Europe
The prevalence of diabetes has actually been estimated by applying the That 1999 criteria [8] for 13 European and 11 Asian cohorts participating in the DECODE and the DECODA studies. In Europe, the age-personal prevalence of diabetes flower along with age up to 70s and 80s in the two men and women [10] (Figure 3.3). In most of the studies, the prevalence was much less compared to 10% in subjects younger compared to 60 years and between 10 and 20% at 60–79 years of age. They were greater in Malta compared to in others populations. The prevalence of isolated postload hyperglycemia (2-h glucose ≥11.1mmol L−1 and fasting glucose <7.0mmol L−1) increased much more along with age compared to did isolated fasting hyperglycemia (fasting glucose ≥7.0mmol L−1 and 2-h glucose <11.1mmol L−1), particularly in women.
A recent German study using That 1999 criteria [8] showed that the prevalence of diabetes in Germany in 2000 was 16.7% in men and 8.6% in women at 55–59 years of age and 23.1% in men and 17.0% in women at 70–74 years of age [13]; that is, rates are within the variation reported for the DECODE study: In the recent Turkish Diabetes Epidemiology Study (TURDEP-II) undertaken in 2010, the prevalence of diabetes was 16.5% and increased along with age, reaching a peak of 37.7% in urban men at 70–74 years and 43.6% in urban women at 75–79 years of age [14]. These rates are greater compared to those reported by an earlier Turkish study in 1997–1998 [15].
Compared along with most of the others racial and ethnic teams worldwide, where age- and sex-personal prevalence of diabetes has actually been reported, Europeans have actually a moderate to reasonable prevalence of diabetes [10].
United States
In the United States, the prevalence of diabetes varies considerably among various ethnic groups. The prevalence was 1.9 times higher in Latino Americans and 1.6 times in African Americans compared to in Whites of the exact same age in the 3rd National Good health and Nourishment Examination Survey (NHANES III) [16]. In NHANES III, where a single fasting plasma glucose≥7.0mmol L−1 was applied for the diagnosis of diabetes, the prevalence of diabetes in US Whites in 1988–1994 was 5.9% in men and 4.8% in women at 40–49 years of age and reached a peak of 19.2% in men and 16.6% in women at 7five years or older [16]. The prevalence of undiagnosed diabetes according to the exact same fasting glucose criteria at a comparable age range of 40–59 years was greater in US Whites compared to in most of the female and in half of the male European populations participating in the DECODE study [10]. The rates were greater in Mexican Americans compared to in US Whites, and were greater compared to seen in any sort of of the populations included in the DECODE study.
The Pima Indians have actually the highest prevalence of diabetes in the world, being 50% at 30–64 years of age, estimated using 2-h postload glucose test alone [17]. The prevalence of diabetes in Native Hawaiians (Polynesian population of Hawaii) in two rural communities was estimated using That 198five criteria [18]. At 30–39 years of age, the prevalence was 6.5% in women and 10.7% in men, reaching a peak of 34.6% in women and 40.0% in men at 70 years or older. others Native American tribes likewise have actually a greater prevalence of diabetes compared to Caucasoids do.
Central and South America
The age-standardized prevalence of diabetes using 2-h glucose criteria alone was investigated in a Brazilian population in Sao Paulo in 1987 and in a Colombian population in Bogota in 1988–1989 [17]. The prevalences in the two populations were similar, about 7% for men and 9% for women. The age-personal prevalence of diabetes in a Mexican population in Mexico City was 4.2% in men and 3.2% in women at 35–39 years of age and reached 23.1% in men and 41.7% in women at 60–64 years of age [17].
Australia
The Australia Diabetes, Obesity and Lifestyle Study (AusDiab) took put in 1999–2000 applying That 1999 criteria mainly in Caucasoids.The prevalence of diabetes increased along with age, from 2.7% in men and 2.2% in women at 35–44 years of age to 23.5% and 22.7% at 7five years or older [19]. These rates were greater compared to those in most of the DECODE populations [10].
Asia and Pacific Islands
Asia The prevalence of diabetes varies markedly among Asian populations. In those participating in the DECODA study, it rises along with age up to 70s and 80s in Chinese and Japanese, and in Indian men and women along with age up to 60s then declines [12] (Figure 3.4a,b). The age- and sex-personal prevalence and the peak prevalence of diabetes were greater in cohorts from India and Singapore compared to in most of the Chinese and Japanese cohorts. In Chinese and Japanese, the prevalence was much less compared to 10% at 30–49 years of age; the peak prevalence was much less compared to 20% in most of the cohorts and none exceeded 30%. In contrast, in India and Singapore the prevalence was over 10% among people aged 40–49 years, and over 30% among those aged 50–69 years for most of the cohorts. The urban Chinese and Japanese had significantly greater prevalences of diabetes compared to their rural counterparts at 40–69 years of age in men and at 50–79 years of age in women (Figure 3.4).The prevalence of diabetes in Korea was within the range observed in China and Japan [20].
In the late 1990s, King et al. carried out a collection of studies on diabetes in Uzbekistan and Mongolia using That 198five criteria [6]. In Uzbekistan, the prevalence of T2DM was relatively reasonable in people younger compared to 4five years, about 1%, and 10–15% at 6five years or older [24]. It was relatively rare in people younger compared to 4five years, about 1%, and 10–15% at 6five years or older. The prevalence in Mongolia [25] was relatively reasonable along with a peak of much less compared to 5% at the age of 6five years or older, comparable to the prevalence reported from China in 1994 [26]. Taking in to account the higher positive cutoff value of 7.8mmol L−1 for fasting glucose for diabetes in the That 198five criteria, the prevalence reported in these studies would certainly be somewhat greater if the most recent cutoff value of 7.0mmol L−1 were used. Since various diagnostic criteria have actually been applied, the outcomes from a few of these studies cannot be compared straight along with those from the DECODA study [12].
