**2. Diabetes as global public health problem**

According to the International Diabetes Federation (IDF) [6], Diabetes Mellitus remains a public health problem. About 537 million people are living with diabetes, constituting a global prevalence rate of 10.5%. Recent reports indicate that more than 1 in 10 adults is diagnosed with diabetes globally. In some countries, one in five person adults is diagnosed with diabetes [6]. It is projected that 643 million and 783 million persons may have diabetes in 2030 and 2045, respectively. Over this period, diabetes estimation is said to increase by 46%, surpassing the estimated world population growth. In Africa, there are 24 million persons living with diabetes [4]. About 360 million residing in urban areas have diabetes, with a prevalence rate of 12.1%, compared with 176.6 million people in rural areas with a prevalence of 8.3%. Diabetes has been reported to be more prevalent among men compared to women. The Middle East and North Africa regions have the highest prevalence of diabetes at 18.1%. However, Africa has the lowest global diabetes prevalence rate, at 5.3%. China, India, and Pakistan have the highest prevalence of diabetes globally [6].

Undiagnosed diabetes poses serious a threat, with global estimates of 87.5% of cases in low- and middle-income countries. However, low-income countries have the highest estimation of undiagnosed diabetes at 50.5% compared to 28.8% in high-income countries [6]. Africa has the highest estimates of undiagnosed diabetes at 53.6%, followed by Western Pacific at 52.8% and South-East Asia at 51.3%. North America and the Caribbean region have the lowest estimate of undiagnosed diabetes at 24.2% [6].

Diabetes has recently been found to be a high-risk Non-Communicable Disease (NCD) linked to Coronavirus Disease-2019 (COVID-19) deaths worldwide. Higher susceptibility to COVID-19 among patients with diabetes is attributed to an impaired immune response due to chronic metabolic dysfunction [7].

Patients with diabetes may develop complications or other health problems such as cardiovascular disease, hypertension, erectile dysfunction, retinopathy, and

kidney disease [8]. It has been reported by several studies that the identification of risk factors can serve as benchmarks to design appropriate prevention measures and minimize the risk and severity of complications [9–10]. The next section discusses the cost of managing diabetes as a sub-topic to illustrate the severity of diabetes as a global public health problem.
