Three Patterns of Rising type 2 Diabetes Prevalence in the World: Need to Widen the Concept of Prevention in Individuals into Control in the Community
DOI:
https://doi.org/10.31729/jnma.240Abstract
This paper analyses the patterns of rising type 2 diabetes prevalence in the world with their plausibleÂreasons focusing on control measures. It shows existence of combinations of three patterns of rises, viz.Â
gradual, rapid and accelerated, leading to prevalence of 4–9% now in Europids, 14–20% in migrant orÂ
urbanized Asian Indians, Arabs, Chinese, Africans, and Hispanics and above 30–50% in indigenousÂ
peoples of Canada, USA, Australia and Pacifi c regions. It demonstrates that though ageing, sedentaryÂ
life and obesity of people explain gradual rise in Europids, effects of rapid transition in nutritionalÂ
status of population and of maternal hyperglycaemia on the risk of offspring developing glucoseÂ
intolerance further add to rapid and accelerated rises respectively. It recommends that currentÂ
approach of primary prevention of diabetes in people, particularly with impaired glucose tolerance,Â
advocating modest loss of excess weight and moderate-intensity exercise, be widen into concept ofÂ
control in community covering rapid and accelerated rises. The control programmes essentially areÂ
vigorous educational campaign and planning to improve nutritional status of women of childbearingÂ
age in rural and poorer sectors of society and to keep weight of adults within recommendedÂ
body mass index (BMI) range, like 18.5–22.9 kg/m
2
for Asian and other similar populations. TheÂ
population-based approaches with examples, considering developing countries, are outlined. TheÂ
paper emphasizes the importance of keeping prepregnancy weight optimum, preferably belowÂ
the middle of recommended BMI range, to avoid even sub-clinical maternal hyperglycemia, forÂ
prevention and control of accelerated rise in any population.Â
Key Words: diabetes, diabetes control, diabetes epidemiology, diabetes prevention, prepregnancy weight
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