Compared along with the European populations included in the DECODE study [10], the age-personal prevalence of diabetes in urban Chinese and Japanese was slightly greater compared to that in Europeans at 30–69 years of age, however was reduced compared to that in Indians. In the elderly population, however, the peak prevalence was greater in a couple of European populations compared to in Indians, such as in Maltese, in Finnish women in Oulu, and in women living in the Canary Islands, Spain.The age at which the peak prevalence of diabetes was reached was similar for Europeans, Chinese, and Japanese (over 70 years), while Indians had their highest prevalence at the age up to 60s then started to decline. These differences in prevalence in the elderly (women, in particular) are probably because of selective mortality associated along with diabetes. The recent survey in China showed a marked raise in the prevalence of T2DM; it was 9.7%, representing an estimated 92.4 million adults in China along with diabetes in 2007 [27].
In all of Asian populations included in the DECODA study, the prevalence of isolated fasting hyperglycemia (fasting plasma glucose ≥7.0mmol L−1 and 2-h plasma glucose <11.1mmol L−1) did not raise along with age (Figure 3.4).The prevalence of isolated 2-h hyperglycemia (2-h plasma glucose ≥11.1mmol L−1 and fasting plasma glucose <7.0mmol L−1) tended to raise along with age in Chinese and Japanese however not in Asian Indians [12].
Pacific Islands
There are amazing differences in the prevalence of diabetes among the Melanesia, Micronesian, and Polynesian populations of the Pacific Islands. According to the 2-h postload glucose criteria alone [6], an age- standardized diabetes prevalence of much more compared to 40% was revealed in the Micronesia population of Nauru in the 1980s [28,29]. The prevalence of diabetes in the Melanesia population of Papua Brand-new Guinea had been reported close to 0% in highland populations [30], whereas in the urbanized Koki people the age-standardized fee exceeds 40%, approaching that of Nauru [29], exhibiting an extreme urban–rural gradient. Intermediate rates are seen in others Pacific Island populations. In the Polynesia population of the Western Samoa, the crude prevalence rates were 3.4 and 8.7% in rural and urban populations, respectively. By 1991, these rates had risen to 6.five and 9.0% in two rural communities and to 16% in the urban settings of Apia [31]. A recent study in the Polynesia population of Tonga in 1998–2000 using 2-h OGTT showed that the peak prevalence of diabetes reached 20% in men and 40% in women aged 60 years or older [32].
Middle East
The prevalences of diabetes in Arabian countries, calculated according to the That 198five criteria [6], have actually been reported to be higher [33–35]. It is relatively reasonable prior to the age of 30 years and starts to raise throughout the 40s, along with the highest in the oldest age group (Figure 3.5). In a rural Palestinian village, in 1996 the prevalence of diabetes was much less compared to 4.0% in people younger compared to 40 years however increased to 11.0% at 40–49 years of age, along with a peak of 21.7% in men and 31.6% in women at 60–6five years of age [35]. The prevalence in Palestine was much like that in rural Saudi Arabia, however the two were reduced compared to that in urban Saudi Arabia [33]. The prevalence of T2DM in 1995–1996 in Kuwait was recalculated using ADA 1997 criteria [7]. It was reduced compared to 3% at age 20–29 years, about 9% at age 30–39 years and greater compared to 15% at age 40–49 [36]. Diabetes is prevalent in all of Arab countries despite the differences in economic status among these countries, indicating that genetic susceptibility and cultural factors might play an vital role in the progress of the disease.
The age-personal fee ranged from 8% at 40–44 years of age to 25% at 60–64 years of age in Israeli Jews [17].
Africa
In subjects aged 30–64 years, the age-standardized prevalence of diabetes using 2-h glucose alone has actually been reported to be greater in Hindu and Muslim Indians living in Mauritius [37] and Tanzania [38], about 10% in Tanzania and 13–18% in Mauritius. The age-standardized fee was pretty reasonable in Bantu in Tanzania, much less compared to 1% in women and 0.9–3.3% in men [39]. The prevalence was 8% in Tunisia [17]. It is interesting to note that the age-standardized prevalence was considerably greater in Chinese living in Mauritius compared to that in Da Qing in China in the mid 1980s [17,37], indicating the importance of impact of the environmental factors.
In Native People: Mapuche and Aymara in Chile and in Siberia in Russian Federation
The native people That still technique their traditional lifestyle and undertake substantial bodily activity have actually really reasonable prevalences of diabetes despite their higher prevalence of obesity [40,41]. Among Aymara the prevalence of diabetes in 1997 was almost undetectable despite the honest truth that 13% of the men and 24% of the women had a physique mass index (BMI) greater compared to 30 kg m−2 [40]. Similar findings have actually been reported among native Mapuche [41,42]. The indigenous teams in northern Siberia likewise showed a pretty reasonable prevalence, being much less compared to 1% in 1994 [43]. This suggests that a healthy and balanced lifestyle along with considerably bodily activity provides protection from the progress of diabetes. A recent report from Mapuche [41] showed that the prevalence in 1998 was greater compared to that reported 1five years ago, as was the prevalence of obesity [42], suggesting a feasible impact of lifestyle adjustments on the trends in prevalence of diabetes.
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