Type 2 Diabetes Mellitus, Pandemic in 21st Century
In the second half of the 20th century it became obvious that a relentless increase in Type 2 diabetes mellitus (T2DM), affecting the economically affluent countries, is gradually afflicting also the developing world. This chapter shows the threat that the T2DM epidemic represents to mankind, with the astonishing recent discoveries on the role of obesity and of body fat in this metabolic disorder. Presently, the highest prevalence of T2DM is in Saudi Arabia. T2DM is very high in over 10% of adults in the USA, Switzerland and Austria. Prevalence is low in Norway, China and in Iceland. Predictions of epidemiologists for the first third of the 21st century claim up to 2.5 times increase in the prevalence of T2DM in the Middle East, Sub-Saharan Africa, India, rest of Asia and in the Latin America. In China the number of patients with T2DM will double in 2030. In the economically advanced countries the increase will be about 50% in 2030.
Increasing urbanization, aging populations, obesity and falling levels of physical activity are all contributing to the rise of T2DM worldwide. The main cause of T2DM pandemic is growing prevalence of obesity in Europe and USA. In the North America and European Union countries obesity is considered to be responsible for up to 70–90% of T2DM in adult population. The precise mechanism by which obesity leads to insulin resistance and to T2DM is not completely known but it may be related to several biochemical factors such as abnormalities in free fatty acids, adipokines, leptin and other substances.
KeywordsInsulin Resistance Free Fatty Acid Brown Adipose Tissue Curr Opin Investig Drug Brain Insulin Resistance
Unable to display preview. Download preview PDF.
- 1.Diabetes Atlas, International Diabetes federation, USA, 2007.Google Scholar
- 3.WHO. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Geneva, Switzerland, 2009.Google Scholar
- 4.CDC. Centres for Disease Control and Prevention. Atlanta, USA, 2007.Google Scholar
- 5.James WPT, Jackson-leach R, Mhurdu CN et al. Overweight and obesity. In: Ezzati M, Lopez AD, Rodgers A et al, eds. Comparative Quantification of Health Risks. WHO, Geneva, 2003.Google Scholar
- 12.lele RD. Pro-insulin, C peptide, glucagon, adiponectin, TNF alpha, AMPK: neglected players in type 2 diabetes mellitus. J Assoc Physicians India 2010; 58:35–40.Google Scholar
- 18.Hardie DG. AMPK: a key regulator of energy balance in the single cell and the whole organism. Int J Obes2008;32Suppl 4:S712.Google Scholar
- 22.De la Monte SM, Longato L, Tong M et al. Insulin resistance and neurodegeneration: roles of obesity, type 2 diabetes mellitus and non-alcoholic steatohepatitis. curr opin Investig Drugs 2009; 10(10):1049–1060.Google Scholar
- 25.Ferencik M, Hulin I. Obesity, fatty tissue and inflammation. Med Monitor 2008; 4:16.Google Scholar