- The global diabetes epidemic is progressing steadily, and populations that were previously unfamiliar with the disease are now struggling to address this chronic health problem. As we recognize World Diabetes Day on Thursday, November 14, the rising prevalence of diabetes seems difficult to accept. The most recent data from the World Health Organization show that 347 million people have diabetes, and this is at least a two-fold increase since 1980. Over 80 percent of diabetics live in low- and middle-income countries, and roughly 50 percent do not know they have the disease.While we tend to speak in broad generalizations about diabetes, we overlook some disturbing health trends. It is true that 90 percent of newly diagnosed cases are type 2 diabetes, which is traditionally classified as “adult-onset” diabetes. However, many children and adolescents are included among the new cases of type 2 diabetes. Up to 45 percent of new cases of type 2 diabetes will occur in young people under the age of 20 years.
Many consider type 2 diabetes to be a disease that affects obese people, but compelling trends in some ethnic groups indicate a high prevalence of type 2 diabetes among people with normal body weight. This is especially true among Asians of Indian and of Chinese decent. A recent report from the Journal of the American Medical Association states that the prevalence of diabetes in China now exceeds that in the United States. Nearly 12 percent (11.6 percent) of Chinese adults are diabetic, compared to 11.3 percent of adults in this country., This rise in diabetes occurs even though the average body mass index (BMI) for a Chinese adult is 23.7, which is normal by international standards. It is possible that some genetic influences affect insulin response and/or glucose control.
Gestational diabetes, like type 2 diabetes, is rising in prevalence, and it threatens our ability to provide good outcomes for pregnant women and their newborns. An estimated 14 percent of India’s women will experience gestational diabetes, often occurring during the second and third trimesters of pregnancy. Because most women with gestational diabetes will not be diagnosed, they are at risk for multiple complications, including birth trauma, macrosomia (infants born weighing >4.5 kg), stillbirth, pre-eclampsia and hemorrhage. On the occasion of World Diabetes Day, we are reminded that we need to find new ways to reach out to women at risk, to reduce the morbidity and mortality related to this chronic disease. In the case of a pregnant woman, increased diabetes prevention and awareness will greatly improve health outcomes for two people, the mother and her newborn child.
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