South-East Asia at a Glance
|Total population (millions)||1,439||1,788|
|Adult population (20-79 years,millions)||838||1,200|
|Diabetes and IGT (20-79 years)|
|Regional prevalence (%)||7.0||8.4|
|Comparative prevalence (%)||7.6||9.1|
|Number of people with diabetes (millions)||58.7||101.0|
|Regional prevalence (%)||5.8||6.4|
|Comparative prevalence (%)||6.2||6.9|
|Number of people with IGT (millions)||48.6||76.4|
|Type 1 diabetes (0-14 years)|
|Number of children with type 1 diabetes (thousands)||113.5|
|Number of newly-diagnosed cases per year (thousands)||18.3|
|Diabetes mortality (20-79 years)|
|Number of deaths, male (thousands)||476.9|
|Number of deaths, female (thousands)||666.0|
|Health expenditure for diabetes (USD)|
|Total health expenditure, R=2, (billions)||3.1||5.3|
Although the South-East Asian Region comprises only seven countries, it is one of the most populous regions in the world. The adult population of India will account for 85% of the region's total population in 2010. There is a wide gap in per capita GDP with Mauritius having the highest at USD12,400, while the other countries all have less than USD5,000, although India which has had an annual growth of 7.3% was experiencing economic development at a faster pace than almost anywhere in the world, except its neighbour, China 1 .
Diabetes and IGT prevalence
Current estimates show that 7.0% of the adult population, or 58.7 million people, will have diabetes in 2010. Studies 2 3 indicate that diabetes prevalence in smaller urban centres (100,000 – 1,000,000 inhabitants) tends to be about half of the larger cities, but still twice that of rural areas (less than 100,000 people).
The anticipated increase in regional diabetes prevalence to 8.4% in 2030 is very much a consequence of the increasing life expectancy in India (the proportion of the population over 50 years is expected to increase from 16% to 23% between 2010 and 2030), and of the urbanization of the population (the proportion living in urban settings will increase from 33% to 46%). Evidence suggests that in more affluent parts of the country, the rural prevalence is higher than in less affluent rural areas 4 , indicating that increasing economic growth will raise diabetes prevalence in India even more than these possibly conservative estimates have indicated. With regard to IGT, the same pattern as for diabetes emerged, with large cities having twice the prevalence of smaller cities, for which the prevalence is twice that of rural areas.
Mauritius, the second smallest country of the region, highlights the extent to which people of Indian origin appear predisposed to diabetes, when exposed to more affluent economic circumstances. This island has one of the world’s highest diabetes prevalence rates with 17% of the adult population affected by diabetes.
India accounts for most of the estimated 114,000 cases of type 1 diabetes in children in the region. The incidence rate for India was frequently used in extrapolation for other countries in the region and therefore plays a pivotal role in the estimates. The large childhood population in India and the widespread use of the Indian data for extrapolation have important consequences not only for the regional total but also for the worldwide estimate. This region contributes more than any other to the worldwide total. Diabetes-associated mortality in children is also likely to play an important role in this region, but unfortunately there is inadequate information to address these issues.
The SEA Region is projected to have the highest number of deaths due to diabetes of all the regions in 2010. An estimated 1.1 million adults is expected to die from diabetes-related causes, accounting for 14.3% of all deaths in the 20-79 age group. Mortality due to diabetes may account for almost a quarter of all deaths in women in the 50-59 age group and 15% of deaths in men in the same age group (see Figure 3.6).
In spite of the large number of people with diabetes in the SEA Region, spending on healthcare for diabetes is expected to be only USD3.1 billion for the region, accounting for less than 1% of the global total. Most of the estimated spending is predicted to occur in India.
National Diabetes Programme
Only one-third of countries in this region responded to the IDF member association survey. According to survey responses, national diabetes programmes have yet to be implemented in this region.
Map 3.6 Prevalence (%) estimates of diabetes (20-79 years), 2010, South-East Asian Region
1: Central Intelligence Agency. The World Factbook. 2008. https://www.cia.gov/library/publications/the-world-factbook/
2: Sadikot SM, Nigam A, Das S, et al. The burden of diabetes and impaired glucose tolerance in India using the WHO 1999 criteria: prevalence of diabetes in India study (PODIS). Diabetes Res Clin Pract 2004; 66 (3): 301-307.
3: Mohan V, Mathur P, Deepa R, et al. Urban rural differences in prevalence of self-reported diabetes in India--the WHO-ICMR Indian NCD risk factor surveillance. Diabetes Res Clin Pract 2008; 80 (1): 159-168.
4: Kutty VR, Soman CR, Joseph A, et al. Type 2 diabetes in southern Kerala: variation in prevalence among geographic divisions within a region. Natl Med J India 2000; 13 (6): 287-292.