Diabetes increase worldwide

I don’t know where to place this but perhaps Manny will place it more appropriately.
Please see the article in today’s washingtonpost.com at http://www.washingtonpost.com/national/health-science/diabetes-becoming-alarmingly-common-worldwide-new-study-finds/2011/06/24/AGMkaFlH_story.html?hpid=z3

The title is “Diabetes becoming alarmingly common worldwide, new study finds.”

Or go to www.washingtonpost.com and scroll down. Currently it is on the left hand side down the page. If you get to it later, just search for ‘diabetes becoming alarmingly.’

It is nothing you don’t know but an interesting read. There is also an interactive graph below the article where you can see the change in certain countries since 1980. Unfortunately, it is men with diabetes. Did they not think women or children got it?

OOPS. Let me correct one thing. If you hover over the dots on the interactive map, it does show the diabetes rate for women vs men. So they did get stats, just named the graph very poorly!

I’ve seen graphs of the incidence of diabetes overlaid with graphs showing the increase in carb intake since the world went on the misinformed low fat craze. The two graphs are nearly identical.

Though I don’t doubt diabetes is increasing due to this and a variety of other reasons it should be noted every time the standards for diabetes diagnosis are tightened the number of cases correspondingly increases. All these news stories about rampant diabetes started not long after the last standard revision.

Perhaps they are increasing or perhaps the establishment is just getting better at recognizing those already there or a little bit of both.

This article just really makes me angry! I realize you posted this in the T2 Diabetes forum, but as a T1D person, I feel the need to comment. While the article does eventually clarify the differences between the two types, it mostly collectively refers to “diabetes.” The studies this article is referring to are clearly about the increase in TYPE 2 DIABETES, as it attributes this increase to obesity and diet. I get so frustrated by media articles that don’t make this very clear and necessary distinction. They are two different conditions brought on, as far as we know, by two completely different causes. I just hate when this isn’t clarified.

I see this is placed in the T2 forum but IMHO the context is far broader, and that’s a good thing :slight_smile:

Over the past decades a lot has changed.

It used to be that T1 kids died in or before young adulthood. That’s just not true anymore. So a lot more T1’s are alive today.

It used to be that there wasn’t “T1 and T2”, it was “Juvenile Diabetes and Diabetes”. Lots of folks who were what we would call today T1 but were diagnosed in adulthood were not given appropriate T1 treatment because… those concepts didn’t really exist.

It used to be that diabetes was simply defined by “sugar in urine”. None of these fancy pants bg or A1C tests that we can buy at the drugstore today. So there were a lot of folks who were never diagnosed or the diagnosis threshold was too high.

There used to be a real stigma about diabetes. So docs would see sugar in urine, or high sugar in blood tests, and not diagnose it other than “watch your sugar” because he didn’t want to label the patient as a “diabetic”. This stigma is mostly overcome today.

Now I’m not saying that the above three factors are “solved problems” today. Some T1’s still die way too young, some T1’s diagnosed as adults are still not being appropriately treated, some still aren’t diagnosed at all, there is still a real stigma even in the medical profession, these are all still big problems. But the continued progress on these four problems, all together, results in many more T1’s and T2’s being alive and counted and receiving treatment today, than there were decades ago.

So what I’m saying, is that I’m not sure the actual incidence is increasing. Just increased awareness and longer lives is, IMHO, responsible for the “alarming increase in numbers” that the media loves to rave about.

“This is likely to be one of the defining features of global health in the coming decades,” said Majid Ezzati, an epidemiologist and biostatistician at Imperial College London, who headed the study. “There’s simply the magnitude of the problem. And then there’s the fact that unlike high blood pressure and high cholesterol, we don’t really have good treatments for diabetes.

I couldn’t believe my eyes when I read that.

Sounds to me like he thinks all diabetics just sit around wallowing in their gloopy syrupy blood sugar, just waiting to be nuisances to public health systems!

One of the things I find most pathetic is that researchers still promote this myth of Type 1 diabetes being a childhood disease, despite all evidence to the contrary. The article states, “Type 1 is an autoimmune disease that comes on in childhood and requires that a person take insulin shots to survive. Type 2 accounts for 90 percent of cases…”. According to the latest statistics from the U.S. Centers for Disease Control (CDC), 56% of new cases of Type 1 diabetes are seen in people over the age of 20, and that 56% excludes all the slow-onset Type 1s (LADAs).

To bustedpancreas: I am a type 1 myself and didn’t know where to post this. I looked for a “general diabetes” forum but did not see one.

I would like to see stats on the current incidence of 1 vs 2.

And we have been seeing “10% for type 1” since forever. Do you really trust that figure? Not sure I do.

