High incidence of type 2 diabetes and increasing conversion rates from impaired fasting glucose and impaired glucose tolerance to diabetes in Mauritius

Journal of Internal Medicine - Tập 256 Số 1 - Trang 37-47 - 2004
Stefan Söderberg1,2, Paul Zimmet2, Jaakko Tuomilehto3, Maximilian de Courten2, Gary K. Dowse2, Pierrot Chitson4, H. Stenlund1, H. Gareeboo4, K. G. M. M. Alberti5, Jonathan E. Shaw2
1Department of Public Health and Clinical Medicine, University of Umeå, Umeå, Sweden
2From the International Diabetes Institute, Melbourne, Victoria, Australia
3Department of Epidemiology and Health Promotion, National Public Health Institute and Department of Public Health, University of Helsinki, Helsinki, Finland
4Ministry of Health, Port Louis, Mauritius
5Department of Metabolic Medicine, Imperial College, London, UK

Tóm tắt

Abstract.Objective.  To describe the incidence of different stages of glucose intolerance in a population from Mauritius followed over 11 years.Research design, methods and subjects.  Population‐based surveys were undertaken in the multi‐ethnic nation of Mauritius in 1987, 1992 and 1998 with 5083, 6616 and 6291 participants, respectively. Questionnaires, anthropometric measurements, and a 2‐h 75‐g oral glucose tolerance test were included. Three cohorts aged between 25 and 79 years with classifiable glucose tolerance data were identified; 3680 between 1987 and 1992, 4178 between 1992 and 1998, and 2631 between 1987 and 1998. Glucose tolerance was classified according to WHO 1999 criteria.Results.  The incidence rate of type 2 diabetes was higher between 1992 and 1998 than between 1987 and 1992. In men, the incidence was similar between cohorts (24.5 and 25.4 per 1000 person‐years) whereas the incidence increased in women (23.3 and 16.4 per 1000 person‐years). The incidence of diabetes peaked in the 45–54 year age group and then plateaud or fell. The incidences of impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) decreased in both men and women. Of normoglycaemic subjects at baseline, more women than men developed IGT and more men than women developed IFG. Of those labelled as IFG in 1987, 38% developed diabetes after 11 years. The corresponding figure for IGT was 46%.Conclusions.  In this study, we report changes in incidence rates of glucose intolerance over a 11‐year period. In particular, differences between men and women were observed. The increased incidence of IGT in women compared with men, and increased incidence of IFG in men compared with women was consistent with, and explains the sex biases seen in the prevalences of these states.

Từ khóa


Tài liệu tham khảo

10.1093/oxfordjournals.aje.a112648

10.2337/diacare.21.4.518

10.2337/diacare.22.12.1993

10.1093/oxfordjournals.aje.a115822

10.1016/S0168-8227(96)90007-8

10.2337/diacare.17.1.70

10.2337/diacare.22.2.241

Brissonnette LG, 1985, Cardiovascular diseases as a cause of death in the island of Mauritius, 1972–1980, World Health Stat Q, 38, 163

World Health Organization.Definition diagnosis and classification of diabetes mellitus and its complications: Report of a WHO Consultation. Part 1. Diagnosis and classification of diabetes mellitus. Geneva:WHO 1999.

Central Intelligence Agency (CIA).The World Factbook. Washington DC 2003. Available fromhttp://www.cia.gov/cia/publications/factbook/geos/mp.html. Accessed on 1 March 2004.

Dowse GK, 1990, High prevalence of NIDDM and impaired glucose tolerance in Indian, Creole, and Chinese Mauritians, Diabetes, 39, 390, 10.2337/diab.39.3.390

10.2337/diacare.14.4.271

10.1136/bmj.311.7015.1255

10.2337/diacare.16.12.1588

10.1007/s001250050643

10.1093/oxfordjournals.aje.a115686

10.1007/BF00403304

10.1093/oxfordjournals.aje.a116786

10.1093/oxfordjournals.aje.a009366

10.2337/diacare.23.8.1108

10.2337/diab.46.4.701

10.2337/diacare.14.2.102

Hodge AM, 1996, Incidence, increasing prevalence, and predictors of change in obesity and fat distribution over 5 years in the rapidly developing population of Mauritius, Int J Obes Relat Metab Disord, 20, 137

10.1001/jama.285.16.2109

10.1002/(SICI)1096-9136(199611)13:11<927::AID-DIA279>3.0.CO;2-E

Alberti KG, 1996, Impaired glucose tolerance – fact or fiction, Diabet Med, 13, S6, 10.1002/(SICI)1096-9136(199611)13:11<927::AID-DIA279>3.0.CO;2-E

10.2337/diabetes.40.4.516

10.1093/oxfordjournals.aje.a115519

10.1093/oxfordjournals.aje.a116468

Harris MI, 1996, Impaired glucose tolerance–prevalence and conversion to NIDDM, Diabet Med, 13, S9

10.2337/diacare.20.7.1183

10.2337/diacare.21.7.1183

Charles MA, 1991, Risk factors for NIDDM in white population. Paris prospective study, Diabetes, 40, 796, 10.2337/diab.40.7.796

10.2337/diacare.21.9.1408

10.1016/S0168-8227(86)80019-5

10.2337/diabetes.42.4.556

10.1136/bmj.313.7064.1044

10.1161/01.ATV.12.8.911

10.2337/diab.44.8.863

10.1056/NEJM200105033441801

10.2337/diacare.20.4.537

10.2337/diacare.22.3.399

10.1007/s001250051269