Diabetes is always related to an anomaly involving the hormone insulin, which is produced by the pancreas. Insulin allows our cells to use the glucose supplied by the foods in our diet. If we do not secrete enough insulin, or if it does not work properly, as in diabetics, this glucose is not able to fuel the cells. It therefore accumulates in the blood flow and is afterwards excreted in the urine.
There are 4 types of diabetes:
– Type 1 diabetes, previously referred to as “insulin-dependent diabetes mellitus” (IDDM) or “juvenile diabetes” typically appears suddenly in young people, usually before the age of 20, along with a gradual destruction of the insulin-producing beta cells of the pancreas (islets of Langerhans). This is often due to an over-strong autoimmune response to an infection, sometimes a very common one (rhinopharyngitis, tonsillitis, gastroenteritis…). The pancreatic beta cells “self-destroy” without remedy. Type I diabetes is treated with insulin replacement therapy in daily injections.
– Type 2 diabetes, formerly called noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, as its sufferers are typically middle-aged. It has also been linked to our Western lifestyle.
– Gestational diabetes is a condition developed by a percentage of expectant mothers due to pregnancy-related hormones. It disappears after delivery and has no impact on the fetus, except for an increased risk of being large for [its] gestational age (LGA). A birth weight over 4 kg (8 lb 13 oz) strongly suggests an undiagnosed gestational diabetes.
– MODY diabetes (Maturity Onset Diabetes in the Young), identified a decade ago by Prof. Philippe Froguel, is a form of type 2 diabetes that develops before the age of 25 (and sometimes even at birth).
Diabetes by numbers
According to surveys conducted on over 2.7 million people in 199 countries between 1980 and 2008, the prevalence of type 2 diabetes in 2008 was 9.8% for men and 9.2% for women, up from respectively 8.3% and 7.5% in 1980. This rising trend has been especially dramatic in Oceania (with 15.5 % diabetic men and 15.9% women), because of the sudden ditching of the traditional fish- and vegetable-rich diet in favor of a Western-style diet, especially among Maori people. South America, Central America, the Caribbean, North Africa and the Middle East also display a higher than average rise.
Circulation, a publication of the American Heart Association, published in 2007 the IDEA (International Day for the Evaluation of Obesity) survey, conducted in 63 countries and on 168,159 subjects aged 18 to 80 years old. Its verdict: over 50% (and up to 66% according to some sources) of the world population is overweight or suffers from obesity, with a prevalence ranging from 7% in Asia to 36% in Canada. The most alarming increases are to be found in newly emerging countries, the so-called BRICs (an acronym for Brazil, Russia, India and China). In China, for instance, there are as many as 90 million obese people (and obesity rose by 156% between 1996 and 2006) and one quarter of the population is overweight, whereas in Mexico, 30% suffer from obesity and 70% of the adults are overweight. Tropical island paradises aren’t spared with a Mauritius Health Department survey showing that 21.2% of schoolchildren aged 13 to 15 are overweight and 6.2% obese (these ratios have been constantly increasing for several decades).
Moreover, for the first time since this type of statistics have been implemented, and probably for the first time in the history of mankind, obese people outrank starving people: 1.6 billion overweight adults (among which 500 million are clinically obese) against “only” one billion undernourished ones.
As for type 2 diabetes, this affects around 250 million people (that is 6% of the world population), many of whom aren’t aware of it. At least one in four member of the at-risk population has never taken a glycemia test, and quite often, type II diabetes is diagnosed only when complications arise. This is a matter of concern, as if the International Diabetes Federation (IDF)’s forecasts are accurate, Type II diabetes prevalence should rise by 55% between now and 2025 in developed countries as well as in new emergent countries like India, China, or the Arabic Gulf States). It also affects younger and younger people, sometimes even before the age of 15-year-olds (the prevalence of type II diabetes in this age group increases yearly by 3%).
The diabetes pandemic’s estimated all-around yearly cost is 340 million dollars and its weight amounts to 5 to 10% of the developed countries’ health budget. It is expected to rank first among human preventables diseases in 20 years time: according to WHO projections, diabetes sufferers could be 300 million in 2025…