Obesity and Diabetes in the Developing World — A Growing Challenge

Hossain, Parvez; Kawar, Bisher; Nahas, Meguid El

doi:10.1056/nejmp068177

Cited by 1,909 publications

(1,355 citation statements)

References 4 publications

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“…A developing country like India, faces the paradox of families, in which the children are underweight and the adults are overweight. This combination has been attributed by some people to intrauterine growth retardation resulting in low birth weight, which apparently confers a predisposition to obesity later in life through the acquisition of a "thrifty" phenotype that, when accompanied by rapid childhood weight gain, is conducive to the development of insulin resistance and metabolic syndrome [3].…”

Section: Review Articlementioning

confidence: 99%

Diabetes Mellitus in India: The Modern Scourge

Mehta¹,

Kashyap

Das³

2009

Medical Journal Armed Forces India

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India has a high prevalence of diabetes mellitus and the numbers are increasing at an alarming rate. In India alone, diabetes is expected to increase from 40.6 million in 2006 to 79.4 million by 2030. Studies have shown that the prevalence of diabetes in urban Indian adults is about 12.1%, the onset of which is about a decade earlier than their western counterparts and the prevalence of Type 2 diabetes is 4-6 times higher in urban than in rural areas. The risk factors peculiar for developing diabetes among Indians include high familial aggregation, central obesity, insulin resistance and life style changes due to urbanization. Screening for gestational diabetes and impaired glucose tolerance among pregnant women provides a scope for primary prevention of the disease in mothers as well as in their children. The problems of obesity and impaired glucose tolerance (IGT) (important predisposing factors) are not confined to adults alone but children are also increasingly getting affected. Most long standing macro and micro vascular complications are also more common among Indian diabetics as compared to other races and ethnic groups. A strong familial clustering of diabetic nephropathy among Indian Type 2 diabetics has also been noted. Clustering of cardiovascular risk factor like Syndrome X is common among urban Indians. The rising incidence of diabetes and its complications are going to pose a grave health care burden on our country. Timely effective interventions/measures and screening tests for complications at the time of diagnosis becomes imperative not only for early detection, but also to prevent progression to end stage disease. Screening for gestational diabetes among pregnant women would also go a long way in primary prevention of the disease. Life style changes/interventions and drugs like rosiglitazone are the current strategies that can prevent and/or delay the onset of diabetes. Simple interventional strategies like "Eat less, Eat on time and Walk more" can go a long way in preventing these chronic disorders among present as well as in the future generations. MJAFI 2009; 65 : 50-54

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Section: Review Articlementioning

confidence: 99%

Diabetes Mellitus in India: The Modern Scourge

Mehta¹,

Kashyap

Das³

2009

Medical Journal Armed Forces India

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“…Obesity remains a public health challenge, because of its association with non-communicable diseases (NCDs), such as hypertension, diabetes mellitus and cardiovascular diseases, that are amongst the leading causes of death worldwide [1–4]. Globally, over 600 million adults are obese, with rapidly increasing levels of obesity occurring in Low-to-Middle Income Countries (LMIC) [5,6].…”

Section: Introductionmentioning

confidence: 99%

Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa

Mashinya

Alberts

Cook

et al. 2018

Global Health Action

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Background: The study was conducted in the Dikgale Health and Demographic Surveillance System (DHDSS) site where we have observed increasing obesity levels, particularly in women, despite evidence of high physical activity (PA) and a relatively low daily energy intake. Objective: This study aimed to assess the socio-demographic, behavioural and biological determinants of body mass index (BMI) in adult residents permanently residing in the DHDSS. Methods: A cross-sectional study was conducted in which socio-demographic, behavioural and biological characteristics from 1143 participants (aged 40–60 years) were collected using a paper questionnaire and standard anthropometric measures. Human immunodeficiency virus (HIV) testing was performed on all participants except those who indicated that they had tested positive. Chi-square and Mann-Whitney tests were used to analyze categorical and continuous variables, respectively, while hierarchical multivariate regression was used to analyze predictors of BMI. Results: The median age of women and men was 51 (46–56) and 50 (45–55) years, respectively. The prevalence of overweight-obesity was 76% in women and 21% in men. A significant negative association of BMI with HIV and smoking and a significant positive association with socio-economic status (SES) was observed in both sexes. In women, BMI was negatively associated with sleep duration (p = 0.015) and age (p = 0.012), but positively associated with sugar-sweetened beverages (SSBs) (p = 0.08). In men, BMI was negatively associated with alcohol use (p = 0.016) and positively associated with being married (p < 0.001). PA was not associated with BMI in either sexes. Full models explained 9.2% and 20% of the variance in BMI in women and men, respectively. Conclusion: BMI in DHDSS adults is not associated with physical inactivity but is associated wealth, marital status, sleep, smoking, alcohol use, and HIV status. Future studies should explore the contribution of nutrition, stunting, psycho-social and genetic factors to overweight and obesity in DHDSS.

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“…Diabetes mellitus is a chronic metabolic disease representing a major cause of morbidity and mortality in contemporary society [1][2][3]. Type 2 diabetes mellitus is the most common form of this disease (about 90% of all cases) and it is characterised by reduced insulin action and insulin deficiency [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

The endoplasmic reticulum in pancreatic beta cells of type 2 diabetes patients

et al. 2007

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Aims/hypothesis Pancreatic beta cells have highly developed endoplasmic reticulum (ER) due to their role in insulin secretion. Since ER stress has been associated with beta cell dysfunction, we studied several features of beta cell ER in human type 2 diabetes. Methods Pancreatic samples and/or isolated islets from non-diabetic controls (ND) and type 2 diabetes patients were evaluated for insulin secretion, apoptosis (electron microscopy and ELISA), morphometric ER assessment (electron microscopy), and expression of ER stress markers in beta cell prepared by laser capture microdissection and in isolated islets.Results Insulin release was lower and beta cell apoptosis higher in type 2 diabetes than ND islets. ER density volume was significantly increased in type 2 diabetes beta cells. Expression of alpha-mannosidase (also known as mannosidase, alpha, class 1A, member 1) and UDP-glucose glycoprotein glucosyl transferase like 2 (UGCGL2), assessed by microarray and/or real-time reverse transcriptase polymerase chain reaction (RT-PCR), differed between ND and type 2 diabetes beta cells. Expression of immunoglobulin heavy chain binding protein (BiP, also known as heat shock 70 kDa protein 5 [glucose-regulated protein, 78 kDa] [HSPA5]), X-box binding protein 1 (XBP-1, also known as XBP1) and C/EBP homologous protein (CHOP, also known as damage-inducible transcript 3 [DDIT3]) was not higher in type 2 diabetes beta cell or isolated islets cultured at 5.5 mmol/l glucose (microarray and real-time RT-PCR) than in ND samples. When islets were cultured for 24 h at 11

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Obesity and Diabetes in the Developing World — A Growing Challenge

Cited by 1,909 publications

References 4 publications

Diabetes Mellitus in India: The Modern Scourge

Diabetes Mellitus in India: The Modern Scourge

Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa

The endoplasmic reticulum in pancreatic beta cells of type 2 diabetes patients

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