Approximately 80%-85% of diabetics are type II, and its prevalence and disease proportion are dramatically on the rise in most countries of the world. Keeping blood sugar under control in diabetes has been associated with lessening the risk for complications such as myocardial infarction, stroke, kidney failure, blindness, nerve transmission difficulties, skin ulceration, and various other difficulties.

The World Health Organization estimates that there are over 150 million diabetics in the world, although less than one third of them have been diagnosed. The market for insulin is likely to grow at 4% per year over the next 20 years as the developed world's overall population ages and becomes more affluent, factors that correlate with a sedentary lifestyle and increase the risk of type II diabetes.

Guidelines from the American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE) call for more aggressive goals for diabetes treatment as well as earlier screening of people at high risk for the disease. Their call for screening to begin at age 30 rather than age 45 in high-risk groups should translate into increased use of insulin and oral hypoglycemics.

The ACE/AACE guidelines not only lower the target for the glycosylated hemoglobin (HbA1c, long term sugar control) test to 6.5% from 8%, but also eliminate any difference between a "target level" and an "action level." The guidelines also set tighter targets for plasma glucose, which should also increase insulin and oral hypoglycemic use in the U.S. These guidelines are positive for insulin sales as well as the oral hypoglycemic market. While medical society guidelines are not always strictly followed, these recommendations have come at a time of heightened patient and physician disease awareness and will generate a trend toward more rigorous management of diabetes. Adherence to these guidelines, slowly being accepted in general internal medicine practice, requires far more rigorous anti-diabetes drug protocols.