Zimmet P, Alberti K George MM, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S; IDF Consensus Group. The metabolic syndrome in children and adolescents – an IDF consensus report. Pediatric Diabetes 2007: 8: 299–306. Paul Zimmet, K George MM Alberti, Francine Kaufman, Naoko Tajima, Martin Silink, Silva Arslanian, Gary Wong, Peter Bennett, Jonathan Shaw and Sonia Caprio; IDF Consensus Group International Diabetes Institute, Melbourne, Victoria, Australia; Department of Endocrinology and Metabolic Medicine, St Mary’s Hospital, London, UK; Center for Diabetes, Endocrinology and Metabolism, Children’s Hospital, Los Angeles, CA, USA; Division of Diabetes, Metabolism and Endocrinology, Jikei University School of Medicine, Tokyo, Japan; Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia; Division of Endocrinology, Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA; Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong; Phoenix Epidemiology and Clinical Research Branch, NIDDK, National Institutes of Health, Phoenix, AZ, USA; and Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1399-5448.2007.00271.x

The metabolic syndrome in children and adolescents - an IDF consensus report.

Background We conducted a systematic review and meta-analysis, the first to our knowledge, summarizing and quantifying the published evidence on associations between type 2 diabetes incidence and s ...

/pdf/type-2-diabetes-incidence-and-socio-economic-position-a-2h10nnd9tx.pdf

Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis

OBJECTIVES 
Diabetes mellitus (DM) is a major public health problem worldwide, and it is a known risk factor for coronary artery disease (CAD). New recommendations for the diagnosis of diabetes have changed the epidemiology of DM. Therefore, we designed this study with the objective to determine the prevalence of DM among Saudis of both sexes, between the ages of 30-70-years in rural as well as urban communities. This work is part of a major national project: Coronary Artery Disease in Saudis study (CADISS) that is designed to look at CAD and its risk factors in Saudi population.
 METHODS 
This study is a community-based national epidemiological health survey, conducted by examining Saudi subjects in the age group of 30-70-years of selected households over a 5-year period between 1995 and 2000. Data were obtained from history, fasting plasma glucose levels, and body mass index. The data were analyzed to classify individuals as diabetic, impaired fasting glucose and normal, using 1997 American Diabetes Association (ADA) criteria, which was adopted by the World Health Organization (WHO) in 1998, to provide prevalence of DM in the Kingdom of Saudi Arabia (KSA).
 RESULTS 
A total of 17232 Saudi subjects were selected in the study, and 16917 participated (98.2% response rate). Four thousand and four subjects (23.7%), out of 16917 were diagnosed to have DM. Thus, the overall prevalence of DM obtained from this study is 23.7% in KSA. The prevalence in males and females were 26.2% and 21.5% (p<0.00001). The calculated age-adjusted prevalence for Saudi population for the year 2000 is 21.9%. Diabetes mellitus was more prevalent among Saudis living in urban areas of 25.5% compared to rural Saudis of 19.5% (p<0.00001). Despite the readily available access to healthcare facilities in KSA, a large number of diabetics 1116 (27.9%) were unaware of having DM.
 CONCLUSIONS 
The overall prevalence of DM in adults in KSA is 23.7%. A national prevention program at community level targeting high risk groups should be implemented sooner to prevent DM. We further recommend a longitudinal study to demonstrate the importance of modifying risk factors for the development of DM and reducing its prevalence in KSA.

https://smj.org.sa/content/smj/25/11/1603.full.pdf

Diabetes mellitus in Saudi Arabia.

