The insulin dependent (IDDM) and non-insulin dependent (NIDDM) forms of diabetes mellitus were previously considered to be rare in most developing countries, but recent evidence shows that the frequency of NIDDM has risen rapidly in some developing country populations, particularly in Asia and the Western Pacific. Studies on the indirect and direct costs of diabetes, mainly from the USA, suggest that the economic burden due to the disease and its complications is very large, but equivalent studies from developing countries are virtually non-existent. Although there is some evidence that the incidence of NIDDM could be reduced, the prevention of diabetes in developing countries does not appear to be a viable policy option. The priority lies with a broad approach to the prevention of a range of non-communicable diseases, including diabetes, and to improved case diagnosis and management. The direct costs in case management in many developing countries will be dominated by the relatively high costs of insulin and oral hypoglycaemic drugs. A major priority is for further research on the incidence, aetiology and prevention of IDDM and NIDDM in developing countries, particularly Africa and Latin America.
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