Duarte Alexandre Assuane, Mohsin Shahriar, Golubnitschaja Olga
Instituto Master de Ensino Presidente Antonio Carlos (IMEPAC), Araguari, Minas Gerais Brazil.
2CEMBIO, Rhinische Friedrich-Wilhelms-University of Bonn, Bonn, Germany.
EPMA J. 2018 May 22;9(2):125-131. doi: 10.1007/s13167-018-0133-y. eCollection 2018 Jun.
Diabetes mellitus (DM) epidemic-on a global scale-is a major and snowballing threat to public health, healthcare systems and economy, due to the cascade of pathologies triggered in a long-term manner after the DM manifestation. There are remarkable differences in the geographic disease spread and acceleration of an increasing DM prevalence recorded. Specifically, the highest initial prevalence of DM was recorded in the Eastern-Mediterranean region in 1980 followed by the highest acceleration of the epidemic characterised by 0.23% of an annual increase resulted in 2.3 times higher prevalence in the year 2014. In contrast, while the European region in 1980 demonstrated the second highest prevalence, the DM epidemic developments were kept much better under control compared to all other regions in the world. Although both non-modifiable and modifiable risk factors play a role in DM predisposition, cross-sectional investigations recently conducted amongst elderly individuals demonstrate that ageing as a non-modifiable risk factor is directly linked to unhealthy lifestyle as a well-acknowledged modifiable risk factor which, in turn, may strongly promote ageing process related to DM even in young populations. Consequently, specifically modifiable risk factors should receive a particular attention in the context of currently observed DM epidemic prognosed to expand significantly over 600 million of diabetes-diseased people by the year 2045. The article analyses demographic profiles of DM patient cohorts as well as the economic component of the DM-related crisis and provides prognosis for future scenarios on a global scale. The innovative approach by predictive diagnostics, targeted prevention and treatments tailored to the person in a suboptimal health condition (before clinical onset of the disease), as the medicine of the future is the most prominent option to reverse currently persisting disastrous trends in diabetes care. The key role of biomedical sciences in the future developments of diabetes care is discussed.
全球范围内，糖尿病（DM）的流行对公众健康、医疗系统和经济构成了重大且不断加剧的威胁，这是由于糖尿病表现后长期引发的一系列病理状况所致。在糖尿病患病率上升的地理分布和加速方面存在显著差异。具体而言，1980年东地中海地区记录的糖尿病初始患病率最高，随后该流行病加速最为显著，年增长率为0.23%，导致2014年患病率高出2.3倍。相比之下，虽然1980年欧洲地区的患病率位居第二，但与世界其他所有地区相比，糖尿病流行的发展得到了更好的控制。尽管不可改变和可改变的风险因素在糖尿病易感性中都起作用，但最近在老年人中进行的横断面调查表明，作为不可改变风险因素的衰老与作为公认的可改变风险因素的不健康生活方式直接相关，而后者反过来可能强烈促进与糖尿病相关的衰老过程，即使在年轻人群中也是如此。因此，在目前观察到的糖尿病流行预计到2045年将显著扩大至超过6亿糖尿病患者的背景下，特别应关注可改变的风险因素。本文分析了糖尿病患者队列的人口统计学特征以及糖尿病相关危机的经济成分，并提供了全球范围内未来情景的预测。通过预测性诊断、针对性预防和针对健康状况欠佳者（在疾病临床发作前）的个性化治疗的创新方法，作为未来医学是扭转目前糖尿病护理中持续存在的灾难性趋势的最突出选择。讨论了生物医学科学在糖尿病护理未来发展中的关键作用。
