 |
The above
headline from the South China Morning Post (2nd June, 2001) reflects a regional
manifestation of what is becoming a worldwide problem. Currently, rates of diabetes are
increasing rapidly worldwide, and in the US close to 50% of the population is overweight,
with around 30% clinically obese. In China, these figures are lower, but the incidence of
diabetes in Beijing increased five-fold between 1980 and 1996, and are set to double
across the country by 2015. Up to 30% of people in some parts of China are overweight. An
age standardised prevalence study of all ethnic groups in Manchester, England, has found
that a staggering 20% of white Europeans, 22% of African-Caribbeans, and 33% of people of
Pakistani descent have type 2 diabetes (Diabetes Care 2001;24:1377-83). Obesity and lack
of exercise were important risk factors, and over 60% of all cases were associated with
poverty (annual income under ?10 000) (BMJ, 14/9/01).
The second stage complications arising after the appearance of diabetes include renal
disease; 40-42% of end-stage renal disease (ESRD) patients in the USA, New Zealand and
Singapore have diabetic nephropathy. Diabetic nephropathy is lower in Europe, but is the
fastest growing cause of ESRD there. The expenditure on ESRD in the USA will double in the
next 10 years to US$28 billion (Lancet, 2001, 357, 1601-8) |
