Asian diabetes rates are soaring, according to a South Korean study. It says the health consequences of the disease are worse in that region than in more prosperous areas. Another new study points out that people do not need to reach a diabetic state for elevated blood sugar levels to be deadly.
Research published in the journal Lancet shows that life-threatening adult diabetes has reached epidemic levels in Asia and the rate of increase shows no signs of slowing.
Doctors at Catholic University of Korea in Seoul say 194 million Asians suffered from diabetes in 2003, a number that could explode to 330 million by 2025.
Doctors link the diabetes epidemic to growing numbers of the overweight and obese. They blame sedentary modern lifestyles and readily available fast foods high in fat and sugar.
At Erasmus Medical Center in Rotterdam, a Dutch public health expert not involved in the research, Johan Mackenbach, says the Asian trend is part of a global pattern of urbanization.
"With economic progress, people start to become obese also in developing countries and so this obesity epidemic is spreading rapidly across the world," said Johan Mackenbach.
The Lancet paper says Asians develop diabetes younger and at lower weight, suffer longer with complications, and die sooner than people in developed countries. It argues that the onset of adult diabetes in younger and younger populations is likely to hurt Asian countries economically because of premature illness and death.
Diabetes-related heart disease and stroke kill nearly one million people each year worldwide. But a second study in the Lancet reveals that pre-diabetic conditions are also deadly. A Harvard School of Public Health team led by Majid Ezzati says elevated blood sugar below the diabetes threshold kills more than twice as many people each year as diabetes - 2.2 million people, 84 percent of them in developing countries.
"Of these 2.2 million, many of them are not called diabetics," said Majid Ezzati. "They are people who could have benefited from lowering their blood glucose, but they are not at the threshold that we call disease."
When you tally all the people dying from high blood sugar each year, including diabetes, the sum is more than three million. Ezzati says this is comparable to the nearly five million annual deaths related to smoking and four million from high blood cholesterol.
"Through the variety of interventions that exist - obviously lifestyle being a part of it and some of it pharmacological - policies and programs should be focusing on shifting the whole distribution of blood glucose in the same way we are aiming to do for things like blood pressure," he said.
But Johan Mackenbach argues that more is needed than drugs or encouraging people to eat healthfully and be physically active. He says individuals are more likely to live this way if the right conditions are present, like pedestrian-friendly environments and improved access to healthy foods.
"We must make it easier for people to behave in a healthy fashion," he said. "We have to think about improving the urban environments in which people live in addition to more individual health promotion efforts."