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Increased Consumption Of Refined Carbohydrates And The Epidemic Of Type 2 Diabetes In The United States: An Ecologic Assessment

Increased Consumption Of Refined Carbohydrates And The Epidemic Of Type 2 Diabetes In The United States: An Ecologic Assessment

Background: Type 2 diabetes is an epidemic that is affecting an ever-increasing proportion of the US population. Although consumption of refined carbohydrates has increased and is thought to be related to the increased risk of type 2 diabetes, the ecologic effect of changes in the quality of carbohydrates in the food supply on the risk of type 2 diabetes remains to be quantified. Objective: The objective was to examine the correlation between consumption of refined carbohydrates and the prevalence of type 2 diabetes in the United States. Methods: In this ecologic correlation study, the per capita nutrient consumption in the United States between 1909 and 1997 obtained from the US Department of Agriculture was compared with the prevalence of type 2 diabetes obtained from the Centers for Disease Control and Prevention. Results: In a univariate analysis, a significant correlation with diabetes prevalence was observed for dietary fat (r = 0.84, P < 0.001), carbohydrate (r = 0.55, P < 0.001), protein (r = 0.71, P < 0.001), fiber (r = 0.16, P = 0.03), corn syrup (r = 0.83, P < 0.001), and total energy (r = 0.75, P < 0.001) intakes. In a multivariate nutrient-density model, in which total energy intake was accounted for, corn syrup was positively associated with the prevalence of type 2 diabetes ( = 0.0132, P = 0.038). Fiber ( = 13.86, P < 0.01) was negatively associated with the prevalence of type 2 diabetes. In contrast, protein (P = 0.084) and fat (P = 0.79) were not associated with the prevalence of type 2 diabetes when total energy was controlled for. Conclusions: Increasing intakes of refined carbohydrate (corn syrup) concomitant with decreasing intakes of fiber paralleled the upward trend in the prevalence of type 2 diabetes observed in the United States during the 20t Continue reading >>

Cities Are The Front Line In The Global Diabetes Epidemic

Cities Are The Front Line In The Global Diabetes Epidemic

Today, 437 million people worldwide have type 1 or type 2 diabetes. New estimates published this month show that three-quarters of a billion people could have the disease by 2045 — and cities are the front line of this challenge. As the growth fast becomes unmanageable for health systems, shortening the lives of millions of urban citizens and constraining economic growth, Novo Nordisk is working with a coalition of major cities to bend the curve on type 2 diabetes. We’re calling for local political and health leaders of all cities to ask what it will take to change the trajectory of the disease in their area and to put into practice the new models that we are forging. A rapidly urbanizing world is changing not just where we live but also how we live. As my predecessor at Novo Nordisk wrote, the way cities are designed, built, and run creates health benefits for citizens — but critically it also creates risks. Towns and cities, where half of the world’s population now lives, are home to two-thirds of people with diabetes. That’s why when we initiated the Cities Changing Diabetes program in 2014, we set out to put a spotlight on urban diabetes. This effort has grown into a global partnership of nine major cities, home to over 75 million people, and over 100 expert partners united in the fight against urban diabetes. Without concerted action, health systems around the world will reach a point in coming decades when they won’t be able to effectively treat patients sustainably. We conservatively estimate that the related costs of diabetes — including medication, supplies, hospital care, and the treatment of complications — will exceed $1 trillion a year by 2045. The catastrophic rise in diabetes won’t be stemmed by medicine alone. That’s why cities need t Continue reading >>

N South African Journal Of Diabetes - The Epidemiology Of The Diabetes Epidemic : A Growing Public Health Concern

N South African Journal Of Diabetes - The Epidemiology Of The Diabetes Epidemic : A Growing Public Health Concern

Introduction The diabetes epidemic is one of the most important public health crisis of our time and the modernized lifestyle prevalent in most parts of the world is a catalyst for its perpetuation. The diagnosis of diabetes mellitus represents a spectrum of metabolic diseases characterized by an absolute or relative and progressive deficiency of insulin, which in many cases is accompanied by inadequate physiological responses to insulin – this leads to a chronic tendency to elevated blood glucose levels. The consequences of diabetes are multifarious - these include enormous financial expenditure by organizations and governments and individuals for the costs of treatment and, perhaps most importantly, an increased (although preventable) risk of complications leading to disability or death. Hence, concerted efforts are required to stem the tide of the epidemic. Continue reading >>

