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Woman using diabetes test kitJeffrey Hamilton/Getty Images

Diabetes is running at record levels worldwide and half the people estimated to have the disease are, as yet, undiagnosed, according to a report released Wednesday.

The number of people living with diabetes is now put at 371 million, up from 366 million a year ago, with numbers expected to reach 552 million by 2030, the International Diabetes Federation (IDF) said.

Diabetes is often viewed as a Western problem, since the vast majority of people have type 2 disease which is linked to obesity and lack of exercise. (Type 1 diabetes is an auto-immune disease the results in the destruction of cells that produce insulin.)

But the disease is also spreading rapidly in poorer countries, alongside urbanization, and four out of five diabetics now live in low and middle-income countries, opening up new opportunities and challenges for the drug industry.

China alone has 92.3 million people with diabetes, more than any other nation in the world, and the hidden burden is also enormous in sub-Saharan Africa where limited health care means less than a fifth of cases get diagnosed.

The IDF estimates that, globally, 187 million people do not yet know they are suffering from the condition.

People with type 2 diabetes have inadequate blood sugar control which can lead to serious complications, including nerve and kidney damage and blindness. Worldwide deaths from the disease are running at 4.8 million a year.

The disease is one of a number of chronic conditions – along with cancer, cardiovascular and respiratory diseases – that health-care campaigners want included in the next set of global development goals, which will replace outgoing Millennium Development Goals in 2015.

For the international pharmaceutical companies, diabetes represents a huge source of revenues, with global sales of diabetes medicines expected to reach $48-billion to $53-billion (U.S.) by 2016, up from $39.2-billion in 2011, according to research firm IMS Health.

Tapping into the potential of increased demand in emerging markets, however, requires a twin-track approach from drug companies which have traditionally focused on pricey new therapies for rich-world markets.

These days, there is a lot more focus on high-volume but lower-margin business in developing economies, many of which are predicted to show high double-digit percentage sales growth for diabetes medicines for years to come. Some drug-makers such as Sanofi, which has a significant presence in Africa, are adopting "tiered" or differential pricing to open up developing world markets.

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