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The growing pandemic of type 2 diabetes: a crucial need for prevention and improved detection
Paul Z. ZIMMET,AO, MD, PhD, FRACP, FRCP, FTSE
Baker IDI Heart and Diabetes Institute, Caulfield, Melbourne
Victoria, AUSTRALIA
Changes in human behavior and lifestyle associated with globalization have resulted in a dramatic increase in the prevalence and incidence of type 2 diabetes globally. Until recently, there was a strong emphasis on genetic susceptibility, and on environmental and behavioral factors such as a sedentary lifestyle, overly rich nutrition, and obesity (particularly central adiposity). More recently, focus has shifted to the potential contribution of the maternal environment and the impact of in-utero influences, ie, the role of epigenetics. This may be an important factor in the very high prevalences of type 2 diabetes now being seen in nations such as India and China, two countries that numerically bear the main brunt of the epidemic. Type 2 diabetes is appearing increasingly in children and adolescents, and the frequency of diagnosis of pediatric type 2 diabetes is outstripping that of type 1 diabetes in some countries already. The prevention of diabetes and control of its micro- and macrovascular complications will require a major integrated approach directed at societal and individual behavioral change if we are to see significant reduction in the huge premature morbidity and mortality it causes. Diabetes is looming as one of the greatest threats to public health in the 21st century. This is an impelling rationale for strengthening efforts for its prevention and control.
Medicographia. 2011;33:15-21
Paul Z. ZIMMET,AO, MD, PhD, FRACP, FRCP, FTSE
Baker IDI Heart and Diabetes Institute, Caulfield, Melbourne
Victoria, AUSTRALIA
Changes in human behavior and lifestyle associated with globalization have resulted in a dramatic increase in the prevalence and incidence of type 2 diabetes globally. Until recently, there was a strong emphasis on genetic susceptibility, and on environmental and behavioral factors such as a sedentary lifestyle, overly rich nutrition, and obesity (particularly central adiposity). More recently, focus has shifted to the potential contribution of the maternal environment and the impact of in-utero influences, ie, the role of epigenetics. This may be an important factor in the very high prevalences of type 2 diabetes now being seen in nations such as India and China, two countries that numerically bear the main brunt of the epidemic. Type 2 diabetes is appearing increasingly in children and adolescents, and the frequency of diagnosis of pediatric type 2 diabetes is outstripping that of type 1 diabetes in some countries already. The prevention of diabetes and control of its micro- and macrovascular complications will require a major integrated approach directed at societal and individual behavioral change if we are to see significant reduction in the huge premature morbidity and mortality it causes. Diabetes is looming as one of the greatest threats to public health in the 21st century. This is an impelling rationale for strengthening efforts for its prevention and control.
Medicographia. 2011;33:15-21