Epidemiology of Diabetes Mellitus (eBook)

Professor Jean-Marie Ekoe. Endocrinologie, Metabolism et Nutrition, Centre de Recherche CHUM, Canada. Professor Marian Rewers. MD, PhD, Professor, Pediatrics & Preventive Medicine, Clinical Director, Barbara Davis Center for Childhood Diabetes, University of Colorado, School of Medicine, USA. Professor Rhys Williams. University of Swansea. Professor Paul Zimmet. Director, International Diabetes Institute, Australia.

The Epidemiology of Diabetes Mellitus 3
Contents 7
About the Editors 17
Contributors 19
Foreword 25
Acknowledgments 27
1: Introduction 29
Introduction to the Second Edition 29
Introduction to the First Edition 30
2: The Clinical Syndrome and the Biochemical Definition 33
Definition of the Diabetic State 33
The Clinical Syndrome 34
The Biochemical Definition 35
Significance of Blood Glucose in a Population 35
3: Diagnosis and Classification 39
Diagnosis and Diagnostic Criteria 39
The Demonstration of an Abnormal Blood Glucose Level Using an Oral Glucose 40
Tolerance Test 40
The Oral Glucose Tolerance Test 40
New Criteria in Diagnostic Value for Fasting Plasma Blood Glucose Concentrations 41
Epidemiological Studies 42
Classification of the Diabetes Mellitus Syndrome and Other Categories of Glucose Intolerance 42
Changes in Terminology 43
Clinical Classification of Diabetes Mellitus and other Categories of Glucose Tolerance 45
The Newly Proposed Staging Classification 46
The Newly Proposed Etiological Types 47
Genetic Defects of ?-cell Function 49
Genetic Defects in Insulin Action 50
Diseases of the Exocrine Pancreas 50
Endocrinopathies 50
Drug- or Chemical-induced Diabetes 50
Infections 50
Uncommon but Specific Forms of Immune-mediated Diabetes Mellitus 50
Other Genetic Syndromes Associated with Diabetes 51
Gestational Diabetes Mellitus 51
Diagnosis of Gestational Diabetes 52
Conclusions 53
4: Epidemiology of Metabolic Syndrome 59
Introduction 59
What is Metabolic Syndrome? 59
Historical Overview 59
Etiology of Metabolic Syndrome 60
Approaches to Defining Metabolic Syndrome 61
Current Working Definitions of Metabolic Syndrome 62
Metabolic Syndrome and other Diseases 66
All-cause Mortality 67
Risk Factors for Metabolic Syndrome 69
Prevalence of Metabolic Syndrome 69
Genetics of Metabolic Syndrome 76
Summary and Conclusion 77
5: Obesity and Diabetes 85
Introduction: Defining Obesity 85
Epidemiological Trends in Obesity 85
Obesity and Diabetes are Causally Linked 87
Attributable Burden of Diabetes due to Excess Weight 87
Age and Regional Variation in the Association between Obesity and Diabetes 87
Central Obesity Versus BMI as a Predictor of Diabetes 88
Physiological Mechanisms Mediating Excess Weight with Diabetes 89
Other Key Risk Factors for Obesity and Diabetes 90
Impact of Social Class on Obesity 90
Early Life Environment and the ‘Programming’ Hypothesis 92
The Increasing Global Burden of Diabetes and Obesity 93
Global Burden of Diabetes 94
Does Weight Loss Improve Diabetic Outcomes? Evidence from Randomized Trials 95
6: Methodology for Physical Activity Assessment 99
Introduction 99
What Is Physical Activity? 100
How Has Physical Activity Been Measured? 100
Application of Physical Activity Assessment: Population and Outcome Considerations 107
Concluding Remarks 108
7: Epidemiology of Nutrition and Diabetes Mellitus: Etiology and Environmental Factors 115
Introduction 115
Carbohydrate and Dietary Fiber 116
Dietary Fats 117
Protein 118
Alcohol 118
Other Dietary Factors and Smoking 119
Physical Inactivity 119
Potential for Intervention 119
Conclusions 120
8: Genetic Epidemiology of Type 2 Diabetes 123
Introduction 123
Genetic Risk 123
Evidence that Type 2 Diabetes is Inherited 124