Diabetes Epidemic Sweeping The Arab World

Diabetes Epidemic Sweeping The Arab World

Diabetes epidemic sweeping the Arab world Number of Hits and Downloads for This Article Apr 25, 2016 (publication date) through Sep 5, 2018 Baishideng Publishing Group Inc, 7901 Stoneridge Drive, Suite 501, Pleasanton, CA 94588, USA Copyright The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. World J Diabetes.Apr 25, 2016;7(8): 165-174 Published online Apr 25, 2016.doi: 10.4239/wjd.v7.i8.165 Diabetes epidemic sweeping the Arab world Bisher Abuyassin, Ismail Laher, Department of Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada Author contributions: Abuyassin B conducted the literature search and prepared the manuscript; Laher I reviewed and edited the manuscript. Conflict-of-interest statement: Authors have no financial conflicts of interest related to this work. Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Correspondence to: Dr. Ismail Laher, PhD, Department of Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, 2176 Health Science Mall, Medical Block C, Vancouver, BC V6T 1Z3, Canada. The prevalence of type-2 diabetes mellitus (T2DM) has increased dramatically during the last 2 decades, a fact driven by the increased prevalence of obesity, the primary risk factor for T2DM. The figures for diabetes in the Arab world ar Continue reading >>

The Global Diabetes Epidemic

The Global Diabetes Epidemic

Twelve years ago, my husband and I packed up all of our belongings and moved to Trivandrum — a steamy, tropical town at the southern tip of India in Kerala. At the time, I was a medical student interested in studying stroke. For the next six months I dressed in a sari and walked to work on jungle roads. At the hospital, I immediately began seeing a steady stream of young patients affected by strokes, many of whom were so severely disabled that they were unable to work. I initially suspected the cause was tuberculosis or dengue fever — after all, this was the developing world, where infections have long been primary culprits for disease. But I soon learned that my hunch was wrong. One of my first patients was a woman in her mid-30s who came in with a headache, vomiting and an unsteady gait. Her scan showed a brainstem stroke. Her blood sugars were very high. The underlying cause of her stroke was most likely untreated Type 2 diabetes. Here I was, halfway around the globe, in a vastly foreign culture, but I was looking at a disease — and the lifestyle that fostered it — that was startlingly familiar. Today, I am an endocrinologist, and diabetes has become a full-blown epidemic in India, China, and throughout many emerging economies. In the United States, diabetes tends to be a disease that, while certainly not benign, is eminently manageable. Just this month, federal researchers reported that health risks for the approximately 25 million Americans with diabetes had fallen sharply over the last two decades. Elsewhere on the globe, however, diabetes plays out in a dramatically different fashion. Patients often lack access to care and can’t get insulin, blood pressure pills and other medicines that diminish the risk of complications. As more and more people develop Continue reading >>

An American Epidemic - Diabetes

An American Epidemic - Diabetes

Upgrade your inbox and get our Daily Dispatch and Editor's Picks. ON February 10th thousands of people crowded into a diabetes exhibit in Denver. They waited in lines to test the newest blood sugar meters. Matt Hoover, a star of the small screen, spoke about how he lost 157lb (71kg) and gained a wife. Representatives dispensed gewgaws. It's an insulated bag, explained one, So if you've got a hot chicken... No one had a hot chicken, though. The diabetic diet can be a Spartan affair. Over at the Cooking Cardiologist presentation, a dietician announced that people with diabetes should feel free to enjoy raisinsjust not too many raisins. Not so many years ago such a scene would have been strange. Colorado is the kind of healthy, outdoorsy state where everyone seems to have a big dog and SUVs are splattered with mud. It has the lowest rate of obesity in the nation, and not coincidentally, about the lowest rate of diabetes. Just under 5% of Coloradans have been diagnosed with the disease. But that is not all that low. And the fact that it is one of the lowest in the country suggests the extent of the diabetes epidemic in America. The disease has become more than twice as common since 1980, and the rate is rising precipitously. According to the Centres for Disease Control and Prevention, 7% of Americans, roughly 21m people, have diabetes. At least 54m Americans have elevated blood sugar levels and are at risk of developing the full-blown disease. Rates are considerably higher among American Indians, African-Americans and Latinos. The economic costs of the disease were conservatively estimated at $132 billion in 2002, and the figure is rising. If you look forward 10 or 15 years, says Dr C. Ronald Kahn of the Joslin Diabetes Centre in Boston, we really won't be able to afford t Continue reading >>

