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Diabetes Epidemic Spreading Worldwide: Experts


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According to the experts, a "perfect storm" of genetics and social change is driving the spread of obesity-linked type 2 diabetes in poorer countries. Visitors to today's China quickly notice McDonald's, KFC and other fast-food outlets springing up in major cities. At the same time, the foot and bicycle are making way for the car on urban streets.

Scientists have also long understood that Asians, Hispanics and blacks are more vulnerable, genetically, to develop type 2 disease compared with those of European descent.

"They simply don't have to get as obese as a European to get diabetes," Silink explained. Among non-Europeans, even a relatively modest increase in abdominal fat -- the so-called "spare tire" -- can trigger changes that lead to insulin insensitivity and diabetes.

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"The risk of diabetes in a European starts rising after a body mass index (BMI, a ratio of weight to height) of about 25 or 26," the normal threshold for overweight, Silink said. "But for a person coming from Bangladesh or India, that risk curve starts after a BMI of just 22," he said.

A person who is 5-feet, 8-inches tall and weighs 145 pounds has a BMI of 22.

Too often, expensive, pay-as-you-go health-care systems in developing countries mean diabetes isn't even detected until it reaches crisis levels, Silink added. The results -- prolonged disability, amputation, even death -- can destroy a family's income.

Urban stress is another factor driving the epidemic, as the world's poor seek employment in cities, Silink said. For reasons that remain unclear, "we know that simply moving from a rural environment to a city doubles your risk of diabetes without any change in body mass," he said. "And if you have to go to a 'mega-city' -- a population of over 10 million -- the risk probably rises fourfold."

Another expert said it's not too late to put the brakes on this developing crisis, however.

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Copyright © 2007 ScoutNews, LLC. All rights reserved.
Last updated 3/16/2007

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SOURCES: Martin Silink, M.D., president, International Diabetes Federation; Alan Moses, M.D., associate vice president, medical affairs, Novo Nordisk, Princeton, N.J.; March 14, 2007, press briefing with Australian Sen. Guy Barnett, Global Changing Diabetes Leadership Forum, New York City


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