A few things to keep in mind when reading studies like this. People are living longer around the world, so in that case many more people may develop T2 and also since their have been better treatments for T1, we are living a lot longer and have many off-spring! It is not like it was 40 years ago when a T1 would die of some complication early in life and not have any kids.

If you'd like some more detailed statistics see the WHO pages.


Prevalence of diabetes worldwide

2000 2030
World 171,000,000 366,000,000

Go to the regional numbers on the sidebar.

Sobering statistics.

Cheers, Alan, T2, Australia
Everything in Moderation - Except laughter

People with diabetes aren’t the only population that are growing…

Alan, that is very interesting. Especially that the increase in some middle eastern countries is predicted to be extremely high compared to others. Examples: Egypt, Iran, Iraq, Pakistan, etc.
Then look at Brazil vs Canada, which are listed next each other (for 2000 to 2030).
Brazil 4,553,000 --> 11,305,000
Canada 2,006,000 --> 3,543,000

You could spend a few months trying to puzzle out the potential factors for variations. Some combination of cultural, economical, educational, health care system factors?

acidrock23, that is a good point, although the proportion of diabetics is also growing.

As others have mentioned, a lot of the increase is to do with increasing longevity, better methods of diagnosis all around the world and sharply reduced diagnostic criteria over the past couple of decades. But underlying all of that is the gradual introduction of lower-fat, higher-carb diets coupled with increasing affluence. It's a complex equation.

Incidentally, the high variant will never happen. Either famine, pestilence, wars or a gradual acceptance of the absolute need for population control or all of those will ensure that.

Cheers, Alan, T2, Australia
Everything in Moderation - Except laughter

In the third world countries I suspect that two factors are the most important.

One is the gradual improvement in diagnostic methods and extension of better medical care to a larger part of the population leading to a higher level of diagnosis. The other is the continued dependence on high-carb diets, especially in Asia, worsened by the increasing spread of the Western menu into those regions (I’ve travelled in India recently and SE Asia a couple of years ago) and rapidly improving affluence. The affluence leads to both increased consumption and reduced physical activity.

Just my opinion.
Cheers, Alan, T2, Australia
Everything in Moderation - Except laughter

I’d read a book, Sacred Games, by Indian-American author Vikram Chandra, that had quite a bit of detail about middle class people in India sort of using a paunch as a status symbol?

Not just the middle class. I enjoyed a daily glass of tea with my driver back in '08. This was one of the chah-wallahs.

I wrote more on Indian food here, but not related directly to diabetes: Food, Glorious Food In India

Cheers, Alan, T2, Australia
Everything in Moderation - Except laughter

Some more interactive maps including projections for 2030.
Theres also one on new cases of T1 in children last year.

Very interesting, thank you for the link.

One thing I noticed after playing with it for a while is a probable difference in diagnostic criteria. Compare the 2010 maps for 20-79 IGT and diabetes. I would be pretty certain that the diagnostic criteria for all of the ex-soviet countries are very different to the rest of the world. Possibly they still use fasting BG of 8mmol/l (144) as we did until a decade ago. That leads to over-reporting IGT and under-reporting diabetes in those nations. Allowing for that, their numbers are probably proportionally similar to Western Europe.

I would surmise that China is also significantly under-reported because of different criteria and a different medical system. Their numbers might increase dramatically over the next decade as a consequence if standardised diagnostic criteria are adopted world-wide. Note the difference in the Chinese map for deaths attributable to diabetes. It seems a lot may only be diagnosed very late in life.

Cheers, Alan, T2, Australia
Everything in Moderation - Except laughter

You got me searching, I found this background paper which shows that some of the figures are extrapolated from neighbouring regions (or plucked out of thin air in the case of large parts of Africa?)
So for example

The lack of data from several of the former socialist republics required that data for many countries be extrapolated from two studies from Poland - urban Krakow [37], and the urban and rural areas near Lublin [38], as well as more recent reports from Bulgaria [39], Croatia [40], Slovakia [41] and Slovenia [42]. These data suggested high levels of diabetes currently, and such high levels of IGT that the diabetes prevalence will almost certainly increase by 2030 to levels above those indicated in Table 13, as these took no account of the higher incidence of diabetes among those with IGT


Well, there is also the fact that South Asians store fat in their bellies. Even otherwise very slim South Asians can have little bellies. No coincidence then that India is the diabetes capital of the world.

In random moments, I sometimes chew on two sets of statistics - that 80% of Type 2s are overweight, but only a minority of all overweight people will ever get Type 2. Then I look around the waiting room of the diabetes department and realize that virtually all the overweight people there carry fat in their bellies.