[Diabetes in 2005]

Abstract

Worldwide the number of persons with diabetes has tripled since 1985 and this disease is increasing at an alarming rate becoming one of the major public health problems. Obviously this situation affects the developed countries following the high prevalence of obesity. But the recent data concerning the developing countries are alarming with, in some areas (North of Africa, Middle East, India, China, and Mexico), a prevalence of diabetes larger than in Europe or North America. Indeed, this huge increase is due to the poor dietary habits of these populations, the westernisation of the diet and subsequently the increased BMI. However some other environmental factors are responsible for this situation, above all, the decrease of physical activity, due to the new ways of life with both their benefits and their deleterious metabolic side effects. Type 2 diabetes is frequently associated with many components of the metabolic syndrome this explaining the frequent association with hypertension, dyslipidemias, and a high cardiovascular and renal risk (diabetes causing one third to 40% of these diseases). The prevention of diabetes by the change of the Lifestyle or if necessary some drugs become a major concern worldwide. Meanwhile the new recommendations for the treatment of diabetes tend to be more vigorous and strict (i.e. "treat earlier and stronger") trying to reach a "near normal" glycaemia, blood pressure and Lipids. The availability of new drugs and the high evidence based Levels of several trials confirm the lawfulness of these approaches.