Diabetes epidemic spreads to developing nations

More than 350 million people in the world now have diabetes, an international study has revealed. The analysis, published online by the Lancet on on Saturday, adds several tens of millions to the previous estimate of the number of diabetics and indicates that the disease has become a major global health problem.

Diabetics have inadequate blood sugar control, a condition that can lead to heart disease and strokes, as well as damage to kidneys, nerves and the retina. About three million deaths a year are attributed to diabetes and associated conditions in which blood sugar levels are disrupted.

The dramatic and disturbing increase is blamed by scientists on the spread of a Western-style diet to developing nations, which is causing rising levels of obesity.
Researchers also say that increased longevity is playing a major role.

“Diabetes is one of the biggest causes of mortality worldwide, and our study has shown that it is becoming more common almost everywhere. It is set to become the single largest burden on world healthcare systems,” one of the study’s main authors, Professor Majid Ezzati of Imperial College London, told the Observer. “Many nations are going to find it very difficult to cope with the consequences.”

Refined methods
The study—which was funded by the World Health Organisation and by the Bill and Melinda Gates Foundation—analysed blood from 2.7-million participants aged 25 and over from across the world over a three-year period. To find out if they had diabetes, doctors measured the levels of glucose in their blood after they had fasted for 12 to 14 hours—blood sugar rises after a meal. If their glucose level fell below 5.6 millimoles per litre, they were considered healthy. If their reading topped seven, they were diagnosed as having diabetes, while a result that ranged between 5.6 and seven indicated that a person was in a pre-diabetic state. Crucially, the study found that the average global level of glucose measured this way had risen for men and women.

The team then used advanced statistical methods to estimate prevalence rates among the participants. It was estimated that the number of adults with diabetes was 347-million, more than double the 153-million estimated in 1980 and considerably higher even than a 2009 study that put the number at 285-million. “We are not saying the previous study was a bad one,” said Ezzati. “It is just that we have refined our methods a little more.”

In percentage terms, the prevalence of male adult diabetics worldwide rose from 8.3% to 9.8% in that period, with adult females increasing from 7.5% to 9.2%. As to the causes, the team attribute 70% to ageing and 30% to the increased prevalence of other factors, with obesity and body mass the most important.

It was found that in the US glucose levels had risen at more than twice the rate of Western Europe over the past three decades. In wealthy nations, diabetes and glucose levels were highest in the US, Malta, New Zealand and Spain, and lowest in The Netherlands, Austria and France. Despite its obesity epidemic, the UK’s diabetes prevalence was lower than that of most other high-income countries. In a league of 27 western high-income countries, British men had the fifth lowest diabetes rates, while British women were eighth lowest.

Other badly affected countries included many Pacific island nations. In the Marshall Islands, for example, one in three women and one in four men have diabetes. Saudi Arabia was also reported to have very high rates. - guardian.co.uk

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