1 Type 2 Diabetes: A 21st Century Epidemic

1 Type 2 Diabetes: A 21st Century Epidemic

Around 415 million people around the world have diabetes (9% of adults), and the vast majority live in low- and middle-income countries. Over the next decade, this number is predicted to increase to 642 million people. Given that diabetes is a major cause of mortality, morbidity, and health care expenditures, addressing this chronic disease represents one of the greatest global health challenges of our time. The objectives of this article are three-fold: (1) to present data on the global burden of type 2 diabetes (which makes up 87–91% of the total diabetes burden), both in terms of prevalence and incidence; (2) to give an overview of the risk factors for type 2 diabetes, and to describe obesity and the developmental origins of disease risk in detail; and (3) to discuss the implications of the global burden and point out important research gaps. Continue reading >>

Cost Of Diabetes Epidemic Reaches $850 Billion A Year

Cost Of Diabetes Epidemic Reaches $850 Billion A Year

(Reuters) - The number of people living with diabetes has tripled since 2000, pushing the global cost of the disease to $850 billion a year, medical experts said on Tuesday. The vast majority of those affected have type 2 diabetes, which is linked to obesity and lack of exercise, and the epidemic is spreading particularly fast in poorer countries as people adopt Western diets and urban lifestyles. The latest estimates from the International Diabetes Federation mean that one in 11 adults worldwide have the condition, which occurs when the amount of sugar in the blood is too high. The total number of diabetics is now 451 million and is expected to reach 693 million by 2045 if current trends continue. The high price of dealing with the disease reflects not only the cost of medicines but also the management of a range of complications, such as limb amputations and eye problems. Continue reading >>

Diabetes And Its Drivers: The Largest Epidemic In Human History?

Diabetes And Its Drivers: The Largest Epidemic In Human History?

Abstract The “Diabesity” epidemic (obesity and type 2 diabetes) is likely to be the biggest epidemic in human history. Diabetes has been seriously underrated as a global public health issue and the world can no longer ignore “the rise and rise” of type 2 diabetes. Currently, most of the national and global diabetes estimates come from the IDF Atlas. These estimates have significant limitations from a public health perspective. It is apparent that the IDF have consistently underestimated the global burden. More reliable estimates of the future burden of diabetes are urgently needed. To prevent type 2 diabetes, a better understanding of the drivers of the epidemic is needed. While for years, there has been comprehensive attention to the “traditional” risk factors for type 2 diabetes i.e., genes, lifestyle and behavioral change, the spotlight is turning to the impact of the intra-uterine environment and epigenetics on future risk in adult life. It highlights the urgency for discovering novel approaches to prevention focusing on maternal and child health. Diabetes risk through epigenetic changes can be transmitted inter-generationally thus creating a vicious cycle that will continue to feed the diabetes epidemic. History provides important lessons and there are lessons to learn from major catastrophic events such as the Dutch Winter Hunger and Chinese famines. The Chinese famine may have been the trigger for what may be viewed as a diabetes “avalanche” many decades later. The drivers of the epidemic are indeed genes and environment but they are now joined by deleterious early life events. Looking to the future there is the potential scenario of future new “hot spots” for type 2 diabetes in regions e.g., the Horn of Africa, now experiencing droughts and f Continue reading >>

