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Epidemiology

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Principles of Diabetes Mellitus

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Abstract

There has been a continuous increase in the incidence and prevalence of diabetes mellitus over the past 20 years, both globally and in the United States of America. A 20 to 69% increase was projected from 2010 to 2030 in developing and developed countries, respectively. The majority of this increase is attributed to type 2 diabetes (T2DM) the most common type of diabetes (87 to 95% of cases). In 2015, it was estimated that 1 in 11 persons in the world had diabetes. T2DM prevalence in the U.S. has quadrupled since 1980s. In 2012, the prevalence was highest amongst American Indians/Alaska Natives (15.9%), lowest amongst Non-Hispanic Whites (7.6%) and intermediate amongst Non-Hispanic Blacks, Hispanics and Asian Americans (13.2, 12.8 and 9.0%, respectively). Recent trends in the U.S. reveal an overall plateau in prevalence, increased incidence amongst youth and an almost equal distribution of T2DM in men and women. This increase in diabetes prevalence in the U.S. and throughout the world has been attributed to an increase in the ability to diagnose diabetes, an increase in lifespan, and the worsening obesity and physical inactivity epidemics seen globally. Differences between groups exposed to similar environments implicates a genetic contribution to the development of diabetes. Data suggests that the modern lifestyle with consequent obesity and sedentarism may interact with preexisting diabetes genes and lead to epigenetic modifications.

The incidence of type 1 diabetes (T1DM) is also on the rise both globally and in the U.S., particularly amongst children under the age of 15. It is estimated that by the year 2050, there will be a 20 to 70% increase in the prevalence of T1DM, depending on age and geographic location. It is unclear whether this is due to improved ability of diagnosis versus a true increase in genetically stable populations under the inducing influence of non-genetic factors changing over time and place.

Once diabetes is diagnosed, efforts must be made to prevent secondary complications through strict glycemic control and control of other metabolic risk factors such as hypertension and hyperlipidemia. Recently in the U.S. there has been a decrease in complications such as stroke, myocardial infarction, amputations, and death due to hyperglycemia. Since many complications are present before T2DM is diagnosed, early diagnosis and prevention of T2DM is key to further decreasing the incidence of complications.

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Authors and Affiliations

  1. Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Mount Sinai St. Luke’s and West Hospitals, Icahn School of Medicine at Mount Sinai, 1111 Amsterdam Avenue, New York, NY, USA

    Deena Adimoolam, Varalakshmi Muthukrishnan & Jeanine B. Albu

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  1. Deena Adimoolam
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  2. Varalakshmi Muthukrishnan
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  3. Jeanine B. Albu
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Correspondence to Deena Adimoolam , Varalakshmi Muthukrishnan or Jeanine B. Albu .

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Editors and Affiliations

  1. Division of Endocrinology, Gerald J. Friedman Diabetes Institute, Lenox Hill Hospital, Hofstra Northwell School of Medicine, Northwell Health, New York, New York, USA

    Leonid Poretsky

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Adimoolam, D., Muthukrishnan, V., Albu, J.B. (2017). Epidemiology. In: Poretsky, L. (eds) Principles of Diabetes Mellitus. Springer, Cham. https://doi.org/10.1007/978-3-319-18741-9_8

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