Two major concerns are that much of this increase in Diabetes will occur in developing countries and that there is a growing incidence of Type 2 Diabetes at a younger age including some obese children even before puberty. In developed countries most people with diabetes are above the age of retirement. In developing countries those most frequently affected are in the middle, productive years of their lives, aged between 35 and 64.
The risks of type 2 Diabetes mellitus in Asian countries tend to increase sharply at levels of BMI generally classified as acceptable in European and North American white people. There have been suggestions to adopt specific classifications of obesity in Asians (e.g. BMI 23 for overweight and 25 or 27 kg/m2 for obesity) and this will greatly affect the prevalence estimates of obesity worldwide currently at about 250 million people.
Each year 7 million people develop Diabetes and the most dramatic increases in type 2 Diabetes have occurred in populations where there have been rapid and major changes in lifestyle, demonstrating the important role played by lifestyle factors and the potential for reversing the global epidemic. A person with type 2 diabetes is 2 – 4 times more likely to get cardiovascular disease, and 80% of people with Diabetes will die from it. Premature mortality caused by diabetes results in an estimated 12 to 14 years of life lost. A person with Diabetes incurs medical costs that are two to five times higher than those of a person without diabetes.
The annual direct healthcare costs of diabetes worldwide, for people in the 20–79 age groups, are estimated to be as much as 286 billion.
High economic and social costs of type 2 Diabetes and its rising prevalence make a compelling case for its prevention. Intervention prior to the onset of type 2 Diabetes may be the only way of preventing the complications of Diabetes. Because of its chronic nature, the severity of its complications and the means required to control them, diabetes is a costly disease, not only for affected individuals and their families, but also for the health systems.
Diabetes mellitus (DM) comprises a group of common metabolic disorders that share the phenotype of hyperglycemia. Several distinct types of DM exist and are caused by a complex interaction of genetics, environmental factors, and life-style choices. Type 1A DM results from autoimmune beta cell destruction, which leads to insulin deficiency. Individuals with Type 1B DM lack immunologic markers indicative of an autoimmune destructive process of the beta cells.
Progress has been achieved in identifying some genes that predispose individuals to developing type 2 Diabetes. Identification of susceptibility genes for Diabetes and its complications will enable earlier implementation of prevention measures targeted to those at highest risk. Identification of genes will also reveal new targets for drug development.
Obesity is one of the principal risk factors for type 2 diabetes. Weight gain leads to insulin resistance through several mechanisms. Clinical trials show that as little as 5% weight loss is sufficient to prevent most obese subjects with impaired glucose tolerance developing type-2 diabetes.
Diabetes is the fourth leading cause of death in most developed countries. Complications from Diabetes, such as coronary artery and peripheral vascular disease, stroke, diabetic neuropathy, amputations, renal failure and blindness are resulting in increasing disability, reduced life expectancy and enormous health costs for virtually every society.
Diabetes is certain to be one of the most challenging health problems in the 21st century.
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