Williams D R
Department of Community Medicine, University Forvie Site, Cambridge, UK.
Eye (Lond). 1993;7 ( Pt 2):202-4. doi: 10.1038/eye.1993.48.
Both non-insulin-dependent (type 2) diabetes mellitus (NIDDM) and insulin-dependent (type 1) diabetes mellitus (IDDM) show a wide variation in incidence and prevalence in different populations. The prevalence of NIDDM varies from close to zero in some populations to 40-50% in the adults of Nauru (Pacific) and in the Pima Indians (North America). The incidence of IDDM in children under 16 years ranges from around 30/100,000 children per year in Finland and other Northern European countries to less than 1/100,000 per year in Japanese children. Many genetic and environmental factors combine to produce this variation. Among the suggestions made for NIDDM are the 'thrifty genotype' and, more recently, the 'thrifty phenotype' hypotheses of Neel and of Hales and Barker respectively. Genetic and environmental factors in IDDM in children have combined to create an apparent gradient of decreasing incidence from northern to southern European countries but with at least one local 'hot spot': the island of Sardinia. The factors responsible for this pattern, and the increasing incidence over time, require further clarification.
非胰岛素依赖型（2型）糖尿病（NIDDM）和胰岛素依赖型（1型）糖尿病（IDDM）在不同人群中的发病率和患病率均存在很大差异。NIDDM的患病率在某些人群中接近零，而在瑙鲁（太平洋地区）的成年人以及皮马印第安人（北美）中则高达40%-50%。16岁以下儿童中IDDM的发病率在芬兰和其他北欧国家约为每年30/10万儿童，而在日本儿童中则低于每年1/10万。许多遗传和环境因素共同作用导致了这种差异。对于NIDDM提出的假说包括尼尔的“节俭基因型”假说，以及最近哈莱斯和巴克分别提出的“节俭表型”假说。儿童IDDM中的遗传和环境因素共同作用，在欧洲国家中形成了从北到南发病率逐渐降低的明显梯度，但至少有一个局部“热点”：撒丁岛。造成这种模式以及发病率随时间增加的因素需要进一步阐明。
