• Africa: 78% of people with diabetes are undiagnosed
• Europe: the highest prevalence of type 1 diabetes in children
• Middle East and North Africa: 6 of the top 10 countries by diabetes prevalence
• North America and Caribbean:  1 adult in 10 has diabetes
• South and Central America: 12.3% of all deaths were due to diabetes
• South-East Asia: almost one-fifth of the world's people with diabetes live in just seven countries
• Western Pacific: 132 million adults have diabetes, the largest number of any region

An overview of all regions

Most people with diabetes live in the economically less developed regions of the world. Even in the region with the lowest prevalence (Africa) it is estimated that around 280,000 deaths are attributable to diabetes in 2011. While more than 80% of people with diabetes live in low- and middle-income countries only 20% of global healthcare expenditures on diabetes were spent in these countries, reflecting huge disparities.

An overview of each of the seven IDF regions is presented here to allow for a better understanding of the diabetes burden and its consequences. Each region is highly diverse not only in socio-economic and geographical terms but also in diabetes prevalence, mortality and healthcare. On the following pages more information is provided about each region.

Diabetes and impaired glucose tolerance (IGT) prevalence

The Western Pacific Region has the largest number of people with diabetes with 132 million while the Africa Region the smallest number with 14.7 million in 2011. However, the Middle East and North Africa Region has the highest prevalence of adults with diabetes at 11.0% in 2011, followed closely by the North America and Caribbean Region at 10.7%. After the Africa Region, the prevalence of the Europe Region is the lowest at 6.7% (Table 3.0).

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The picture is similar for IGT. The Western Pacific Region is estimated to have the greatest number of people with some 85 million in 2011, although the North America and Caribbean Region has the highest comparative prevalence of IGT (10.7%). Overall, the prevalence of IGT was generally lower than that of diabetes, except in the Europe and the North America and Caribbean regions which have a higher prevalence.

Mortality

Mortality attributable to diabetes ranges from 6.1% of all deaths in those aged 20-79 years in the Africa Region to over 15% in the Western Pacific Region. Beyond 49 years of age, diabetes constituted a higher proportion of all deaths in women than in men in all regions, reaching over 20% of all deaths in some regions and age groups (Section 2.4). These estimates suggest that diabetes is a considerable cause of death and investing in reducing this burden is justified and necessary.

Healthcare expenditures

The disparities between the regions can clearly be seen in the healthcare expenditures for diabetes. The North America and Caribbean Region spent an estimated USD 223 billion or 48% of the global healthcare expenditures for diabetes in 2011.  The Europe Region spent about half that amount at USD 130 billion. These two regions combined had the highest expenditures due to diabetes in 2011.  In comparison, the Western Pacific Region spent only USD 72 billion on diabetes healthcare despite having the largest number of people with diabetes. The South and Central America and Middle East and North Africa Regions each spent less than 5% of the global total on healthcare expenditures due to diabetes, while the Southeast Asia and Africa Regions spent less than 1% in 2011.

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