http://www.welcome-to-china.com/biz/fyi/72p.htm
http://english.people.com.cn/200410/13/eng20041013_160062.html
http://www.medforum.nl/reviews/diabetes_and_obisity.htm
Coca-colonization
'Globalization' and 'Coca-colonization' are having profound effects on
health worldwide. We face a huge public health challenge from both
Type 2 diabetes and obesity, from childhood through to old age.
Obesity has reached epidemic proportions globally. The situation is
worsening. In Europe, USA and Australia, the prevalence is high and
increasing. Over 60% of the adult population of the USA and Australia
is either overweight (BMI 25–29.9) or obese (BMI > 30). Over 20% of
adults fall into this latter category. In some developing countries as
well as among disadvantaged groups in developed countries, e.g.
Mexican-Americans, Afro-Americans, Native Canadians and Australian
Aborigines, an even more extreme situation exists. Generalized and
abdominal adiposity, and physical inactivity are independent risk
factors for Type 2 diabetes and impaired glucose tolerance.
Epidemic obesity
Epidemic obesity with some of the highest prevalence in the world
exists in these populations, e.g. 70% of Samoans have a BMI in excess
of 30. In both Samoa and Mauritius, two populations where longitudinal
data are available, there have been dramatic increases in prevalence
over relatively short time periods (Figure 1). Similar trends have
been noted in American Pima Indians, Australian Aborigines, migrant
Asian Indians and Mexican-Americans.
Coincident with the high rates of obesity, the prevalence of Type 2
diabetes is also escalating. This increase is expected to continue,
and recent projections show that there are currently 120 million
people worldwide with Type 2 diabetes, and by the year 2010, this
figure is expected to climb to well over 230 million. This represents
an epidemic of major proportions. The majority of the new cases will
be those with Type 2 diabetes and the majority of these will be in
China, the Indian subcontinent and Africa. We estimate that from 65
million cases of Type 2 diabetes in Asia and Oceania in 1995, the
number will double to 135 million by 2010. Some of the highest
recorded rates of Type 2 diabetes are found in the Pacific Islands
with 1 in 3 adults affected in a number of countries. A major concern
here is the growing socio-economic burden of cardiovascular disease,
blindness, renal failure and amputations resulting from the diabetes
epidemic. Obesity and Type 2 diabetes represent just two constituents
of the Metabolic Syndrome, a cluster of cardiovascular disease risk
factors also described as ‘The New World Syndrome'. Sooner, rather
than later, serious morbidity and mortality from cardiovascular
disease is inevitable.
Type 2 in the young
Another issue of major concern is that Type 2 diabetes has generally
been believed to be rare in children, adolescents and young adults.
Not so any longer! An important and alarming feature of the diabetes
epidemic is that Type 2 diabetes is increasing in these younger age
groups. This poses significant problems as the safety of therapies
used in Type 2 diabetes, apart from insulin, has not been tested in
this age group. Obesity has been implicated in this trend in Afro- and
Mexican-Americans and Pacific Islanders.
****
TC