19. Epidemiology and prevention of diabetes


Diabetes mellitus type 1

  • Epidemiology
    • 5% of all diabetes cases
    • Onset in childhood
    • Most prevalent in white
  • Etiology
    • Genetic factors
    • Autoimmune disease
    • Viral infections
  • Protective factors
    • Breast feeding
    • Vitamin D
  • Prevention
    • Secondary
      • Screening of relatives or high-risk populations
    • Tertiary
      • Glucose control

Diabetes mellitus type 2

  • Epidemiology
    • Worldwide prevalence rising
    • Becoming more and more of a problem in developing countries as well
    • Prevalence: 9% of US
      • Rising
    • Onset > 40, but age of onset is decreasing
    • Hispanics, native americans, Asians, blacks > whites
  • Etiology
    • Associated with metabolic syndrome
    • Family history
    • Obesity
    • High calorie diet
    • Physical inactivity
    • Dyslipidaemia
    • Hypertension
    • Genetic factors
      • LPL
      • Insulin receptor
      • Glucose transporter
    • Socioeconomic factors
  • Scoring systems
    • Gives the risk of developing type 2 diabetes
    • FINDRISK
    • AUSDRISK
  • Prevention
    • Primary
      • Population-based health programmes
      • Prevention of obesity
      • Reduce fat
      • Reduce sugar
      • Increase fruit, vegetables
    • Secondary
      • Screening
    • Tertiary
      • Management of cardiovascular risk factors
      • Glucose control