Pradeepa R, Mohan V
Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control and ICMR Centre for Advanced Research on Diabetes, Chennai, India.
Eur J Clin Nutr. 2017 Jul;71(7):816-824. doi: 10.1038/ejcn.2017.40. Epub 2017 Apr 19.
Diabetes, a major lifestyle disorder, has become a global burden, and the prevalence rates are rising steeply in developing economies. Rapid socioeconomic transition with urbanization and industrialization are the main causes for the global diabetes epidemic. Among developing economies, the highest increase in number of people with diabetes is in China followed by India. In India, the epidemic of diabetes continue to increase and is experiencing a shift in diabetes prevalence from urban to rural areas, the affluent to the less privileged and from older to younger people. Diabetes is a progressive disorder leading to complications, which are broadly divided into small vessel or microvascular disease and large vessel or macrovascular disease. Microvascular complications affect the inner part of the eye-the retina known as diabetic retinopathy, the kidney termed as diabetic nephropathy and the peripheral nerves termed as diabetic neuropathy. The macrovascular complications affect the heart, the brain and the peripheral arteries termed as cardiovascular disease, cerebrovascular disease and peripheral vascular disease, respectively. Given the lifelong expenditure associated with diabetes and its complications, individuals, families and the society are unable to cope with the economic, emotional and social disease burden due to diabetes. The economic burden of diabetes can be reduced by providing universal healthcare coverage, access to affordable medicines and early detection and treatment of the disorder. This emphasizes the need for a multi-prolonged strategy to minimize the burden of diabetes and its complications.
糖尿病是一种主要的生活方式紊乱疾病，已成为全球负担，且在发展中经济体中患病率急剧上升。城市化和工业化带来的快速社会经济转型是全球糖尿病流行的主要原因。在发展中经济体中，糖尿病患者人数增长最多的是中国，其次是印度。在印度，糖尿病流行仍在加剧，且糖尿病患病率正从城市向农村地区、从富裕人群向弱势群体、从老年人向年轻人转移。糖尿病是一种渐进性疾病，会导致并发症，这些并发症大致分为小血管或微血管疾病以及大血管或大血管疾病。微血管并发症会影响眼睛内部——称为糖尿病视网膜病变的视网膜、称为糖尿病肾病的肾脏以及称为糖尿病神经病变的周围神经。大血管并发症分别影响心脏、大脑和周围动脉，称为心血管疾病、脑血管疾病和周围血管疾病。鉴于与糖尿病及其并发症相关的终身支出，个人、家庭和社会都无法应对糖尿病带来的经济、情感和社会疾病负担。通过提供全民医保覆盖、获得负担得起的药物以及对该疾病进行早期检测和治疗，可以减轻糖尿病的经济负担。这凸显了采取多管齐下的策略以尽量减轻糖尿病及其并发症负担的必要性。
