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Increased Prevalence Of Diabetes - Not All Bad News (pp 503, 537)
August 13, 2003Research published in this week's issue of THE LANCET illustrates how a steady increase in the prevalence of diabetes in a Danish population has not been accompanied by an increase in incidence (new cases) of the disease, as deaths from diabetes have actually fallen over the past decade.
The prevalence of diabetes has increased worldwide. Henrik Stovring from the University of Southern Denmark and colleagues report the findings of an epidemiological analysis of drug-treated diabetes for the 470,000 inhabitants of the county of Fyn, Denmark, between 1993 and 1999.
The total proportion of people with diabetes (prevalence) increased by around 3% annually, the proportion of new cases of diabetes in the population (incidence) remained unchanged; there was a 3% reduction in deaths from diabetes in 1999 compared with 1993 despite the increased prevalence of diabetes in the study population. The investigators comment that 'future research into the causes of rising diabetes prevalence should take this fall in mortality into account to avoid incorrect conclusions about the relation between western lifestyle and the growing number of diabetics.'
In an accompanying Commentary (p 503), Edwin Gale from the University of Bristol, UK, concludes: "this report reminds us that the rising prevalence of type 2 diabetes is complex and deserves more detailed examination. Make no mistake, obesity and diabetes are indeed on the increase, a problem big and deadly enough to need no supporting rhetoric, but not all increases are sinister. Let us take some comfort from the hint that, in some populations at least, the prevalence of type 2 diabetes may have risen mainly because people are being picked up and treated earlier or are living longer."
Lancet
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