Thrifty Genotypes or Phenotypes? 124
Prediction of Future Type 2 Diabetes 125
Genetic Variability 125
Mapping Genetic Variability 126
Linkage 126
Calpain 10 and Type 2 Diabetes 127
Association Studies and Candidate Genes for Type 2 Diabetes 127
Common Variants in Mody Genes 130
Genetic Prediction of Type 2 Diabetes 131
Why is it Difficult to Replicate a Finding of an Association with a Complex Disease? 132
Why Do Not Linkage Studies Detect All Associations? 133
Whole-genome Association Studies 133
Genetic Influences on Age-Related Decline in Mitochondrial Dysfunction 134
Gene–Environment Interactions 135
Pharmacogenetics 135
Future Directions 135
9: Epidemiologic Aspects of Type 2 Diabetes Mellitus in Europe 139
Introduction 139
A Diabetes Epidemic? 139
Changing Patterns 139
Conclusion 145
10: The Burden of Diabetes and its Complications in the Middle East and Eastern Mediterranean Region 149
Introduction 149
Type 1 Diabetes 149
Type 2 Diabetes 151
Risk Factors for Diabetes in the Middle East and Eastern Mediterranean Region 154
Adult Obesity 154
Childhood Obesity 155
Complications of Diabetes 155
Diabetes Prevention 156
Diabetes Surveillance 156
Conclusions 156
11: Epidemiology of Diabetes in Africa 161
Introduction 161
Prevalence of Diabetes 162
Intermediate Categories of Abnormal Glucose Tolerance/Glycemia Total Glucose Intolerance (TGI)
Urban–Rural Differences 167
Ethnic Differences and the Effect of Migration 167
Prevalence of Known Diabetes 168
Gender Distribution 168
Impact of Age 168
Measures of Adiposity: Body Mass Index (BMI) and Waist Circumference Waist:Hip Ratio (WHR)
Family History 171
Physical Activity 171
Is the Prevalence of Diabetes Increasing in Africa? 171
Other Biochemical Variables 171
Longitudinal Studies 171
Other Factors 171
Complications 171
Costs of Diabetes Care 172
Future Trends 172
12: Epidemiology of Diabetes Mellitus in Latin America 175
Introduction 175
Epidemiology of Type 1 Diabetes in Latin America 175
Epidemiology of Type 2 Diabetes in Latin America 178
Mortality by Diabetes 185
Diabetic Complications 186
Conclusion 187
13: Diabetes in the Caribbean . . . an Epidemiological Review! 191
Introduction 191
Some Related Health Issues 192
Diabetes and Obesity 194
Atypical Diabetes 196
The Burden of Diabetes Mellitus in the Caribbean 196
Acknowledgments 196
14: Japan 199
Introduction 199
Incidence and Prevalence Study 199
Mortality Study 202
15: Epidemiology of Diabetes Mellitus in China 207
Introduction 207
Socioeconomic Impact of Diabetes 207
Prevalence of Hyperglycemia and Type 2 Diabetes 208
Diagnosis of Hyperglycemia in Chinese Populations 208
Gestational Diabetes Mellitus 210
Childhood Obesity and Diabetes 211
Type 1 Diabetes 212
Type 2 Diabetes and Metabolic Syndrome (METS) 213
Diabetic Complications 218
From Epidemiology to Prevention 222
Conclusion 224
16: Epidemiology of Diabetes in South East Asia 235
Diabetes: Burden, Global Prevalence and Projections 235
Scenario in South East Asia 235
Rising Prevalence of Diabetes in the Indian Subcontinent 236
Impaired Glucose Tolerance and Impaired Fasting Glucose 239
Genetic Factors 240
Acquired Risk Factors 240
Environmental Risk Factors 241
Diabetes Risk Score 244
Prevention of Diabetes 244
Chronic Complications of Diabetes 245
Type 2 Diabetes in Children 246
Costs of Treating Diabetes 246
17: The Epidemiology of Diabetes in Pacific Island Populations 253
Introduction 253
Geography 253
Epidemiological Transition 254
General 254
Prevalence of Diabetes 255
Rates of Undiagnosed Diabetes 264
Diagnosing Undiagnosed Diabetes 264
Screening for Undiagnosed Diabetes 264
Diabetes Complications 265
Obesity 265
Conclusion 266
18: Epidemiology of Type 2 Diabetes in North America 269
Introduction 269
