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Diabetes mellitus type 2 epidemiology. Scientific electronic library. Risk factors and diagnosis

The epidemiology of diabetes mellitus has once again proven an increase in incidence.

The VI All-Russian Congress of Endocrinologists ended in the capital, during which the most pressing problems of diagnosing and treating diabetes mellitus were discussed. The first report, which was presented during a separate symposium held on May 30 during the Congress, dedicated to innovative solutions in the treatment of diabetes, was the speech of Corresponding Member of the Russian Academy of Medical Sciences M.V. Shestakova “The importance of epidemiological programs in modern diabetology: from diagnosing new cases to monitoring the effectiveness of diabetes treatment.”

Results of the epidemiology of diabetes mellitus

Today, diabetes mellitus has taken third place among diseases leading to early disability and death. So far, it is only “overtaken” by cardiovascular diseases and cancer. At the same time, the number of people suffering from diabetes is increasing every year. According to scientists, at the moment the number of sick people doubles every 10-12 years.

M.V. Shestakov noted that the number of cases of the disease continues to increase due to the diagnosis of type 2 diabetes. This is the same variant of the disease that is provoked by eating disorders and physical inactivity. At the same time, the “start” of type 2 diabetes is literally getting younger every year. Type 1 diabetes, which is mostly caused by hereditary factors, generally maintains an approximately static picture of the number of people with diagnosed diabetes mellitus.

At the same time, scientists note that the epidemiology of diabetes mellitus, especially type 2 diabetes, is characterized by a significant percentage of undetected cases of the disease. According to experts, at the moment, for every 1 case of identified and diagnosed disease, there are 3-4 cases of undetected ones. Diabetes mellitus is dangerous if it is asymptomatic during the first stages. Often in this case, the presence of the disease is confirmed only in the later stages of the disease. At the moment when we can talk about vascular lesions of types 1 and 2. At the moment when we can already talk about

The epidemiology of diabetes mellitus currently occupies a central place in the study of its natural evolution, pathogenesis, classification and development of scientifically based methods of prevention. Although in the 65 years since the discovery and clinical use of insulin, much has been done to understand the etiology, pathogenesis and clinical evolution of diabetes, the epidemiological approach to its study in the last 20 years has made it possible...

Along with the population-specific method, epidemiology uses various statistical and mathematical, clinical, physiological and functional, laboratory and other methods to establish patterns of the natural development of diabetes mellitus. Epidemiological studies can be continuous or selective. In a continuous study, the entire population of a certain economic-geographical region is examined; in selective studies, only a part of it is examined, representative of a number of characteristics of the entire population...

Genetic screening based on the determination of HLA antigens associated with susceptibility to IDDM, conducted in the UK, showed that about 60% of those examined have HLA antigens DR3 and DR4, the most common markers of IDDM, and only 6% of them have both antigens. Screening of these 6% of individuals for diabetes did not reveal a higher prevalence in this group. At the same time...

Studies conducted by the Department of Epidemiology of Diabetes Mellitus of the Institute of Epidemiology and Chemistry of the Academy of Medical Sciences and other institutions in our country did not reveal such a trend. Diabetes mellitus is an accumulating disease and tends to accumulate in the population. With new cases of IDDM occurring at older ages, usually up to 30–35 years, its prevalence is increasing. Patients with IDDM make up about 12-15% of all patients with diabetes mellitus...

Different climate zones may influence the prevalence of diabetes. For example, in Kyrgyzstan [Kalyuzhny I.T., 1981], in high mountain areas the prevalence of diabetes mellitus is lower than in the valleys. However, other explanations can be found for this. There are also population differences in the prevalence of diabetes mellitus. Diabetes mellitus is extremely rare among the indigenous population of Siberia and the Far East, and...

Risk factors for diabetes mellitus vary in nature and are not the same for IDDM, NIDDM and malnutrition-related diabetes. For IDDM, risk factors are certain viral infections (rubella, chickenpox, mumps, Coxsackie B4, epidemic hepatitis), toxic substances (Nitrosamine, rodenticides, cyanide compounds, uric acid), heredity with diabetes, haplotypes HLA B8, DW3, DRW3, B15, DW4,…

The prevalence of NIDDM increases with age, reaching a maximum at 60–70 years of age. However, the incidence can be very significant already before the age of 40 years in populations with a high incidence and prevalence of diabetes mellitus of this type. Obesity is often associated with NIDDM. At the onset of the disease, more than 80% of patients are overweight. The incidence of diabetes mellitus increases exponentially with increasing...

