This week’s Lancet contains an extremely important and well written article on the steeply increasing incidence (new cases per year) and prevalence (total cases at one time) of diabetes a population study of Ontario Canada between 1995 and 2005.
This obesity-diabetes epidemic will definitely impact the previously increasing life expectancy. Dr. Olshansky et al. were correct when they predicted that obesity epidemic may cause a decline in the life expectancy. The key findings are:
1. The prevalence of diabetes increased 69%, from 5·2% in a population of 7,
2. The prevalence rates increased to a greater extent in the population under age 50 (94%) than in those older than age 50 (63%).
3. The prevalence increased in a straight line by 6.2% annually from 1995 to 2005.
4. The overall prevalence remained higher in men than in women (9·4% vs 8·4% in 2005, p<0·0001).
5. In 2003, the incidence rate was a shocking 8.2 per 1,000 people.
6. The greatest rise in diabetes occurred in young women (108·2%) compared with an 81·4% increase in young men.
7. The rate of new cases increased 31% from 6·6 per 1000 in 1997 to 8·2 per 1000 in 2003. Translated: more cases are being diagnosed today than ten years ago.
8. The adjusted mortality rate in people with diabetes fell by 25% from 1995 to 2005. Of note, however, the mortality improvement in Ontario, Canada is higher (better) than that seen in other developed nations, notably Denmark and the US.
Diabetes is one of the most costly “and burdensome” chronic diseases and a leading cause of blindness, vascular disease (myocardial infarction, stroke, and peripheral artery occlusion), and renal failure.
This increase in type-2 diabetes can be directly attributed to increasing obesity rates; obesity in Ontario increased 20% to 30% during the study period. The authors pointed out that the new diagnostic criteria did not appear to cause the increase in incidence.
The obesity epidemic is a new phenomenon (see CDC obesity tables) , continues to grow, and cause an epidemic of type-2 diabetes and will shorten life expectancy. We know that to be true for individuals with obesity and diabetes, but these population numbers appear powerful enough to impact future population life expectancy.
This is a tsumania that we are poorly prepared to handle and one that will consume the health care system. We must start to seriously attack this obesity epidemic. Are you at risk?
Stay well. Live well as long as you are alive. Dr. Bob
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