Diabetes Epidemiology

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http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf

Diabetes is a costly disease for the individual and society.
Affects generally around 7% of the population in developed countries with large geographic and ethnic variations in incidence. In Australia, the prevalence of diabetes was 8% in men, 6.8% in women and is rising . The prevalence of impaired glucose tolerance was 17.4% in men and 15.4% in women.
Global prevalence of diabetes is expected to reach 366 million by 2050
Importance of understanding of the scale of epidemiological studies :
1. Rational health planning – the magnitude of the clinical workload relevant to diabetes can be determined together with resources required to meet it
2. Placement of the disease in a proper perspective – its importance relative to other disorders can be determined
3. The identification of individuals, groups or communities who are at high risk for the development of diabetes – offer possibilities for research into aetiology and for health promotion/disease prevention programs
4. Awareness of any change in the nature of diabetes over time – facilitates the evaluation of intervention programs

Type 1:
Registries widely used
Considerable geographic variability in incidence – rates are highest in Norway, Finland, Sweden, Canada; lowest in Japan, Chile, Mexico, China, South America.
Incidence is increasing. Environmental factors and diet are thought to be the reason for the increases.

Type 2:
True prevalence not known. Type 2 accounts for up to 85%-95% of cases of diabetes mellitus.
Up to 20% over age 80 have diabetes.
Prevalence in Massachusetts, USA has increased from 0.9% in 1958 to 3% in 1995
Increasing incidence of diabetes parallels increase in incidence of obesity.
Epidemic in some countries.
Lowest prevalence is in less developed countries and rural areas (up to 2% in China and Africa; >50% in Pima Indians in Arizona).
Rates higher in urban compared to rural communities

Increasing incidence of obesity in children  increased incidence of type 2 diabetes in children.

Impaired glucose tolerance:
Check results from Ausdiab study.

Morbidity and mortality:
Large public health problem due to the complications of diabetes:
• increase in acute hospitalisations
• increased mortality (mostly from the cardiovascular complications)

Financial costs of diabetes:
Costs to individual and society.

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