The prevalence of Type 2 diabetes among UK men has risen by 10.9% over the past three decades, with a dramatic increase in more recent years accounting for a large proportion of the overall increase, report UK researchers.

Prevalence of the condition has increased sharply worldwide in recent years, and researchers predict that the disease is likely to reach epidemic proportions during this century, explain Mary Thomas (University College London) and colleagues.

For this study, Thomas and co-investigators used data collected from a cohort of 7722 British men from across the UK, aged 40 “59 years at baseline, who were followed-up from 1978 “2005 for incidence of Type 2 diabetes.

The researchers carried out seven sequential surveys during the study period. Diagnosis of diabetes was defined by self-reported diagnosis of diabetes or self-reported use of anti-diabetes medication on returned questionnaires.

Writing in the journal Diabetic Medicine, the researchers report that the prevalence of Type 2 diabetes increased from just 1.2% in 1978 to 12.1% in 2005.

They calculated that the average age-adjusted increase in Type 2 diabetes prevalence over the study period was 7.0%.

However, the increase in prevalence was not uniform as the annual rate of increase from 1979 “2000 ranged from 4.3% to 6.9%, but increased dramatically to an average of 11.2% in the 2000 “2005 period.

Men from Scotland had the greatest increase in prevalence of Type 2 diabetes, with the lowest UK prevalence ” 0.52% ” in 1979 and the highest UK prevalence ” 13.0% ” in 2005.

The authors note that the rate of increase was strongly related to body mass index (BMI), with annual rates of increase rising with increasing BMI. Individuals with a BMI below 22.5 kg/m² had an annual increase of less than 3% compared with a higher than 10% annual increase in men with a BMI of 27.5 kg/m² or more.

Thomas et al estimate that if all participants had maintained a BMI of under 25 kg/m² for the entire duration of the study, 68% of diabetes cases would have been prevented.

“These results emphasize the urgency of population-wide measures to control the increase in Type 2 diabetes prevalence, particularly by limiting the rising prevalence of obesity at all ages,” concludes the team.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract

Metabolic syndrome increases the risk for microalbuminuria more than three-fold in Middle-Eastern people with Type 2 diabetes, an Iranian study shows.

A number of reports have demonstrated an association between the metabolic syndrome and microalbuminuria, but this relationship has been less well studied in people with Type 2 diabetes.

Alireza Esteghamati and co-workers (Tehran University of Medical Sciences, Tehran, Iran) recruited 800 consecutive adults with Type 2 diabetes attending for follow-up visits at an endocrinology clinic in Tehran.

Metabolic syndrome was defined by the International Diabetes Federation (IDF) criteria, with the exception of waist circumference, which was defined by recently established cut-offs for Middle-Eastern populations of 91.5 cm for men and 85.5 cm for women (compared with IDF values of 94 cm for men and 80 cm for women).

Microalbuminuria was defined by urinary albumin excretion between 30 and 299 mg/day on at least two of three occasions. Patients with macroalbuminuria and those with poor renal function were not included.

In this study, 645 patients had metabolic syndrome and 155 did not. Microalbuminuria was present in 237 (29.6%) patients with metabolic syndrome, and increased in prevalence with increasing numbers of metabolic abnormalities, report the authors in the journal Acta Diabetologica.

When patients were divided into those with (237 patients) and without (563 patients) microalbuminuria, metabolic syndrome was significantly more common among patients with microalbuminuria (90.3%) than those without (76.6%) even though there was no significant difference between the groups in terms of age, gender, and renal function.

Multivariate regression analysis revealed metabolic syndrome was the strongest correlate of microalbuminuria with an odds ratio of 3.3. This was followed by HbA1c and diabetes duration, which were both associated with a 1.3-fold greater risk for microalbuminuria.

The authors acknowledge that, as a cross-over study, the results do not allow them to draw any cause-and-effect conclusions, but suggest that “the presence of metabolic syndrome in a Type 2 diabetic patient is an independent alarm for renal involvement.”

“We expect interventional measures that improve metabolic control to aid in regression of microalbuminuria,” they conclude.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract

Know Yourself

The most important consideration to keep in mind is your own weight, target blood sugar level, drug regimen such as insulin shots and blood sugar lowering agents and the presence or absence of other diseases. What’s more, take into account your personal tastes and lifestyle needs.

Knowing Your Food Groups

Before creating an effective diabetic diet plan, you should know the fundamentals about food. Foods basically fall into four categories:

1. Carbohydrates: Carbohydrates are the body’s main source of energy. Starches like bread, rice and cereals, fruits and vegetables, sweet drinks and snack foods such as sodas potato chips.First of all, identify and focus on the healthy sources of carbohydrates such as whole wheat bread as opposed to white bread. The second step is where carbohydrate counting comes in. The amount you need from this group depends on your target blood sugar level. A 45%-60% of carbohydrates of your daily calories is an acceptable amount although it may vary for different individuals.

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2. Fats: Contrary to popular belief, fats are needed by the body too provided they are in the right amount. Keep your fat intake within 20%-35% of your daily calories. Look out for saturated and trans fats and limit the intake of the former to no more than 7% of your daily calories and as much as possible avoid the latter completely. Choose omega 3 fatty acids rich foods sush as salmon and mackerel, monounsaturated and polyunsaturated fats such as olive oil for cooking your meals.

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3. Proteins: These are needed by the body primarily for tissue repair and muscle growth. But proteins are broken down into glucose too in a process known as gluconeogenesis to provide energy. Hence, it can trigger high sugar levels too. A modest 15%-20% protein of your daily calorie intake is a reasonable range.

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4. Fibers: These are usually found in fruits and vegetables. They should compose a larger part of your meal because they give the body the sense of being full and thus, curb your overeating tendencies. A 25-30g of fiber each day is good for you.

Keep in mind that 1 g of carbohydrate and 1g of protein provides 4 kilocalories each. 1g of fat is equivalent to 9 kilocalories.

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Use Food Exchange Lists

This information provides the diabetic patient the power to choose food from an approved list of food categories in order to cater, to a certain extent, to her own personal preferences. With it, the diabetic can substitute a certain food for another one belonging to the same food group. It provides approximately the same amount of the necessary nutrients and has a similar effect on the blood sugar levels. As a result, the target blood sugar level remains predictable and more importantly, still attainable.