An undoubted risk factor for diabetes mellitus and impaired glucose tolerance is systematic alcohol consumption. It affects the vascular wall, microcirculation, metabolism, and enzyme systems. Decreased physical activity also remains an important risk factor for diabetes and cardiovascular disease. Most often it is associated with obesity, dyslipoproteinemia, and a decrease in the biological effect of insulin. Risk factors for diabetes...

Epidemiological studies of diabetic angiopathy, the main complications of diabetes mellitus, have developed in recent years. An example of such studies was the WHO multinational program “Vascular lesions in patients with diabetes mellitus”, conducted in 14 countries (Mazowiecki A.G., 1983]. Based on standardized and unified research methods, important data were obtained not only on the actual prevalence, but also about factors...

The epidemiology of diabetic microangiopathies (damage to small vessels more specific to diabetes) is a new area in the study of diabetes mellitus. Their prevalence, in contrast to the prevalence of diabetic macroangiopathies, is the same in all national groups examined. Depending on the duration of diabetes mellitus, it is 17.868% in men aged 35–55 years and 14.2–62.2% in women. As further research showed [Lukashina T.V.,...

Treatment of diabetes has changed significantly over the past 50 years. The discovery and use of insulin preparations in clinical practice, the use of oral hypoglycemic drugs of various chemical natures and mechanisms of action, and the widespread use of other medications, among which angioproteggors should be highlighted, significantly influenced the course and complications of diabetes mellitus and, at the same time, the immediate causes of mortality. If before use...

The most universal definition of diabetes mellitus is “a state of chronic hyperglycemia that may develop as a result of the influence of many exogenous and genetic factors, often complementary to each other” (Report of the WHO Expert Committee on Diabetes Mellitus, 1981). The name “diabetes” (from the Greek “diabaio” - I pass through) as a term was introduced back in ancient times (Aretheus of Cappadocia, 138-81 BC),...

In different countries of the world, the number of patients with diabetes is 4-7% of the general population. The most common are two main types of diabetes mellitus: type 1 diabetes mellitus, typical for children and adolescents, as well as young people, which accounts for 10-15% of patients and type 2 diabetes mellitus, which accounts for 85-90% of patients . Dedov I.I., Melnichenko G.A., Fadeev V.F. Endocrinology. - M.:GEOTAR-Media, 2010. - 432 p.:il The prevalence of type 1 diabetes and type 2 diabetes is significantly different.

The incidence of type 1 diabetes varies significantly in different countries of the world. The highest frequency is in the Scandinavian countries (Finland, Sweden, Denmark, Norway). Seasonal variations in the incidence of the disease have been recorded. The highest frequency of manifestation of type 1 diabetes occurs in the winter months, which coincides with the maximum incidence of viral infectious diseases. There are two age peaks of incidence - 10-12 years and 5-7 years.

The prevalence of type 2 diabetes is 5-7% and is constantly growing. In the Russian Federation, the number of patients with type 2 diabetes is 3 million 121 thousand people, but the real number of patients, according to epidemiological studies, is 2-3 times higher. Clinical endocrinology: A guide for doctors / Ed. E.A. Kholodova. - M.: Medical Information Agency LLC, 2011. - 736 p.: ill. There is a trend towards an increase in the incidence of type 2 diabetes at a younger age. If earlier the disease was registered mainly in 45-50 years old, now it is younger than 30 years old, and even in children and adolescent age groups. Familial forms of the disease are common.

The epidemiology of diabetes is also influenced by the following factors:

· Geographical location. All countries located south of the equator have an incidence of no more than 15 per 100,000 population, while countries in the northern hemisphere have a higher incidence.

