EPIDEMIOLOGY OF DIABETES MELLITUS IN BULGARIA

The prevalence of diabetes mellitus in Bulgaria was assessed in 1990 and 1993 by gathering information from a countrywide public health care system. A constant increase of prevalence rate was established beginning from 0.19% in 1963 to 1.61% in 1990 and reaching 1.71% in 1993. Higher prevalence rate was registered in central districts of the country, while in peripheral districts with insufficient specialized diabetological health care it was reported to be unusually low, under 1.0%. Differences in the districts are probably due to insufficient early detection, hidden prevalence and poor registration. Information about diabetic complications was gathered in 1990 and 1994. Prevalence rate of diabetic complications in Bulgaria was comparable with that in other European countries. National Diabetes Care Program from 1987 and implementation of Saint Vincent Declaration since 1989 resulted in a decrease of proliferative retinopathy from 3.3% in 1990 to 2.9% in 1994, blindness due to diabetes from 0.87% to 0.37%, total number of amputations from 1.90% to 0.64% and amputations above the ankle from 0.13% to 0.04%, respectively. Mortality due to diabetes mellitus was increasing constantly from 8.59/100000 population in 1973 to 18.95/100000 population in 1993. However, in the last seven years, mortality rate increased more slightly with a tendency to reach a plateau level in the next several years - around 19.0/100000. This might be due to increased efforts in the struggle with diabetes mellitus of the health care providers, diabetologists and lay persons organizations. Biomedical Reviews 1996; 5: 57-63.