ter Riet Gerben
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Huisartsgeneeskunde, Amsterdam, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:A679.
Some authors claimed that if current trends prevail, 1.32 million people will have been diagnosed with diabetes mellitus in the Netherlands by 2025. In this commentary, the author sheds doubt on some of the underlying assumptions. First, the author argues that advanced age in itself cannot be an immutable cause of diabetes since there must be underlying mechanisms, which may be modifiable. Second, improved early detection of diabetes, which is a cause for a higher prevalence, also creates possibilities for action. Finally, the author does not believe that the current rates of overweight will be sustained over the next 16 years through to 2025. The author also discusses the debate surrounding the use of the Diabetes Prevention Program in the U.S. and the application of the Archimedes mathematical model to calculate cost-effectiveness of rapid adoption of the Diabetes Prevention Program versus delayed adoption or drug treatment with metformin, as well as the heated debate with the Markov modellers of the Diabetes Prevention Program research group about model details and validations.
一些作者声称，如果当前趋势持续下去，到2025年荷兰将有132万人被诊断患有糖尿病。在这篇评论中，作者对一些潜在假设提出了质疑。首先，作者认为高龄本身不可能是糖尿病的一个不变病因，因为必然存在潜在机制，而这些机制可能是可以改变的。其次，糖尿病早期检测的改善是患病率上升的一个原因，这也为采取行动创造了可能性。最后，作者不相信目前的超重率在到2025年的未来16年里会持续下去。作者还讨论了围绕美国糖尿病预防计划的使用以及阿基米德数学模型的应用展开的辩论，该模型用于计算快速采用糖尿病预防计划与延迟采用或使用二甲双胍进行药物治疗的成本效益，以及与糖尿病预防计划研究小组的马尔可夫建模者就模型细节和验证展开的激烈辩论。
