Diabetes: Leveraging the Tipping Point of the Diabetes Pandemic

Diabetes is one of the fastest growing public health problems in the world, with significant variations in its prevalence and in the major risk factors for type 2 diabetes among ethnic groups. In this issue of Diabetes , the Perspective by Unnikrishnan et al. (1) focuses on the global prevalence of diabetes, ethnic differences in susceptibility to diabetes, and major determining factors for type 2 diabetes. A major concern today is the increasing number of people with type 2 diabetes in middle-income and low-income countries, such as China and India. Vulnerability to diabetes among immigrants from Korea, the Pacific Islands, South Asia, and the Philippines to the U.S. or Europe compared with the Caucasian population is highlighted. Although obesity and its correlate insulin resistance, as well as genetic factors, have been considered the established determining factors for type 2 diabetes risk, recent evidence shows that early loss of β-cell function plays a much more important role in the pathogenesis of type 2 diabetes, especially in nonobese individuals of southern and eastern Asian origin. The results from the China National Diabetes Survey have indicated that the prevalence of diabetes in Chinese adults aged ≥20 years increased from 1% in 1980 (2) to 9.7% in 2007–2008 (3) and 11.6% in 2010 (4). One recent pooling of data from 751 studies including 4,372,000 adults from 146 of 200 countries estimated that the number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014, while the global age-standardized diabetes prevalence increased from 4.3% in 1980 to 9.0% in 2014 in men and from 5.0% to …