· Ethnic, racial characteristics. For example, in the United States, white people are 1.5 times more likely to have type 1 diabetes than African Americans or Hispanics. Type 2 diabetes mellitus is most common among Mongoloids, followed by people of the Negroid race. Belonging to the Mongoloid race increases the risk of developing diabetic nephropathy and coronary heart disease, but reduces the risk of diabetic foot syndrome. People of the Negroid race are more likely to experience severe, difficult-to-treat arterial hypertension and a more frequent development of gestational diabetes mellitus.

· Floor. The prevalence among men (less than 60 years of age) is higher than among women; with age, the risk of incidence is approximately the same. Of interest is the fact that, for example, within Europe, in countries where the incidence is above 20 per 100,000 population (Great Britain, Italy, Norway, etc.) men get sick more often, and in countries with a prevalence below 4.5 per 100,000 population (Romania, Macedonia, etc.) on the contrary - women get sick more often. A child born from a mother with type 1 diabetes has a 1:50 risk of developing the disease, and a child born from a sick father has a 1:15 risk of developing the disease.

Currently, diabetes ranks third among the causes of high disability and mortality in patients after cardiovascular diseases and cancer. The incidence of diabetes is constantly growing. Every 12-15 years, the number of people with diabetes doubles on average. In all countries of the world, the number of patients with diabetes is increasing mainly due to an increase in the number of patients suffering from type 2 diabetes. According to WHO experts, in 1994 the number of patients with diabetes worldwide was about 110 million, in 2000 - more than 170 million Human. It is predicted that by 2010 the number of people with diabetes will exceed 230 million people. Similar trends are observed in Russia: in 1997, about 2.1 million patients with diabetes were registered, in 2000 - about 3 million people, and in 2010, it is expected that their number will increase to 5-7 million. However, these indicators reflect the morbidity status of diabetes only in terms of referral rates, i.e. when patients self-refer to a doctor (registered prevalence). The bulk of patients with type 2 diabetes remain unaccounted for, because due to unexpressed complaints or their absence, patients do not visit a doctor. According to selective epidemiological studies conducted in developed countries of the world, for every patient who consults a doctor, there are 3-4 people who are unaware of the presence of diabetes. Studies based on the results of active clinical examination of Moscow residents have shown that the real (actual) prevalence of type 2 diabetes is 3-4 times higher than the registered one. Similar results were obtained regarding the prevalence of vascular complications in types 1 and 2 diabetes.

This situation is typical both for Russia and for all developed countries of the world. In this regard, the American Diabetes Association has proposed new diagnostic criteria for diabetes, which will allow diagnosis to be made earlier and thereby prevent the development of late complications of diabetes.

Classification of diabetes mellitus

There are a number of classifications of diabetes mellitus according to various criteria. Taken together, they form part of the diagnosis and allow a fairly accurate description of the condition of a diabetic patient.

Etiological classification

I. Type 1 diabetes mellitus or “juvenile diabetes,” however, people of any age can get sick (destruction of β-cells leading to the development of absolute lifelong insulin deficiency)

II. Diabetes mellitus type 2 (defect in insulin secretion due to insulin resistance)

III. Other forms of diabetes:

genetic defects (anomalies) of insulin and/or its receptors;

diseases of the exocrine pancreas;

endocrine diseases (endocrinopathies): Itsenko-Cushing syndrome, acromegaly, diffuse toxic goiter, pheochromocytoma and others;

drug-induced diabetes, infection-induced diabetes, unusual forms of immune-mediated diabetes;

genetic syndromes combined with diabetes mellitus.

IV. Gestational diabetes mellitus is a pathological condition characterized by hyperglycemia that occurs during pregnancy in some women and usually disappears spontaneously after childbirth

Today, according to WHO, the disease affects approximately 246 million people worldwide. According to forecasts, this number could almost double.

The social significance of the problem is increased by the fact that the disease leads to premature and fatal outcomes due to irreversible changes that appear in the circulatory system. How serious is the prevalence of diabetes among the world's population?

Statistics on the incidence of diabetes in the world

Diabetes mellitus is a chronic condition.

Due to the constant characteristic manifestations of vascular, cardiac, cerebral or peripheral complications that occur against the background of neglected hypoglycemic control, diabetes is considered to be real.

