Editor: Qing Qiao

Epidemiology of Type 2 Diabetes

Personal Book: US $29 Special Offer (PDF + Printed Copy): US $121
Printed Copy: US $107
Library Book: US $116
ISBN: 978-1-60805-529-6
eISBN: 978-1-60805-361-2 (Online)
Year of Publication: 2012
DOI: 10.2174/97816080536121120101

Introduction

This e-book on diabetes epidemiology starts with the evolution in the diagnostic criteria for diabetes, particularly the changes in the last 15 years and their impact on the prevalence of the disease. The increasing trend in prevalence of diabetes worldwide, and its impact on people’s health and economic development are described by regions and countries. The rationale for a diabetes screening program, recent development in screening strategies and screening tools are thoroughly reviewed and presented. Because obesity is one of the major risk factors for diabetes and has been included in several risk assessment questionnaires, the obesity-diabetes association is particularly addressed in this e-book. The diagnostic cut-off value for surrogate measurement of body fat mass such as body mass index (BMI) and waist circumference is also discussed. The measurement errors and the strength of the association of diabetes with BMI and waist circumference are formally compared. Other diabetes related metabolic disorders such as dyslipidemia and hyperuricemia are also discussed with regard to their association with different degree of glucose intolerance including pre-diabetes and undiagnosed diabetes. The risk of dyslipidemia with cardiovascular mortality and morbidity in people with different glucose levels is estimated within different ethnic groups and the ethnic differences are compared. Recent interest on diabetes-cancer association is on the rise. Academic literature on this issue presented in this volume. The relationship of diabetes with cardiovascular disease is also recognised. In this book the focus is set on the impact of various levels of fasting and 2-hout post-load glucose on the occurrence of cardiovascular mortality and morbidity.

Foreword

In 1997, the American Diabetes Association decided to change the cut-points for glucose defining whether an individual had diabetes or not. This event triggered the development of an international research network within diabetes epidemiology - the Diabetes Epidemiology: Collaborative analysis of Diagnostic criteria in Europe (DECODE) and Asia (DECODA). Although the primary aim was to evaluate the impact of the revised diagnostic criteria from a public health perspective, this initiative proved to be an excellent platform for studies focusing on understanding the rationale for ethnic variability in susceptibility to diabetes and its complications. Such an insight can only be achieved through access to population-based data from different regions of the world. The DECODE and DECODA studies in combination with other initiatives like DETECT-2 have taught us, that well established risk factors for diabetes as obesity and age have very different impact in different populations. In a scientific community, dominated by data from Europe and North-America, our knowledge regarding risk factors and high risk groups stems from a small minority of the population of the world. Had we used this knowledge to develop prevention strategies in Asia and Africa, then our efforts would have had little effect. DECODE and DECODA taught us that although risk-factors may be the same, the cut-point for being at risk varies tremendously between populations. The International Diabetes Federation has taken the consequence of this, and developed region-specific cut-points for at-risk levels of obesity.

The present eBook is written by a group that has worked extensively on the DECODE and DECODA data. They have highlighted the importance of the variability within the species of Homo Sapiens when it comes to physiological responses to the external and internal environment. This eBook reviews the epidemiology of diabetes in this specific context, which has proven to be so helpful in diabetes and obesity epidemiology. It is my hope that in the future we will see similar trends in studies of human physiology and clinical medicine. Meanwhile, at least we can say that epidemiology showed us the way.

Knut Borch-Johnsen
Odense, Denmark


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