2. Diabetes epidemiology
2.1 Type 2 diabetes
2.1.1 Prevalence estimates: heterogeneity of results and time trends
2.1.2 Undiagnosed diabetes
2.1.3 Regional differences
- Maier W.
- Holle R.
- Hunger M.
- Peters A.
- Meisinger C.
- Greiser K.H.
- et al.
2.2 Childhood onset type 1 diabetes
2.2.1 Incidence estimates and time trends
2.2.2 Risk factors
|Environmental factors||Hypothesis and mechanism [source]|
|Lifestyle||• Overload of the beta cells sensitises them to immune damage |
|Foetal and peri-natal factors||• Rapid weight gain in childhood |
|• Caesarean section |
|• Breastfeeding, birth order, maternal age, birth weight, viral infections |
|Dietary factors||• Early introduction of complex dietary proteins |
|• Vitamin D deficiency |
|Exposure to pathogens||• Decreased exposure to pathogens |
|• Enterovirus infections |
|• Environmental pollution |
3. Morbidity and mortality
3.1 Diabetic retinopathy
3.2 Diabetic nephropathy
3.3 Diabetic neuropathy
3.4 Cardiovascular disease in diabetes
- Schramm T.K.
- Gislason G.H.
- Kober L.
- Rasmussen S.
- Rasmussen J.N.
- Abildstrom S.Z.
- et al.
3.5 Disability and quality of life
3.7 Mortality and socioeconomic status
- Walker J.J.
- Livingstone S.J.
- Colhoun H.M.
- Lindsay R.S.
- McKnight J.A.
- Morris A.D.
- et al.
3.8 Death certificates
4. Determinants of health: risk factors and social environments
4.1 Established risk factors
|Risk of developing type 2 diabetes||Dietary factors [source]|
|Reduced risk||Mediterranean diet pattern |
|Fruit and vegetable intake |
|Fermented dairy products |
|Fatty fish intake |
|Tea intake |
|Elevated risk||Red and processed meat intake |
|Sweetened beverages |
|Null association||Total dairy products or milk intake |
|Total fish intake |
|Dietary energy density |
|Carbohydrate intake |
4.2 Emerging risk factors
5. Care and management
- 1.disease prevention and early detection (although the authors pointed out that prevention “plays only a secondary role in European health systems”),
- 2.new professions, qualifications and settings including nurse-led clinics and presence of secondary-care physicians at community-based clinics,
- 3.disease management programmes based on co-ordinated, evidence-based care, and
- 4.integrated care models that attempt to combine treatment for multiple morbidities rather than having a single disease focus and to co-ordinate care between community, out-patient/ambulatory and in-patient settings.
5.1 Barriers to care and access
- 1.the patient (for example, lack of knowledge, motivation to change behaviour or to adhere to proposed lifestyle or pharmaceutical interventions),
- 2.the individual professional (for example lack of motivation, effective communication skills knowledge of guidelines or locally available interventions),
- 3.the health care team (for example, lack of communication between different members of a health care team), and
- 4.the organisation of health care (for example, lack of disease registers, individual care plans or financial incentives and lack of guidelines relevant to sub-populations such as the elderly or ethnic minorities).
- Govan L.
- Wu O.
- Briggs A.
- Colhoun H.M.
- McKnight J.A.
- Morris A.D.
- et al.
Conflicts of Interest
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