Diabetes and its drivers: the largest epidemic in human history?
Top Cited Papers
Open Access
- 18 January 2017
- journal article
- editorial
- Published by Springer Science and Business Media LLC in Clinical Diabetes and Endocrinology
- Vol. 3 (1), 1-8
- https://doi.org/10.1186/s40842-016-0039-3
Abstract
The “Diabesity” epidemic (obesity and type 2 diabetes) is likely to be the biggest epidemic in human history. Diabetes has been seriously underrated as a global public health issue and the world can no longer ignore “the rise and rise” of type 2 diabetes. Currently, most of the national and global diabetes estimates come from the IDF Atlas. These estimates have significant limitations from a public health perspective. It is apparent that the IDF have consistently underestimated the global burden. More reliable estimates of the future burden of diabetes are urgently needed. To prevent type 2 diabetes, a better understanding of the drivers of the epidemic is needed. While for years, there has been comprehensive attention to the “traditional” risk factors for type 2 diabetes i.e., genes, lifestyle and behavioral change, the spotlight is turning to the impact of the intra-uterine environment and epigenetics on future risk in adult life. It highlights the urgency for discovering novel approaches to prevention focusing on maternal and child health. Diabetes risk through epigenetic changes can be transmitted inter-generationally thus creating a vicious cycle that will continue to feed the diabetes epidemic. History provides important lessons and there are lessons to learn from major catastrophic events such as the Dutch Winter Hunger and Chinese famines. The Chinese famine may have been the trigger for what may be viewed as a diabetes “avalanche” many decades later. The drivers of the epidemic are indeed genes and environment but they are now joined by deleterious early life events. Looking to the future there is the potential scenario of future new “hot spots” for type 2 diabetes in regions e.g., the Horn of Africa, now experiencing droughts and famine. This is likely to occur should improved economic and living conditions occur over the next few decades. Type 2 diabetes will remain one of the greatest challenges to human health for many years to come.Keywords
This publication has 44 references indexed in Scilit:
- Explaining the Increase of Diabetes Prevalence and Plasma Glucose in MauritiusDiabetes Care, 2011
- Prevalence and risk factors of diabetes and impaired fasting glucose in NauruBMC Public Health, 2011
- Exposure to the Chinese Famine in Early Life and the Risk of Hyperglycemia and Type 2 Diabetes in AdulthoodDiabetes, 2010
- Prevalence of Diabetes among Men and Women in ChinaThe New England Journal of Medicine, 2010
- Projecting the Future Diabetes Population Size and Related Costs for the U.S.Diabetes Care, 2009
- High Prevalence of Diabetes and Cardiovascular Risk Factors Associated With Urbanization in IndiaDiabetes Care, 2008
- Increasing prevalence of Type 2 diabetes mellitus in all ethnic groups in MauritiusDiabetic Medicine, 2004
- Diabetes in Aborigines and other Australian populationsAustralian Journal of Public Health, 1992
- Standardization of definition, classification, and reporting in diabetes-related epidemiologic studiesDiabetes Care, 1979
- Metabolic Maladies in New Zealand MaorisBMJ, 1964