Nephrology Dialysis Transplantation, Vol 13, Issue 90008 2-5, Copyright © 1998 by Oxford University Press
R Trevisan, M Vedovato and A Tiengo
Insulin-dependent diabetes mellitus (IDDM) develops predominantly in
children and young adults, but may appear in all age groups. The incidence
of IDDM differs greatly among populations, with Finland and Sardinia
showing the greatest incidence rates ( 30-35% of cases annually per 100 000
children up to age 14 years) and oriental populations showing the lowest
rates. IDDM is diagnosed more frequently in the winter months. The major
genetic susceptibility to IDDM is linked to the HLA complex on chromosome
6. These genetic backgrounds interact with environmental factors (possibly
certain viruses, foods and climate) to initiate the immune-mediated process
that leads to {beta}-cell destruction.Non-insulin dependent diabetes
(NIDDM) is the most common form of diabetes. The prevalence of NIDDM varies
enormously from population to population. The greatest rates have been
found in Pima Indians. The major environmental factors identified as
contributing to this form of diabetes are obesity and reduced physical
activity. NIDDM shows strong familial aggregation in all populations and is
clearly the result of an interaction between genetic susceptibility and
environmental factors. Before NIDDM develops, insulin concentrations are
high for the degree of glycaemia and of obesity, reflecting the presence of
insulin resistance. As insulin resistance worsens, glucose levels increase,
with the appearance of glucose intolerance and, finally, of NIDDM, when
insulin response cannot compensate for insulin resistance.Key
words: epidemiology; genetics; type I diabetes mellitus (IDDM);
type II diabetes mellitus (NIDDM)
ORIGINAL ARTICLES
The epidemiology of diabetes mellitus
Divisone di Malattie del Metabolismo, Dipartimento di Medicina Clinica e Sperimentale, Universitá di Padova, via Giustiniani 2, 35100 Padova, Italy; Corresponding author
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