1. The prevalence of Type 2 Diabetes Mellitus is increasing at an alarming rate throughout the world. Why is this happening? Can anything be done to reduce this epidemic? By Dilshan Gunawardene

2. Global Burden of Diabetes 14.2 17.5 23% 15.6 22.5 44% 9.4 14.1 50% 26.5 32.9 24% 84.5 132.3 57% 1.0 1.3 33% World 2000: 151 million 2010: 221 million Increase 46% Adapted from Zimmet et al, Nature 2001; 414; 782-787

3. Diabetes Mellitus Definition Definition Diagnosis Diagnosis Impact of Type 2 Diabetes Mellitus on the UK Impact of Type 2 Diabetes Mellitus on the UK Morbidity and Mortality of Type 2 Diabetes Mellitus Morbidity and Mortality of Type 2 Diabetes Mellitus

4. Diabetes Mellitus (Cont...) Genetics – Genetics – Twin Studies Familial Aggregation Ethnic Variation Patho-physiology – Patho-physiology – Various Possibilities

5. Why is the prevalence of Type 2 Diabetes Mellitus increasing at such an alarming rate throughout the world? What is fuelling this “explosion” ?

6. Obesity – Definition, “Epidemic” of Obesity, Association with Type 2 Diabetes and Obesity – Definition, “Epidemic” of Obesity, Association with Type 2 Diabetes and Effect on Insulin Resistance Obesity Insulin Resistance Hyperinsulinaemia (normal glucose tolerance) Diminished Insulin Secretion Type 2 Diabetes

7. Physical Activity Physical Activity Diet Diet Smoking Smoking Alcohol Alcohol Other Modifiable Risk Factors for Type 2 Diabetes

8. Factors contributing to the Diabetes Epidemic Changes in Lifestyle – The “Thrifty Hypothesis” Changes in Lifestyle – The “Thrifty Hypothesis” Greater Longevity Greater Longevity Increased Prevalence of Type 2 Diabetes in Young People Increased Prevalence of Type 2 Diabetes in Young People

9. Can anything be done to slow down the escalating rates of Type 2 Diabetes Mellitus?

10. Possible Measures that can be Implemented Effective Lifestyle Interventions Effective Lifestyle Interventions Health Promotion through Increasing Education and Awareness Health Promotion through Increasing Education and Awareness Screening High Risk Populations Screening High Risk Populations

11. To conclude…… There is a worldwide epidemic of Type 2 Diabetes Mellitus There is a worldwide epidemic of Type 2 Diabetes Mellitus Environmental risk factors such as obesity, and “Westernisation” are believed to be the main causes Environmental risk factors such as obesity, and “Westernisation” are believed to be the main causes Interventions are needed before it’s too late!!! Interventions are needed before it’s too late!!!

12. Thank You for Your Attention Any Questions???