THE DIABETIC EPIDEMIC

This is my first medical topic. As had mentioned before, I wish this site to be one that my readers will benefit. So be prepared for a scientific account of Diabetes Mellitus, Type 2.

Diabetes is the 4^th largest cause of mortality in developed countries and becoming an epidemic in many developing countries.

Prevalence

Worldwide, about 285 million or 6.6% of age group 20-79 had diabetes in 2010. And this is expected to increase to 438 million or 7.8% of adult population by 2030. The North America and Caribbean Region have the highest prevalence at 12.1% of its adult population.

Age distribution

The 40-59 year group are mostly affected

Gender distribution

There are about 1 million more women than men with diabetes and this difference is expected to increase by 6 million by 2030.

Risk factors

Both genetics and environment play important roles as excess animal fat consumption, lack of exercise and obesity.

Mortality due to Diabetes

The number of deaths due to diabetes in 2010 showed an increases of 5.5% over that for the year 2007. Regionally, there was an increase of 29% in N.America, 12% in South East Asia and 11% in Western Pacific Region.

Complications in Type 2 Diabetes

These results from both microvascular and macrovascular effects. The former cause renal, retinal and neurological damages while the latter involve in strokes, myocardiac infarction and peripheral vascular disease. About 80% die from cardiovascular complications. Diabetics have coronary heart disease mortalities that are 2 to 4 times those of nondiabetics, and they are twice as likely to suffer from strokes. Retinopathy is present in more than a third of newly diagnosed type 2 diabetics. About 20% of diabetics die from renal disease, first seen as microalbuminaemia between 30-300mg/day and later as macroalbuminaemia of more than 300 mg/day.

Results from important Trials

In the UKPDS study, it showed that intensive glycaemic control with a sulfonylurea or insulin that achieved a mean HBA1c level of 70% over a 10 year period was associated with a 255 reduction in microvascular end pounts, with a less significant 16% reduction in risk for myocardiac infarction(P=0.052). Thus for every percentage point of decrease in HBA1c there was a 35% reduction in the risk of microvascular complication.

In the Steno-2 study(2003) it confirmed the good effect of multifactorial intervention with its 50% reduction in risk of cardiovascular disease.

Conclusion

You need to know if you are a pre- diabetic, recently diagnosed diabetic or a diabetic with complications as treatment regimes differ greatly. Do something for yourself, get your blood sugar checked and if in the diabetic range, get it controlled!