It's not one of those things you really want someone to notice when they step off the plane at Port Columbus. "I am struck by seeing the fatness that is around," said Dr. Pierre Lefébvre, former president of the International Diabetes Federation in Belgium and the speaker who opened Ohio State University's two-day international summit on diabetes at Easton yesterday.

Widening waistbands are hardly our city's problem alone. Obesity has fueled a global health threat that grows rapidly each year. In nations where it once was a minor concern, Type 2 diabetes, the kind that used to be the problem of paunchy middle-aged adults, is increasing in children.

Hundreds of scientists, doctors and others signed up for the meeting, both to learn more about the burgeoning toll of the disease and to share ideas on how to reverse the trend.

Public-health leaders started to warn of an increasing incidence of diabetes four decades ago, Lefébvre told the crowd.

Today, they're watching the numbers soar worldwide.

About 246 million people 20 to 79 years old have the disease, he said, and the number is projected to jump to 380 million by 2025.

Eighty percent of those cases are expected to occur in developing countries.

There are islands in the Pacific where a third of the population has diabetes, Lefébvre said.

An increasingly Westernized world (think french fries, double cheeseburgers and a sedentary lifestyle) has been blamed in part for the diabetes crisis.

The health ramifications are distressing: cardiovascular disease, lower survival rates after a heart attack, amputations and blindness.

Diabetes is expected to cause 3.8 million deaths worldwide this year. That's about 6 percent of deaths and about the same as lives lost to HIV and AIDS.

And the financial fallout is staggering. In the United States, where 19 million people have the disease, $135 billion is spent each year, Lefébvre said.

Leaders around the world are beginning to realize the severity of the diabetes problem, the costs both to individuals and society, and the work that must be done to drive the numbers down, said Dr. Chip Souba, interim executive office of the OSU Medical Center.

In Ohio, advocates continue to push for a law to require health-insurance policies to cover diabetes supplies including glucose-monitoring strips.

All but two states have passed similar laws, said Dr. Aaron Kowalkski, director of strategic research projects for the Juvenile Diabetes Research Foundation.

"It's shocking, actually," he said of the absence of an Ohio law.

"Maybe this is the year that it will happen," he said, adding that Gov. Ted Strickland has said he's supportive.

In Ohio, 8 percent of adults -- or about 685,600 people -- have diabetes, according to statistics from 2003 to 2005.

In minority populations, the numbers are even higher. More than one in 10 blacks and Latinos in Ohio have the disease.

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