Diabetic Nephropathy in the Third World

Abstract

Although diabetes mellitus is not a leading cause of death in the Third World, it is certainly an important cause of morbidity and mortality. The prevalence of diabetes mellitus in South-East Asia has been reported to vary from 1.99% to 3.5% [1]. However, data from different studies cannot be compared because their diagnostic criteria for diabetes mellitus have been different. Detailed epidemiologic studies using the same standard criteria are needed to define prevalence rates. The prevalence of diabetes is higher in the urban as compared with the rural population. This can be explained due to differences in dietary habits, environmental factors, and socioeconomic conditions. The prevalence of diabetes is higher in patients with undernutrition [2]. It has been suggested that undernutrition causes chronic stress with its concomitant hormonal changes. Epidemiologic studies have further shown that viral or other infectious agents may play an important etiologic role in the genesis of diabetes [3]. Special attention has been focused on coxachie virus. In the Third World, the incidence of infections is very high because of unhygienic conditions that increase the prevalence of diabetes mellitus.