Diabetes is moving from being a disease of developed countries to a disease in developing countries like India and China, and this could put pressure on healthcare systems through rising healthcare costs, said Philip Clarke, associate professor at University of Sydney's School of Public Health.

Clarke and his colleagues examined records of 11,140 patients with severe diabetes in 20 countries, including the complications they suffered, money spent and length of hospital stays; and they found diabetes hit healthcare costs more severely in poorer countries.

Patients in Asia and Eastern Europe had higher incidence of some events (eg. stroke) than patients in established market economies, lower rates of hospitalization and longer lengths of stay, according to the report.

While average per capita spending on healthcare in China was around $216 (international dollars) a year, health expenditure for a diabetic who ends up with stroke would be 10 times more, or $2,166, according to the study, which was published in the latest issue of PLoS Medicine.

International dollar is the equivalent of the US dollar but adjusted for purchasing power across countries.

We know there are efficient ways of reducing these rates of complications. If you can stop people having strokes through blood pressure control, you can clearly reduce these patients' healthcare costs, Clarke told Reuters by telephone.

Nearly 250 million people worldwide have diabetes and this number is increasing, with three quarters of all people with diabetes living in the developing world.

The 20 countries involved in the study are China, India, Malaysia, the Philippines, the Czech Republic, Estonia, Hungary, Lithuania, Poland, Russia, Slovakia, Australia, Canada, France, Germany, Ireland, Italy, the Netherlands, New Zealand and Britain.

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