Diabetes prevalence

The IDF's e-Atlas  shows some sobering data on diabetes – and reminds us that this is a worldwide problem that is getting worse.

This image (from the home page of the IDF) tells the story well:

OBesity image from IDF

Diabetes – one of the most challenging health problems in the 21st century Diabetes mellitus can now be found in almost every population in the world and epidemiological evidence suggests that, without effective prevention and control programmes, diabetes will likely continue to increase globally. Diabetes is now one of the most common non-communicable diseases globally. It is the fourth or fifth leading cause of death in most developed countries and there is substantial evidence that it is epidemic in many developing and newly industrialized nations.

Today I discharged a 500 lb patient from the hospital.  He wanted me to tell him why he was so fat.  "I must have a gland problem" he says.

Yes he does.  And it's taken him many years to get to where he is. 

In the context of the Atkins fad – and all of the other low-carb plans – I do think that we – as a species – are predisposed to overeating in the context of overabundance.  Here's how it goes:

2000 years ago (ok — even 200 years ago!), when we were cavemen and cavewomen, our ancestors would eat whatever they could get their hands on.  IN the fall – when there were more ample supplies – especially carbohydrates – they ate more.  Eating lots of carbs caused insulin secretion – which made their blood sugars fall … and made them hungry (recall that insulin makes people hungry) … so they ate more – which was good.  Fat people in November would survive until March.  People who didn't get fat in the Fall would die in February.

So we've evolved with a great mechanism to eat more when there are abundant supplies.

Our overweight patients are not "weak" or inferior – indeed, they have evolved well.  They're Darwin's success stories!

'cept now it's always harvest time.