Abstract
This paper analyses the patterns of rising type 2 diabetes prevalence in the world with their plausible reasons focusing on control measures. It shows existence of combinations of three patterns of rises, viz. gradual, rapid and accelerated, leading to prevalence of 4-9% now in Europids, 14-20% in migrant or urbanized Asian Indians, Arabs, Chinese, Africans, and Hispanics and above 30-50% in indigenous peoples of Canada, USA, Australia and Pacific regions. It demonstrates that though ageing, sedentary life and obesity of people explain gradual rise in Europids, effects of rapid transition in nutritional status of population and of maternal hyperglycaemia on the risk of offspring developing glucose intolerance further add to rapid and accelerated rises respectively. It recommends that current approach of primary prevention of diabetes in people, particularly with impaired glucose tolerance, advocating modest loss of excess weight and moderate-intensity exercise, be widen into concept of control in community covering rapid and accelerated rises. The control programmes essentially are vigorous educational campaign and planning to improve nutritional status of women of childbearing age in rural and poorer sectors of society and to keep weight of adults within recommended body mass index (BMI) range, like 18.5-22.9 kg/m2 for Asian and other similar populations. The population-based approaches with examples, considering developing countries, are outlined. The paper emphasizes the importance of keeping prepregnancy weight optimum, preferably below the middle of recommended BMI range, to avoid even sub-clinical maternal hyperglycemia, for prevention and control of accelerated rise in any population.
Highlights
INTRODUCTIONCurrent literature indicates that diabetes (type 2 diabetes) is increasing – and increasing rapidly – all over the world.[1] Ethnicity is considered to be an important factor in diabetes development with higher rates being reported in Asians, Hispanics, African Americans and indigenous peoples of the USA, Canada, Australia and Pacific regions.[1]
Current literature indicates that diabetes is increasing – and increasing rapidly – all over the world.[1]
Ethnicity is considered to be an important factor in diabetes development with higher rates being reported in Asians, Hispanics, African Americans and indigenous peoples of the USA, Canada, Australia and Pacific regions.[1]
Summary
Current literature indicates that diabetes (type 2 diabetes) is increasing – and increasing rapidly – all over the world.[1] Ethnicity is considered to be an important factor in diabetes development with higher rates being reported in Asians, Hispanics, African Americans and indigenous peoples of the USA, Canada, Australia and Pacific regions.[1]. Further diabetes prevalence is similar in different migrant or urbanized ethnic groups like Asian Indians, Arabs, Chinese, Africans, and Hispanics.[1,3,4,5,6] The heterogeneity in diabetes prevalence in the world is no doubt rooted in more recent environmental events rather than genetic factors.[5,7] Effects of environmental factors right from the conception to adult life need to be considered. Diagrammatic representation of increase in diabetes prevalence in different populations of the world
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