EPIDEMIOLOGY OF DIABETES

MELLITUS

Dr.S.AJAY RAJ

LEARNING OBJECTIVES

• Explain the definition of Diabetes mellitus.

• Differentiate the types of Diabetes.

• Describe the magnitude of the problem across the world & in India.

• List out the epidemiological determinants of Diabetes Mellitus.

DEFINITION

• A metabolic disorder of multiple aetiology

characterized by chronic hyperglycaemia with

disturbances of carbohydrate, fat and protein

metabolism resulting from defects in insulin

secretion, insulin action or both

WHO Clinical classification of

Diabetes mellitus

1.Diabetes mellitus(DM)

• Type 1 or Insulin-dependent diabetes mellitus

• Type 2 or Non-insulin dependent diabetes mellitus

• Malnutrition related diabetes mellitus(MRDM)

• Other types(secondary to pancreatic, hormonal,

drug-induced, genetic and other abnormalities)

2.Impaired glucose tolerance(IGT)

3.Gestational diabetes mellitus(GDM)

4

Types of diabetes

Type 1 diabetes Type 2 diabetes Gestational diabetes

• Lack of insulin

• Autoimmune

• Usually children

• Insulin resistance

• Lifestyle factors

• Usually adults

• Insulin resistance

• During pregnancy

• Risks to mother and child

MAGNITUDE

Almost half of all people with diabetes live in just three countries

ChinaIndiaUSA

Indian scenario

• 65.1 million individuals with diabetes

• Diabetes Prevalence-8.56%

• Diabetes capital of the world

• More worryingly, this number is set to

increase to 87 million by 2030, more than 15

million more than China, which lies in second

place.

EPIDEMIOLOGICAL DETERMINANTS

AGENT FACTORS

Insulin deficiency caused by:

• Pancreatic disorders

• Defective insulin production

• Destruction of beta cells

• Decreased insulin sensitivity

• Genetic defects

• Autoimmunity

HOST FACTORS

• Age

• Sex

• Genetic factors

• Genetic markers

• Immune mechanisms

• Obesity

• Maternal diabetes

ENVIRONMENTAL RISK FACTORS

• Sedentary lifestyle

• Diet

• Dietary fibre

• Malnutrition

• Alcohol

• Viral infections

• Chemical agents

• Stress

• Socioeconomic status

• Urbanization

REFERENCES

• Park’s Textbook of Preventive and Social

Medicine-22nd edition

• IDF Diabetes Atlas-6th edition