Diabetes in the Americas.

Diabetes mellitus is an important cause of disability and death throughout the Americas. Of the three main types (insulin-dependent, noninsulin-dependent, and malnutrition-related), virtually all cases in the Americas are either insulin-dependent (generally assessed in terms of incidence and usually occurring in subjects under 30) or noninsulin-dependent (generally assessed in terms of prevalence and usually occurring in subjects over 30). Data on noninsulin-dependent diabetes mellitus (NIDDM) in various parts of the Americas point to prevalences ranging from 1.4% (among the Mapuche Indians in Chile) to 14.1% (among residents of Mexico City). However, the use of different methods and standards to gather and analyze these data renders comparison of the NIDDM situations in different countries uncertain. A fair amount of comparable data on insulin-dependent diabetes mellitus (IDDM) have been gathered in various countries of the Region. These point to marked differences in annual incidence--ranging from 0.7 cases per 100,000 in Peru to 27 among males on Prince Edward Island, Canada--that have not been adequately explained, underlining the need for additional comparable data. Considering the seriousness of the disease, it is important to know how many people have and develop diabetes, so as to be able to take preventive and therapeutic measures and guide public health actions. Hence, further cooperation directed at effective standardization of procedures and goals is indicated. Such cooperation, which should also come to include standardized national and hemispheric diabetes programs, must be achieved in accordance with the resources available to each country.