The undertaking that I gave on becoming President of the International Diabetes Federation is the same undertaking that was given by every President since the founding of our Federation more than sixty years ago – including such illustrious figures as Maria de Alva, Sir George Alberti, Pierre Lefèbvre, Martin Silink and, my immediate predecessor, Jean Claude Mbanya. But I assume the Presidency under extraordinary circumstances never before experienced by the Federation. This is a moment of history that troubles our minds and hurts our hearts. Never before has diabetes blighted the lives of so many millions of people worldwide: by our own guarded estimates, 371 million are affected as I write, and millions more with impaired glucose tolerance, the evidence of pre-diabetes. For every minute it takes you to read this page, between eight and 10 people will have died of the complications of diabetes.