Applying recent findings to clinical care in type II diabetes.

There is a global perspective to the economic consequences of diabetes, which is illustrated in the many publications now being produced on this subject. Because of the higher prevalence of type II diabetes, its impact is greater than that of type I diabetes in both developed and developing countries (but particularly in the latter). It has frequently been argued that advances in the therapy of diabetes and, in particular, advances in the prevention of diabetic complications, will reduce the costs of care. This may well be the case. However, the effects of these preventive measures on the quality of life of individuals living with diabetes and on the indirect costs of diabetes are likely to be much more marked than their effects on direct costs. The economic arguments for applying these findings are compelling in the long term but, in the short term, their application entails considerable investment. While the capacity of any country to make these investments is limited, the capacity of developing countries to make these even short term investments is severely limited and will be further taxed as noncommunicable diseases such as diabetes become more and more prevalent while the problems of treating and preventing communicable diseases remain a challenge.