Type 2 Diabetes: An Epidemic Requiring Global Attention And Urgent Action

Type 2 Diabetes: An Epidemic Requiring Global Attention And Urgent Action

Decades ago, the global epidemic of type 2 diabetes was predicted by epidemiologists who observed large and rapid increases in the prevalence of type 2 diabetes among indigenous peoples who adopted Western lifestyles (1–4). Subsequent epidemiological studies demonstrated that essentially all non-Europid populations who escape the ravages of communicable diseases, enjoy abundant food and less physically demanding lifestyles and survive to middle and old age are at increased risk for type 2 diabetes, its complications, and comorbidities. The global epidemic of type 2 diabetes has been documented in a series of progressively more precise, refined, and sobering projections (5). In 1993, King et al. (6) assembled estimates of the prevalence of diabetes for adults around the world. In 1997, Amos et al. (7) first used age-specific prevalence rates for type 2 diabetes from different countries and current and projected age distributions of the world population to estimate the present and future numbers of people with diabetes worldwide. Using similar methods but incorporating additional age- and sex-specific and rural- and urban-specific diabetes prevalence rates, King et al. (8), Wild et al. (9), and Shaw et al. (10) repeated these analyses. In general, these studies projected that the number of adults with diabetes in the world will more than double between 2000 and 2030, with most of the increase occurring in developing countries, particularly in Asia. Not surprisingly, countries with the largest populations have and will have the greatest number of individuals with diabetes. Accordingly, India and China top the lists. The most recent studies have projected that by 2030, India will have 79–87 million and China 42–63 million adults with diabetes (9,10). The latter projec Continue reading >>

The Obesity Epidemic And Rising Diabetes Incidence In A Low-income Racially Diverse Southern Us Cohort

The Obesity Epidemic And Rising Diabetes Incidence In A Low-income Racially Diverse Southern Us Cohort

The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort Roles Conceptualization, Formal analysis, Methodology, Writing original draft, Writing review & editing Affiliation Department of Epidemiology and Biostatistics, University of Texas Health Science Center, Tyler, Texas, United States of America Roles Formal analysis, Methodology, Validation, Writing review & editing Affiliation International Epidemiology Field Station, Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Rockville, Maryland, United States of America Roles Formal analysis, Methodology, Validation, Writing review & editing Affiliation International Epidemiology Field Station, Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Rockville, Maryland, United States of America Affiliation International Epidemiology Field Station, Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Rockville, Maryland, United States of America Affiliation Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America Affiliation Department of Internal Medicine, Meharry Medical College, Nashville, Tennessee, United States of America Continue reading >>

The Diabetes Epidemic : What Is Diabetes And Why Is It A Problem? [article]

The Diabetes Epidemic : What Is Diabetes And Why Is It A Problem? [article]

This is the first of three articles on diabetes. This article looks at how blood sugar is normally controlled and what happens in Diabetes. It also covers why Diabetes is such a problem. The next two articles will look at Type 1 and Type 2 Diabetes seperately and in more depth. Diabetes is a disease that has reached epidemic proportions both internationally and within New Zealand. It is the leading cause of blindness, kidney failure and lower limb amputations in the world. So what is this horrible disease? How do we get it? And let’s face it – we are personal trainers not physiologists. How much do we really need to understand about the disease to train our Diabetic clients effectively? Normal Glucose Metabolism To understand Diabetes we first need to recap how glucose (blood sugar) is normally regulated in our bodies. Insulin and glucagon are the two hormones that keep our glucose levels controlled. Insulin is released from the beta cells on our pancreas when glucose levels are high. Insulin helps move glucose from the blood stream into our muscles and liver, and stores any extra glucose as fat. Glucose cannot enter your body’s cells from the bloodstream by itself, so insulin acts like a ‘key’. Once released into the blood, insulin binds to insulin receptors (the ‘keyholes’) located on the cell walls, ‘unlocking’ the cell and allowing the glucose to enter. This glucose can either be used immediately as energy or stored as glycogen or fat for future use. When blood glucose levels are low, insulin secretion is decreased, and the hormone glucagon is released from the pancreas instead. Glucagon works to break down the glycogen stores in the liver. This glucose is then released back into the bloodstream to raise the low glucose levels, meaning there is a c Continue reading >>

