.28.520

1.92.45.4

1.92.15.3

141734

1.51.84.3

Total

131535

6777

195

3.94.69.4

2.22.45.2

161945

244283683

9.61119

6.17.216

89106269

313689

6.16.914

123146442

111331

171948

6983

221

4853114

4856144

131635

9.31119

7999

228

8.71024


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Countryand year

Niger199520002025

Nigeria199520002025

Reunion199520002025

Rwanda199520002025

Population(000)

3,7804,43210,616

49,36957,297124,633

402443641

3,3923,9718,496

Sao Tome and Principe199520002025

Senegal199520002025

Seychelles199520002025

Sierra Leone199520002025

Somalia199520002025

South Africa199520002025

Sudan199520002025

Swaziland199520002025

Togo199520002025

Uganda199520002025

505576

3,7124,3299,075

444867

2,0622,3154,460

3,9014,55210,492

21,75124,79944,663

12,72514,87930,995

388466986

1,8202,1264,841

8,6559,927

23,242United Republic of Tanzania

199520002025

Zaire199520002025

Zambia199520002025

Zimbabwe199520002025

12,93215,00933,073

18,30821,24050,658

3,9514,54210,166

5,0975,72311,781

Prevalence(%)

1.01.0I.I

1.21.21.3

1.51.52.0

0.90.91.0

1.31.31.3

1.21.21.3

10.010.010.0

1.21.21.3

1.11.11.2

1.41.41.6

1.11.11.3

1.11.11.4

1.11.11.2

1.00.91.0

1.01.11.2

1.11.11.2

1.11.11.2

1.11.11.3

Rural

313570

275299437

1.51.51.7

293368

——

222436

———

121215

283155

93102133

90104165

2.32.54.3

131425

7077151

90100170

132148262

212544

293048

Urban

6.68.642

301387

1,221

4.35.311

2.93.719

———

212784

———

131643

141868

205245588

4858

227

1.92.69.8

7.19.134

131884

4358

232

6883

329

222483

2734109

Male

222669

360431

1,061

3.44.06.8

192253

0.40.40.6

273278

1.71.92.6

151738

263180

186216438

85100246

2.63.29.2

121437

5058151

8398

260

122142386

283287

3742104


Female

151843

216254597

2.42.85.7

131534

0.30.30.4

161843

2.62.94.0

9.31021

161843

112130282

5362146

1.61.94.9

8.09.222

333685

5160142

7889

205

151740

202253

20-44

182154

258304699

2.22.53.1

161942

———

192351

———

111225

202358

122138247

6372

163

2.02.45.6

8.71026

4249124

6376184

90106285

212563

283371

Age (years)

45-64

131641

233279696

2.42.85.8

111232

———

172052

———

101125

161949

122146325

5465162

1.62.06.4

7.79.023

283183

5158160

7787

223

161750

202365

>65

5.76.817

85102263

1.31.53.6

5.15.812

———

6.67.718

———

3.74.28.5

6.47.317

5462149

222566

0.60.72.1

3.54.110

131529

202458

333884

5.86.514

8.29.221

Total

3744112

576685

1,658

5.86.813

323786

0.70.71.0

4351121

4.44.86.7

242859

4249123

298346721

138162392

4.25.114

202359

8394

236

134158402

200231591

4248127

5664157

Separate urban and rural estimates were not calculated for demographically developed and some small island countries. Some small island countries also lack age-specific estimates. Developed countries comprise EME and FSE. Developing countries are all others.


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