Diabetes mellitus in Iceland: Prevalence, organization of services, pregnancy outcome and long-term complications

In keeping with the St. Vincent Declaration the state and outcome of diabetes care in Iceland has been evaluated. In 1974 the management of diabetes was centralized at the diabetic clinic, the National University Hospital, Reykjavik. In 1989 a validated prevalence of Type I (insulin-dependent) diabetes was 1.44/1,000 (population 251,742) and the estimated prevalence of Type II (non-insulin dependent) diabetes treated with oral antidiabetics was 5.36/1,000. When compared to the other Nordic countries, Iceland has the lowest prevalence of both types of diabetes mellitus. During 1981-1990 there were 86 diabetic pregnancies with a perinatal mortality of 2.3%, with no perinatal mortality from 1983. Fetal anomalies were 2.3%. The prevalence of diabetic blindness is approximately 0.3% for both Type I and Type II diabetes. The prevalence of diabetic end-stage renal failure is also very low with only 7 diabetic (5 Type I and 2 Type II) patients having needed dialysis since 1968. Of all patients who have needed dialysis in Iceland, diabetic patients represent only 7%. Of the 5 Type I diabetic patients 4 have received kidney transplants and no longer require dialysis.