Global And Societal Implications Of The Diabetes Epidemic

Global And Societal Implications Of The Diabetes Epidemic

Global and societal implications of the diabetes epidemic Changes in human behaviour and lifestyle over the last century have resulted in a dramatic increase in the incidence of diabetes worldwide. The epidemic is chiefly of type 2 diabetes and also the associated conditions known as 'diabesity' and 'metabolic syndrome'. In conjunction with genetic susceptibility, particularly in certain ethnic groups, type 2 diabetes is brought on by environmental and behavioural factors such as a sedentary lifestyle, overly rich nutrition and obesity. The prevention of diabetes and control of its micro- and macrovascular complications will require an integrated, international approach if we are to see significant reduction in the huge premature morbidity and mortality it causes. Man may be the captain of his fate, but he is also the victim of his blood sugarWilfrid Oakley [Trans. Med. Soc. Lond. 78, 16 (1962)] Globalization, coca-colonization and the chronic disease epidemic: can the doomsday scenario be averted? The rising global burden of diabetes and its complications: estimates and projections to the year 2010 Global burden of diabetes, 19952025. Prevalence, numerical estimates and projections Redefining type 2 diabetes: 'diabesity' or 'obesity dependent diabetes mellitus'? Development and consequences of insulin resistance: lessons from animals with hyperinsulinaemia Definition, Diagnosis and Classification of Diabetes mellitus and its Complications. Part 1: Diagnosis and Classification of Diabetes Mellitus (Department of Noncommunicable Disease Surveillance, Geneva, 1999). Diabetes epidemiology as a trigger to diabetes research American Diabetes Association. Economic consequences of diabetes mellitus in the U.S. in 1997 Type 2 diabetes among North American children and adolesce Continue reading >>

Is Diabetes Becoming The Biggest Epidemic Of The Twenty-first Century?

Is Diabetes Becoming The Biggest Epidemic Of The Twenty-first Century?

Diabetes is a major public health problem that is approaching epidemic proportions globally. Worldwide, the prevalence of chronic, noncommunicable diseases is increasing at an alarming rate. About 18 million people die every year from cardiovascular disease, for which diabetes and hypertension are major predisposing factors. Today, more than 1.7 billion adults worldwide are overweight, and 312 million of them are obese. In addition, at least 155 million children worldwide are overweight or obese. A diabetes epidemic is underway. According to an estimate of International Diabetes Federation comparative prevalence of Diabetes during 2007 is 8.0 % and likely to increase to 7.3% by 2025. Number of people with diabetes is 246 million (with 46% of all those affected in the 40–59 age group) and likely to increase to 380 m by 2025. The comparative prevalence of IGT is 7.5% in 2007 and likely to go up to 6.0 by 2025. The number of people with IGT is 308 million in 2007 and likely to be 418 m by 2025. (1) Almost 80% of the total adult diabetics are in developing countries. The regions with the highest rates are the Eastern Mediterranean and Middle East, where 9.2 % of the adult population is affected, and North America (8.4%). The highest numbers, however, are found in the Western Pacific, where some 67 million people have Diabetes, followed by Europe with 53 million. India leads the global top ten in terms of the highest number of people with diabetes with a current figure of 40.9 million, followed by China with 39.8 million. Behind them come USA; Russia; Germany; Japan; Pakistan; Brazil; Mexico and Egypt. Two major concerns are that much of this increase in Diabetes will occur in developing countries and that there is a growing incidence of Type 2 Diabetes at a younger age in Continue reading >>

Diabetes: Biggest Epidemic In Human History

Diabetes: Biggest Epidemic In Human History

Remember back in history class, when they talked about the Great Diabetes Epidemic of 1665? Of course you don’t; there was never any such thing. Certainly, there have been many epidemics throughout history. These could be enormously destructive; killing millions, toppling empires, depopulating entire landscapes.1 But diabetes as a mass killer? That’s something new. But that is exactly where we are today. Epidemiologists are warning that the Great Diabetes Epidemic is upon us – right now. The result of the combination of obesity and type 2 diabetes (“diabesity”) is likely to be the biggest pandemic in human history.2 Perhaps the word “epidemic” sounds overly dramatic to some ears. But the Centers for Disease Control (CDC) explains that “epidemic” simply refers to an increase in the number of cases of a disease above what is normally expected in a population in a given area. Relatedly, “pandemic” refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people.3 And so CDC refers quite specifically to the diabetes “epidemic” that currently affects almost 30 million Americans, which is forecast to rise to nearly 55 million people over the next decade.4, 5 This chart illustrates the growth in diabetes in the U.S. through the year 2030: Regarding the spread to other countries, the World Health Organization estimates that the number of people with diabetes grew by nearly 300% from 1980 to 2014, to 422 million worldwide.6 That number is also predicted to rise, to 642 million people living with diabetes worldwide by 2040.7 Altogether, taking into account both the number of people it will affect, and what it will cost to treat, one researcher has gone so far as to predict that type 2 diabetes is on t Continue reading >>

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