Abstract
Currently, the global prevalence of diabetes is 8.8%. This figure is expected to increase
worldwide, with the largest changes projected to occur in low- and middle-income countries.
The aging of the world’s population and substantial increases in obesity have contributed
to the rise in diabetes. Global shifts in lifestyles have led to the adoption of unhealthy
behaviours such as physical inactivity and poorer-quality diets. Correspondingly,
diabetes is a rapidly-increasing problem in higher- as well as lower-income countries.
In Canada, the prevalence of diabetes increased approximately 70% in the past decade.
Although diabetes-related mortality rates have decreased in Canada, the number of
people affected by diabetes has continued to grow because of a surge in the number
of new diabetes cases. Non-European ethnic groups and individuals of lower socioeconomic
status have been disproportionately affected by diabetes and its risk factors. Clinical
trials have proven efficacy in reducing the onset of diabetes in high-risk populations
through diet and physical activity interventions. However, these findings have not
been broadly implemented into the Canadian health care context. In this article we
review the evolving epidemiology of type 2 diabetes, with regard to trends in occurrence
rates and prevalence; the role of risk factors including those related to ethnicity,
obesity, diet, physical activity, socioeconomic status, prediabetes, and pregnancy;
and the identification of critical windows for lifestyle intervention. Identifying
high-risk populations and addressing the upstream determinants and risk factors of
diabetes might prove to be effective diabetes prevention strategies to curb the current
diabetes epidemic.
Résumé
La prévalence mondiale du diabète est actuellement de 8,8 %. Ce nombre est censé augmenter
à l’échelle mondiale, et les variations les plus importantes devraient se produire
dans les pays à revenu faible et moyen. Le vieillissement de la population mondiale
et les augmentations considérables du taux d’obésité ont contribué à la hausse de
la prévalence du diabète. Les modifications au mode de vie à l’échelle mondiale ont
favorisé l’adoption de comportements malsains tels que la sédentarité et de piètres
régimes alimentaires. Par conséquent, le diabète est un problème en croissance rapide
dans les pays à revenu plus élevé, mais aussi dans ceux à revenu plus faible. Au Canada,
la prévalence du diabète a augmenté d’environ 70 % au cours des dix dernières années.
Bien que les taux de mortalité liée au diabète aient diminué au Canada, le nombre
de personnes atteintes de diabète a continué d’augmenter à cause de la hausse du nombre
de nouveaux cas de diabète. Les groupes d’origine ethnique non européenne et les personnes
ayant un faible statut socioéconomique ont été touchés de manière disproportionnée
par le diabète et ses facteurs de risque. Des essais cliniques ont montré que des
interventions ciblant l’alimentation et l’activité physique pouvaient réduire efficacement
l’apparition du diabète chez les populations à risque élevé. Cependant, ces résultats
n’ont pas été totalement appliqués dans le contexte des soins de santé canadiens.
Dans cet article, nous passons en revue trois volets: l’épidémiologie en évolution
du diabète de type 2 en ce qui a trait aux tendances des fréquences et de la prévalence;
le rôle des facteurs de risque, y compris ceux liés à l’origine ethnique, à l’obésité,
à l’alimentation, à l’activité physique, au statut socioéconomique, au prédiabète
et à la grossesse; et l’établissement de fenêtres critiques pour les interventions
liées au mode de vie. La reconnaissance des populations à risque élevé et la prise
en charge des déterminants en aval et des facteurs de risque de diabète pourraient
s’avérer des stratégies efficaces de prévention du diabète pour enrayer l’épidémie
actuelle de la maladie.
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Article info
Publication history
Published online: March 12, 2018
Accepted:
March 8,
2018
Received:
February 10,
2018
Footnotes
See page 560 for disclosure information.
Identification
Copyright
© 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
