Hi, I'm Professor Azeem Majeed. I'm going to introduce you to the etiology and epidemiology of type 2 diabetes. Diabetes is non-communicable disease and is ranked as the sixth leading cause of death globally in the 2017 probabilities disease study. In addition to deaths, diabetes is also responsible for a major amount of global mobility ranked six for years of life lost due to disability also known as YLDs. The International Diabetes Federation or IDF estimates that one lab garlands globally has diabetes and only half of those have been properly diagnosed and knowing about it. You may already be aware that there are two major types of diabetes, type 1 diabetes and type 2 diabetes. Type 1 diabetes is a condition where the body's immune system attacks the cells that produce the insulin which controls blood sugar. Type 1 diabetes generally occurs early in life and it's a lifelong condition. However, a cancer sometimes occur later in life and in older people. Type 2 diabetes is a condition where the body does not produce enough insulin or the body cells do not react to insulin, sometimes described as insulin resistance. Type 2 diabetes is generally acquired and does not usually pain until middle age or later in life or there can sometimes be found in younger people. Globally, type 2 diabetes is by far the more common, around 90 percent or more of cases globally are type 2 diabetes. Therefore, in this talk I'm going to focus only on type 2 diabetes as the causes and treatments are very different from those for type 1 diabetes and type 2 diabetes represents the largest threats in terms of number of global cases and burden of disease. Type 2 diabetes is caused by a combination of risk factors including both lifestyle and genetic factors. It's more likely to develop in people who are overweight or obese or are physically inactive and who have diet that is high in sugars and calories. These risk factors overlap with those for the diseases, in particular cardiovascular disease. The most common risk factors for cardiovascular disease and diabetes are often grouped together and termed the metabolic syndrome. The conditions which can be grouped together into metabolic syndrome include high blood pressure, overweight and obesity, taking as measured by waist circumference and unhealthy balance of blood lipids and insulin resistance. In a healthy individual, the hormone insulin allows the glucose in the blood to pass into cells where it is used to produce energy. But when this process cannot happen with diabetes, the glucose levels in the blood buildup causing hyperglycemia or high blood glucose level and it's simply diabetes which include polydipsia, drinking lots of fluids and polyuria, passing lots of urine develop. Other early symptoms of diabetes include filling very tired, blurred vision, losing weight unexpectedly and cut some wounds that he'll most early unexpected. However, in many people with diabetes, type 2 diabetes there are no symptoms of disease and therefore it often goes undiagnosed. Left untreated, diabetes can cause major health complications which include nerve damage such as that of feeling a numbness in the limbs, foot issues and other foot problems such as infections, loss of vision, kidney problems and heart disease and stroke. Treatment for diabetes includes following healthy diets and managing weight as well as using medications to manage blood sugar or produce insulin or injecting insulin as needed. Now, turn to the epidemiology of diabetes. Globally diabetes, take the type two diabetes, is a major burden of disease and has been rising rapidly over the last few decades. The global burden of diabetes has increased from about 4.7 percent in 1980 to around to 8.5 percent in 2014. Diabetes is rising more rapidly in middle and low-income countries, and the RDF estimates four to five people with diabetes now live in middle and lower income countries. Diabetes also affects every region of the world but it's most common in the Western Pacific region which includes East and Southeast Asia, Australia and the Pacific Islands. It's estimated by the RDF that one in 13 adults with diabetes lives in this region. Currently, number of cases in Africa is roughly low compared to the rest of the world. However, Sub-Saharan Africa is predicted to face a major increase in the future duties, population, aging and changing diets and lifestyles. There's also major variation within countries, in particular by socioeconomic status but the trend is not existing globally. In low and middle-income countries, diabetes is often associated with higher socioeconomic status and rising income levels and it's linked with urban lifestyles such as the most densely job and access of high calories fast foods. However, in high-income countries the opposite is true with lower socioeconomic status linked to high prevalence of diabetes. So what does the future hold for diabetes? Is projected to continue to grow as a major global burden of disease and it's estimated that there are now around 425 million people with diabetes globally and this number will increase to around 630 million by 2045 almost entirely due to increase in the number of people with type 2 diabetes. One particular concern with riser diabetes is rapid growth in middle and low-income countries. Diabetes is a condition that we managed quite successfully but it is expensive to treat. It requires regular monitoring and medicines and special services for complications. These treatments are difficult and costly to provide even in high-income countries with robust health systems. With the growth of diabetes expected and the lack of resources to support management of the disease in many countries, it will become one of the major health challenges to be tackled in years to come globally.
