The Epidemiology of Diabetes Mellitus: An International Perspective. J-M Ekoé, P Zimmet, R Williams (eds). Chichester: John Wiley, 2001, pp. 437, £120. ISBN: 0-471-97448-X.

Extract

Once considered primarily as a risk factor for heart disease, diabetes has now become a high profile public health concern in its own right, due to the escalating epidemic of diabetes in older people, and the emergence of type 2 diabetes in children.

The number of people with diabetes worldwide is set to double in the next 20 years, as a result of increasing obesity and longevity. While some of this increase will be observed in Europe and North America, it is clear that the bulk of the epidemic will be observed in non-European origin populations, in countries undergoing rapid westernization. If anything, the European origin populations are the anomaly, being substantially protected from type 2 diabetes compared to other world populations. This is reflected in our current understanding of the epidemiology of diabetes, derived mainly from the study of non-European populations, such as the Pima Indians and Naruans. But it is clear that diabetes risks, manifestations, natural history and even the criteria for the definition of diabetes itself, may vary considerably by population.