OBJECTIVE To establish the relation between socioeconomic status and the age-sex specific prevalence of type 1 and type 2 diabetes mellitus. The hypothesis was that prevalence of type 2 diabetes would be inversely related to socioeconomic status but there would be no association with the prevalence of type 1 diabetes and socioeconomic status. SETTING Middlesbrough and East Cleveland, United Kingdom, district population 287 157. PATIENTS 4313 persons with diabetes identified from primary care and hospital records. RESULTS The overall age adjusted prevalence was 15.60 per 1000 population. There was a significant trend between the prevalence of type 2 diabetes and quintile of deprivation score in men and women (χ 2 for linear trend, p CONCLUSION These data confirm an inverse association between socioeconomic status and the prevalence of type 2 diabetes in the middle years of life. This finding suggests that exposure to factors that are implicated in the causation of diabetes is more common in deprived areas.

https://jech.bmj.com/content/jech/54/3/173.full.pdf

Diabetes prevalence and socioeconomic status: a population based study showing increased prevalence of type 2 diabetes mellitus in deprived areas

1. The aims of the consensus meeting were to review the epidemiology, pathophysiology, management, and implications of the rising prevalence of type 2 diabetes in young people and to suggest means by which the continuing rise in incidence and prevalence might be prevented.

2. The overall global prevalence of type 2 diabetes is rising steadily. Previously, type 2 diabetes was predominantly a disease of middle-aged and older people. In recent decades, the age of onset has decreased and type 2 diabetes has been reported in adolescents and children worldwide, particularly in high-prevalence populations. Japan has seen an approximate fourfold rise in the incidence of type 2 diabetes in 6- to 15-year-olds, and between 8 and 45% of newly presenting children and adolescents in the U.S. have type 2 diabetes. The problem is particularly noticeable in indigenous peoples. Population-based data, however, are sparse and indeed absent in most countries.

3. Additional cardiovascular risk factors are often associated with type 2 diabetes in the young, and microangiopathy is as common or commoner in those developing type 2 diabetes at a young age as in those with type 1 diabetes. This has profound societal implications.

4. Diagnostic separation of type 2 from other types of diabetes in young people can be difficult, and sophisticated testing may be necessary.

5. Data on the pathophysiology in the young are sparse, but there is no evidence to suggest differences from adults. The incidence of type 2 in the young is rising in parallel with the incidence of overweight and obesity, suggesting a possible causal relationship, particularly when the obesity is central and in relation to decreased physical activity. Other factors include family history, gestational diabetes in the mother, and low birth weight. All of these are associated with insulin resistance, although decreased insulin secretion is also required.

6. Mass screening for type …

https://care.diabetesjournals.org/content/diacare/27/7/1798.full.pdf

Type 2 diabetes in the young: the evolving epidemic: the international diabetes federation consensus workshop.

OBJECTIVE To compare the prevalence of diabetes between the poor and rich of rural and urban populations in Bangladesh. RESEARCH DESIGN AND METHODS A total of 1,052 subjects from urban and 1,319 from rural communities (age ≥ 20 years) of different socioeconomic classes were investigated. Capillary blood glucose levels, fasting and 2 h after a 75-g glucose drink (2-h blood glucose [BG]), were measured. Height, weight, waist, hips, and blood pressure were also measured. RESULTS Age-adjusted (30–64 years) prevalence of NIDDM was higher in urban (7.97% with 95% CI 6.17–9.77) than in rural subjects (3.84%, CI 2.61–5.07), whereas impaired glucose tolerance (IGT) prevalence was higher in rural subjects. In either urban or rural areas, the highest prevalence of NIDDM was observed among the rich, and the lowest prevalence was observed among the poor socioeconomic classes. The rural rich had much higher prevalence of IGT than their urban counterpart (16.5 vs. 4.4%, CI 6.8–17.4). Increased age was an important risk factor for IGT and NIDDM in both rural and urban subjects, whereas the risk related to higher BMI and waist-to-hip ratio (WHR) was less significant in rural than urban subjects. Using logistic regression and adjusting for age, sex, and social class, the urban subjects had no excess risk for NIDDM. In contrast, an excess risk for glucose intolerance (2-h BG ≥ 7.8 mmol/l) was observed in the rural subjects. CONCLUSIONS Adjusting for age, sex, and social class, the prevalence of NIDDM among urban subjects did not differ significantly from that among rural subjects. Increased age, higher socioeconomic class, and higher WHR were proven to be independent risk factors for glucose intolerance in either area.

abu Sayeed M

Papers

Effect of socioeconomic risk factors on the difference in prevalence of diabetes between rural and urban populations in Bangladesh