TY - JOUR AU - Bhattarai, Madhur Dev PY - 2009/04/01 Y2 - 2024/03/28 TI - 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 JF - Journal of Nepal Medical Association JA - J Nepal Med Assoc VL - 48 IS - 174 SE - Review Article DO - 10.31729/jnma.240 UR - http://jnma.com.np/jnma/index.php/jnma/article/view/240 SP - 173-9 AB - This paper analyses the patterns of rising type 2 diabetes prevalence in the world with their plausible <br />reasons focusing on control measures. It shows existence of combinations of three patterns of rises, viz. <br />gradual, rapid and accelerated, leading to prevalence of 4–9% now in Europids, 14–20% in migrant or <br />urbanized Asian Indians, Arabs, Chinese, Africans, and Hispanics and above 30–50% in indigenous <br />peoples of Canada, USA, Australia and Pacifi c regions. It demonstrates that though ageing, sedentary <br />life and obesity of people explain gradual rise in Europids, effects of rapid transition in nutritional <br />status of population and of maternal hyperglycaemia on the risk of offspring developing glucose <br />intolerance further add to rapid and accelerated rises respectively. It recommends that current <br />approach of primary prevention of diabetes in people, particularly with impaired glucose tolerance, <br />advocating modest loss of excess weight and moderate-intensity exercise, be widen into concept of <br />control in community covering rapid and accelerated rises. The control programmes essentially are <br />vigorous educational campaign and planning to improve nutritional status of women of childbearing <br />age in rural and poorer sectors of society and to keep weight of adults within recommended <br />body mass index (BMI) range, like 18.5–22.9 kg/m<br />2<br />for Asian and other similar populations. The <br />population-based approaches with examples, considering developing countries, are outlined. The <br />paper emphasizes the importance of keeping prepregnancy weight optimum, preferably below <br />the middle of recommended BMI range, to avoid even sub-clinical maternal hyperglycemia, for <br />prevention and control of accelerated rise in any population. <br />Key Words: diabetes, diabetes control, diabetes epidemiology, diabetes prevention, prepregnancy weight ER -