Diabetes often leads to cardiovascular diseases

In European countries, the number of people with diabetes is approximately 250 million. Moreover, an impressive number do not even suspect the existence of the disease in themselves.

If we look at the statistics of the occurrence of this disease in children and adolescents, we can find shocking figures: children aged 9 to 15 years are most often affected by the disease.

Prevalence of complications in patients with diabetes

Diabetes is a problem not only in our country, but throughout the world. The number of diabetics is increasing every day.

If you pay attention to the statistics, you can conclude that approximately 371 million people suffer from this disease worldwide. And this, for a second, is exactly 7.1% of the population of the entire planet.

The main reason for the spread of this endocrine disorder is a radical change in lifestyle. According to scientists, if the situation does not change for the better, then by about 2030 the number of patients will increase several times.

An impressive incidence rate was found in the United States. In this country, approximately 21% of the population suffers from diabetes. But in our state the statistics are lower - about 6%.

However, even despite the fact that in our country the level of the disease is not as high as in the United States, experts predict that very soon the indicators may approach those of the United States. Thus, the disease will receive the title of epidemic.

Type 1 diabetes, as mentioned earlier, occurs in people under 29 years of age. In our country, the disease is rapidly growing younger: at the moment it is detected in patients from 11 to 17 years old.

Frightening figures are provided by statistics regarding those individuals who recently underwent examination.

About half of all the inhabitants of the planet do not even know that the disease is already waiting for them. This concerns heredity. The disease can develop asymptomatically for a long time, without provoking absolutely any signs of illness. Moreover, in most economically developed countries of the world the disease is not always correctly diagnosed.

Due to late detection, diabetes can subsequently lead to serious complications, devastatingly affecting the functioning of the heart and blood vessels. Organs such as, are also affected. Subsequently emerging disorders can lead to disability.

Despite the fact that the prevalence of diabetes in African countries is considered very low, it is here that there is a high percentage of people who have not yet undergone a special examination. The whole reason lies in the low level of literacy and lack of awareness about this disease.

Prevalence of complications in people with both types of diabetes

The lack of proper treatment will necessarily manifest itself in a whole complex of dangerous complications, which are divided into several main groups: acute, late and chronic.

As you know, it is acute complications that can bring more problems.

They pose the greatest threat to human life. These include conditions whose development occurs over a minimum period of time.

It could even be several hours. Usually such manifestations lead to death. It is for this reason that qualified assistance must be provided immediately. There are several common types of acute complications, each of which is different from the previous one.

The most common acute complications include: lactic acid coma, as well as others. Late consequences appear over several years of illness. Their harm is not in their manifestation, but in the fact that they slowly worsen a person’s condition.

Complications of a chronic nature are noted over the last 11-16 years of life.

Even with strict adherence to all requirements for treatment, blood vessels, organs of the excretory system, skin, nervous system, and heart suffer. In representatives of the stronger sex, complications that appear as a result of diabetes mellitus are diagnosed much less frequently than in women.

The latter suffer more from the consequences of such endocrine disruption. As noted earlier, the disease leads to dangerous disorders associated with the performance of the heart and blood vessels. People of retirement age are often diagnosed with blindness, which appears due to the presence of diabetic retinopathy.

But problems with the kidneys lead to thermal renal failure. This disease can also be caused by diabetic retinopathy.

About half of all diabetics have complications that affect the nervous system. Later, neuropathy provokes the appearance of decreased sensitivity and damage to the lower extremities.

Due to serious changes occurring in the nervous system, people with pancreatic dysfunction may develop a complication such as diabetic foot. This is a rather dangerous phenomenon, which is directly related to disorders of the cardiovascular system. It can often lead to limb amputation.

Approximately 900,000 limb amputations occur annually due to advanced disease. That is why, in order to avoid a similar fate, you need to be more attentive to your own health.

Video on the topic

This video discusses the general description, types, treatments, symptoms and statistics of diabetes:

If you have diabetes, you should not neglect treatment, which consists not only of special medications, but also of and giving up bad habits (which include abuse). You also need to periodically visit your personal endocrinologist and cardiologist in order to find out about your exact health status.