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The Epidemiology of Diabetes Mellitus is Subject to Change

13 Jan 2017Health Essays

Introduction

Diabetes type II is a metabolic degenerative disease characterized by either low production of insulin levels, resistance of cellular response to insulin or impaired structure of cellular reception as affected by various etiological effectors. The increase of blood sugar in the body due to inappropriate transmission and reception of insulin functions with cellular receptors. According to studies made, there are various environmental and dietary contributing factors, which directly provide a cause and effect relationship in the increasing conditions of DM Type II patients. Moreover, another parallelism involves the obesity as well as overweight epidemic rates, which greatly contributes to the epidemiologic cases of diabetic mellitus (Schulze & Hu, 2004 p.446).

In the past, between 1935-1996, the prevalence rate of DM type II has reached 765%. During the first half of 20th century, the ration of diabetic or cardiovascular disease mortality progresses to 1:5. According to financial statistics, such conditions have dealt around 20% of health-care expenditures, specifically $220 billion in direct medical cost of 1997. In our current generation, Type 2 DM is in the status of epidemic as evidenced by affecting almost 8% of the population in the United States (Liu, 2002 p.298).

During 1991-1992, only eight states had a diabetes prevalence exceeding 6%, but by 1997-1998 the number of states with such a prevalence had risen dramatically to 23. In most of the states, the increase was independent of age, gender, ethnic group, or educational level. The greatest morbidity and mortality rates from type 2 diabetes occur in the elderly and minority groups in the United States, a trend that epidemiological studies predict will not change in the near future (Bouchard, 2007 p.193).

There is now a considerable amount of evidence to suggest that rapid acculturation is associated with increased rates of Type 2 diabetes. There are clearly several characteristics of the Western way of life, which predispose to the development of obesity. It may simply be that the increase in obesity resulting from an aggregation of these factors, especially physical inactivity and increased intake of energy-dense foods leading to energy intake in excess of requirements, explains the increasing rates of Type 2 diabetes (Ekoé etal, 2001 p.133).

Lifestyle changes are some of the factors that are linked with the causation of Diabetes Mellitus. According to statistics, 47 million American inpiduals possess the condition and experiences diabetic manifestations. Type II Diabetes Milletus involves around 90%-95% of the over-all diabetic cases (Schulze & Hu, 2004 p.445).

The epidemiologic status of Diabetes Mellitus has increased tremendously for the past two decades and expectations suggest that this increase pattern and epidemiologic count progression shall continue into the next decade. According from the World Health Organization, for the next 25 years, the diabetic epidemic is assumed to grow in all regions most markedly in the Americas, the Eastern Mediterranean and Southeast Asia. It is expected that by year 2025, 300 million people, from the 1995 epidemiologic count of 160 million, shall possess the condition of diabetes worldwide (Gabiola, 2006 p.1).

Epidemiological surveys for diabetes are complicated to perform and prone to underestimate the real magnitude of the problem. Recent estimates by the International Diabetes Institute and the World Health Organization suggest that globally the number of persons with diabetes will increase from 151 million in the year 2000 to 221 million by the year 2010. This rate of increase is predicted to occur in virtually every country throughout the world. However, the greatest increases for the next decade are expected to occur in developing countries, particularly in Asia. One of the most important recent population-based studies from the United States (the Third National Health and Nutrition Examination Survey, NHANES III) showed a marked increase in the prevalence of diabetes.

Epidemiological predictions drawn by NHANES III are consistent with the trend seen in virtually developed Western country. It is predicted that the number of people diagnosed with type 2 diabetes in the United States will increase by 165% in the next 50 years, rising from 11 million in 2000 to 29 million by year 2050. The highest increases are expected to occur among people aged 75 years and over (336%) and among African Americans (275%) (Bouchard, 2007 p.193).

One of the perceived factors affecting this change is the lifestyle modifications. The one billion overweight adults in the world, 300 million are clinically obese. This is an alarming situation, even in light of limited availability of population-based data. Obesity and overweight are major risk factors for chronic diseases, including diabetes mellitus (Bagchi & Preuss, 2007 p.21). Obesity is the etiological factor in the development of type 2 diabetes mellitus with 70-80% of type 2 diabetes patients presenting with obesity or those with BMI of greater than 30kg/m2. This phenotype is associated with insulin-resistance and thus differs metabolically from type 1 diabetes, which is an insulin-deficient state (Barnett & Kumar, 2004 p.99).

