Type 2 Diabetes Causes & Effects
Image by Bill_Owen via Flickr
Type 2 diabetes is reaching epidemic proportions around the globe and is largely a man-made problem. Your diet is the issue, yet few people seem to understand why or how eating the wrong foods can create this ever increasing problem.
Here is an interview with Dr Simon Griffin, that explains the current position.
Type 2 diabetes is a condition in which the body does not make sufficient insulin or the insulin it makes doesn’t work sufficiently well to maintain a normal level of blood glucose and so the blood glucose rises. The problem with this is that it leads to an increased risk of complications such as heart disease, stroke, amputations, kidney failure, blindness and so on affecting the large and small blood vessels in the body, leading to huge costs for individuals, the health system and wider society.
Type 2 diabetes is increasingly common. Perhaps up to 4.5 million people will have it in the UK by 2020. It is more common in people who have a family history, people who are overweight, and people who have other related conditions like high blood pressure. It is more common in different ethnic groups like Asians and Afro-Caribbeans.
How many people are known to have type 2 diabetes?
366 million people have type 2 diabetes worldwide, 80% of whom live in low and middle income countries. In the UK it is probably around 5% of the adult population. Historically, it has been believed that a similar proportion has diabetes but don’t know it yet.
The prevalence of type 2 diabetes varies according to different countries in the world. In some countries, such as some pacific islands, up to 50% of the population develop diabetes. In most high income countries you’d expect the prevalence to be single figure percentages.
What are the main problems of having undiagnosed diabetes?
Most people that have undiagnosed diabetes don’t feel any symptoms. The issue is the harm that the raised blood glucose causes to the large and small blood vessels. This begins to happen before diagnosis, such that when people are diagnosed with diabetes many of them have complications already present. Up to 50% of people have some signs of tissue damage at the point at which they are diagnosed.
How did your research into screening for type 2 diabetes develop?
That is a long story. It started off while I was doing a study when I was in Southampton, which was focused on trying to improve the care of people with newly diagnosed diabetes. What I noticed was that all the people with newly diagnosed diabetes that the practices recruited had certain characteristics about them that made me think that it would be quite easy to find these people earlier because they were clearly different from the age/sex matched population in the practices. For example, they were more overweight, they were more likely to be on blood pressure drugs and so on.
So I developed a score to see if that would help in identifying people who had diabetes. The question then was if we can find these people, should we? That led to a whole program of work trying to decide whether it was worthwhile trying to find people with diabetes earlier and if we did then what treatment should they be offered.
The study that we published is one example of the studies that led from that initial interest back in the late 1990’s.
What did your research involve?
We recruited general practices in and around Cambridge and surrounding counties, and, with their permission, we helped them to look in their medical records with a search using the score I just mentioned. We identified the people aged 40-69 who were at highest risk of having undiagnosed diabetes. We took the top 25% of those at highest risk of undiagnosed diabetes and randomly allocated the practices to either screen or not screen.
In the practices that were screening, we gave the list of people at high risk to the practice and we asked them to invite those people for finger prick testing. So, they wrote to all of those people offering them an appointment and if they didn’t attend that appointment to arrange a time for a follow-up one. Around 73% of those people at high risk attended in the screening practices. We also had a comparison group where we didn’t tell the GPs who the high risk patients were, so they didn’t systematically invite people for screening.
What were the results of your research?
What we found 10 years later was that there was no difference in mortality in the high risk populations in the screening practices and the high risk populations in the control no-screening practices. This suggests that population screening for type 2 diabetes in the short term won’t lead to reduction in premature mortality rates in the wider population….More at Type 2 diabetes screening: an interview with Dr Simon Griffin, MRC … – News-Medical.net
More Reading
