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To estimate the incidence and prevalence of diabetes among adults in Manitoba, Canada, from 1986 to 1991.A population-based database of individuals diagnosed with diabetes (Manitoba Diabetes Database) was created using data from Manitoba Health's comprehensive insurance system. Using this database, estimates of the annual incidence and prevalence of diabetes among Manitoba adults aged greater or equal to 25 years were made for the years 1986-1991. Age-specific and age-adjusted rates were calculated separately for men and women.The prevalence of diabetes in 1991 was 66.9/1,000 among adults greater or equal 25 years. Between 1986 and 1991 the age-adjusted prevalence rose steadily among both men and women. In 1991, the incidence of diabetes was 5.6/1,000. After an observed decline prior to 1989, the annual incidence of diabetes appears to be relatively stable.The prevalence of diabetes is increasing steadily despite relatively stable incidence rates. Population-based data are required for projecting future trends and are an important tool for planning the required health resources.