North American Sources of Data to Monitor Diabetes 269
Current and Future Prevalence of Diabetes 270
Incidence of Diabetes 275
Diabetes Complications 275
Mortality 277
Summary 278
19: Non-Caucasian North American Populations: Native Americans 283
Native Americans 283
Diabetes in Native Americans 283
Magnitude of the Problem of Type 2 Diabetes in Native Americans 284
Determinants of Type 2 Diabetes 285
Potentially Modifiable Risk Factors 287
Complication of Type 2 Diabetes 289
Conclusion 293
20: Epidemiology of Type 2 Diabetes in Hispanic North Americans 301
Introduction 301
Hispanic Population Profile 301
Size and Distribution of Hispanic Population—Regional Trends 302
Age and Socioeconomic Characteristics 303
Prevalence of Diabetes 304
Incidence of Diabetes 306
Lifetime Risk 307
Trends in Diabetes Prevalence and Incidence 307
Future Projections 310
Diabetes Mortality Trends 311
Risk Factors 313
Genetic Admixture 316
Possibilities for Prevention 316
Preventive Practices for Complications 317
Directions for Future Research 318
21: Non-Caucasian North American Populations: African Americans 323
Introduction 323
Prevalence 324
Incidence 325
Risk Factors for Type 2 Diabetes 325
Is there a Metabolic Insulin Resistance Syndrome in African Americans? 328
Pathogenesis of Type 2 Diabetes in African Americans 331
Clinical Variants of Diabetes in African Americans 332
Complications of Diabetes 336
22: Epidemiology of Diabetes in Asian North Americans 351
Introduction 351
Prevalence of Type 1 Diabetes in Asian North Americans 351
Prevalence of Type 2 Diabetes in Asian North Americans 351
Incidence of Type 2 Diabetes in Asian North Americans 355
Risk Factors for Type 2 Diabetes in Asian North Americans 355
Pathogenesis of Type 2 Diabetes in Asian North Americans 358
Diagnosis of Diabetes in Asian North Americans 360
Complications of Diabetes in Asian North Americans 360
Conclusions 361
23: Epidemiology of Type 2 Diabetes in Children and Adolescents 367
Introduction 367
Prevalence and Incidence 367
Profile of Children and Adolescents with Type 2 Diabetes 371
Factors in the Development of Type 2 Diabetes 372
Conclusions 377
24: Global Epidemiology of Type 1 Diabetes 383
Introduction 383
Natural History and Islet Autoantibodies 383
Incidence of Type 1 Diabetes in Different Countries 384
Familial Aggregation and Relation to Other Diseases 392
Epidemiologic Evidence for Environmental Risk Factors 393
Conclusion 399
25: Epidemiology of Childhood Diabetes Mellitus in Non-Caucasian Populations 413
Introduction 413
Descriptive Epidemiology of Childhood-Onset Diabetes: Prevalence and Incidence Across the World 413
Descriptive Epidemiology of Childhood-Onset Diabetes: Temporal Trends and Migrant Studies 418
The Range of Diabetes in Youth Across the World: the Question of Mixed Phenotype 419
Risk Factors for Childhood Diabetes in Non-Caucasian Populations 421
Summary 425
26: Genetic Epidemiology of Type 1 Diabetes Mellitus 431
Introduction 431
Evidence of a Genetic Contribution to Type 1 Diabetes 431
Evidence of Environmental Determinants 432
Predicting Risk of Type 1 Diabetes: Available Markers 433
Predicting Risk of Type 1 Diabetes: Methodological Considerations 434
Predicting Risk of Type 1 Diabetes: A Hyphothetical Example 436
Concluding Remarks 438
27: Recent Trends in Screening and Prevention of Type 1 Diabetes 441
Introduction 441
Risk Prediction 442
Prevention 448
Conclusions 453
28: Non pharmacological Prevention of Type 2 Diabetes 463
Introduction 463
Why Primary Prevention of T2D? 463
Major Lifestyle Trials in Prevention of T2D 464
Long-term Effectiveness of Lifestyle Prevention of T2D 467
Clinical Trial Evidence of the Effect of Lifestyle Factors on T2D Risk 468