The suggestion that refined carbohydrates, and sugars in particular, might be involved in the etiology of type II diabetes. Carbohydrate consumption and DM Type II prevalence from year 1963- 1997 validates possible relationship between refined carbohydrate effects on DM Type II occurrence. According to the data obtained, the consumption of carbohydrates has increased to 500 g/d as compared to the previous data consumption, which 374 g/d from the year 1909 – 1963. During this period, it has been noted that the prevalence rate of obesity has increased by 80% while the prevalence of the occurrence of the disease, Diabetes Milletus Type II, has been noted to be increased by 47% (Gross et al, 2004 p.774).

Obesity is one of the pointed causes of such diabetic count increase that influences the number of diabetes patients. Community-based study in Framingham Offspring Study Cohort, they have assessed that the rate of acquiring diabetes for ages 40 and 55 has doubled its risk rate. The analysis has been linked to the assessment gathered in 1990 wherein an absolute increase of incidence rate of DM Type II patient has increased 2.5%. It has also been noted that diabetes is much more evident in inpiduals who have obese status while those who are overweight and normal baseline have not shown significant correlations with diabetic increased rate (Fox etal, 2006).

During the past 20 years, alterations in American diet have proportionately and consistently altered the occurrence of the disease causation itself. DM Type II has reached it epidemic case especially as the contributing factors in reaches their full exposure and influence in the society. The population findings, metabolic assessments and prospective studies on the obtained subjects have suggested that refined carbohydrates increases several factors, such as obesity, glucose intolerance, dyslipidemia, and finally, type II diabetes. Such risk may be reduced by the use of other alternative carbohydrates, such as low-GI carbohydrate sources and products that are high in fiber (Gross et al, 2004 p.777-778).

Among the major reasons behind the expected dramatic increase in the incidence of type II diabetes are the anticipated world population growth, mostly in developing countries, the increase in life span or longetivity in most Western countries, and certain environmental factors. In particularly, rapidly changing and unhealthy dietary patterns, along with increasingly sedentary lifestyles, lead to the root cause of such change, obesity. Even small changes in lifestyle can be very significant for preventing and treating type II diabetes and for determining the incidence of this metabolic disorder in the long term. In contrast, unhealthy diets rich in high saturated fats, together with reduction in physical activity even at early ages, may result in a public health problem even greater than predicted to date by epidemiological studies (Bouchard, 2007 p.193).

On the other hand, there is rather more support for the suggestion that foods rich in slowly digested or resistant starch or high in soluble dietary fiber might be protective. Countries with high intakes of these foods have low rates of diabetes, and in fact, even the mortality rates of diabetes mellitus have reduced. The data gathered have indicated that these refined carbohydrates induce alteration in its own compositions that contributed to the risks of conjuring the disease as evidenced by the epidemiologic conditions of diabetic inpiduals. Most evidently in the current generation wherein refined carbohydrates are much more utilized than those dietary carbohydrates, the effect indeed is greatly seen since the American society today possess less than half of its population suffering from Diabetes Milletus II conditions.

Reference

  • Bagchi, D., & Preuss, H. G. (2007). Obesity: Epidemiology, Pathophysiology, and Prevention. CRC Press.
  • Barnett, A. H., & Kumar, S. (2004). Obesity and Diabetes. John Wiley and Sons.
  • Bouchard etal, C. (2007). Physical Activity and Health. Human Kinetics.
  • Ekoe et.al, J. M. (2001). The Epidemiology of Diabetes Mellitus: An International Perspective. John Wiley and Sons.
  • Gabiola, J. (2006, November 20). Type II Diabetes Mellitus: Epidemiology and Treatment Update.
  • Gross et al, L. S. (2004, January). Increased Consumption of refined Carbohydrates and the Epidemic of Type 2 Diabetes in the United States: An Ecologic Assessment. American Society for Clinical Nutrition, 79, 774-779.
  • Fox etal, C. S. (2006, April 27). Trends in the Incidence of Type 2 Diabetes Mellitus From the 1970s to the 1990s . American Heart Association, Inc. ,
  • Liu, S. (2002, January). Intake of Refined Carbohydrates and Whole Grain Foods in Relation to Risk of Type 2 Diabetes Mellitus and Coronary Heart Disease. Journal of the American College of Nutrition, 21, 298-306.
  • Schulze etal, M. B. (2005, January). Dietary Pattern, Inflammation and Incidence of Type II Diabetes in Women. American Society for Clinical Nutrition, 82, 675-84.
  • Schulze, M. B., & Hu, F. B. (2005, October). Primary Prevention of Diabetes: What Can Be Done and How Much Can be Removed?. Annu. Rev. Public. Health, 26, 445-67.

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