Does the Risk Reduction Work in the Entire Population? 469
Costs Associated with Lifestyle Intervention to Prevent T2D 469
Detection of People at High Risk for Developing T2D 470
Conclusion 471
29: Pharmacological Prevention of Type 2 Diabetes 477
Introduction 477
Prevention by Glucose-lowering Agents 479
Prevention by Antiobesity Agents 484
Prevention by Lipid-Lowering Agents 487
Effects of RAAS Inhibition on Development of Diabetes 488
Prevention by Various Drugs 491
Conclusion 494
30: The Epidemiology of Eye Diseases in Diabetes 503
Introduction 503
Diabetic Retinopathy 503
Retinal Vascular Diseases 512
Neuro-ophthalmic Manifestations 513
Cataract 513
Glaucoma 514
Conclusion 514
31: The Epidemiology of Diabetic Kidney Disease 527
Introduction 527
Definition 527
Incidence and Prevalence of Diabetic Kidney Disease 528
Association with CVD 531
Etiological Factors: Markers of Risk for Development of DN 532
Lipids 535
Familial Predisposition 535
Smoking 536
Fibrinogen 536
Kallikrein 537
Novel Cardiovascular Risk Factors 537
The Epidemiology of Prevention 538
32: Epidemiology of Large-vessel Disease in Diabetes: Coronary Heart Disease and Stroke 547
Introduction 547
Risk Factors 547
Outcomes 554
Type 1 Diabetes Risk Factors 556
Outcomes 557
Summary 557
33: The Epidemiology of Peripheral Vascular Disease 567
Introduction 567
Measurement and Validity 567
PAD Prevalence 568
PAD Incidence 572
PAD and Mortality 572
Risk Factors for PAD 573
Epidemiology of Renal Arterial Stenosis and Diabetes Mellitus 576
Epidemiology of Abdominal Aortic Aneurysm and Diabetes Mellitus 578
Epidemiology of Venous Thromboembolic Disease and Diabetes 585
Conclusions 587
34: Epidemiology of Diabetic Neuropathy 593
Introduction 593
Classification of the Diabetic Neuropathies 594
Etiology of Diabetic Neuropathies 596
How Common is Diabetic Neuropathy? 598
The Diabetic Foot 599
Risk Factors for the Diabetic Foot 600
Epidemiological Data on Diabetic Foot Problems 600
Prevention of Ulceration and Amputation in Diabetic Patients 601
35: Epidemiology of Acute Complications: Diabetic Ketoacidosis, Hyperglycemic Hyperosmolar State and Hypoglycemia 605
Diabetic Ketoacidosis 605
HHS 612
Hypoglycemia 614
36: Mortality and Life Expectancy Associated with Diabetes 631
Introduction 631
Methodological Issues Associated with Mortality Data 631
Mortality Trends of Type 1 Diabetes 632
Mortality Trends of Type 2 Diabetes 633
Type 1 Diabetes and Mortality 635
Type 2 Diabetes and Mortality 640
Conclusions 646
37: Economic Costs 655
Introduction 655
Health Economics 656
Identifying the Costs of Diabetes 656
Direct Medical Costs 656
Indirect Morbidity and Mortality Costs 656
Direct Cost Estimates 657
Estimates of Costs Faced by People with Diabetes 661
Evaluative Studies in Diabetes Health Economics 662
Estimates from Evaluation Studies 663
Indirect Cost Estimates 665
Conclusions 666
38: Clinical Practice Guidelines: A Global Perspective 669
History of Clinical Practice Guidelines 669
Guidelines for Guidelines 671
Comparison of International Guidelines 672
The Future of Guidelines 676
39: Antipsychotic Therapies and Glucose Dysregulation in the Mental Illness Population 685
Introduction 685
The Epidemiology of Metabolic Syndrome in the Mentally Ill 686
Atypical Antipsychotics and Diabetes 687
Reversal of Metabolic Syndrome and Glucose Dysregulation/Diabetes 688
Conclusions 688
40: Diabetes, Insulin Resistance and Glucose Metabolism in HIV Infection and its Treatment 693
Introduction 693
Prevalence 693
Pathogenesis 696
Lipodystrophy Treatment Considerations 700
Summary 700
Index 705

"Highly referenced. Recommended to all diabetologists and epidemiologists" (Pediatric Endocrinology, May 2009)