Type 2 ِDiabetes as a Prominent Global Health Issue: a Narrative Review

Subject Areas :

Asal Ansaripour ¹ , Behnood Abbasi ²

1 - School of Medicine, University of Nicosia, Nicosia, Cyprus.
2 - Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch. Islamic Azad University, Tehran, Iran

Received: 2021-11-12 Accepted : 2022-02-28 Published : 2022-03-01

Keywords: Prevention /, Hyperglycemia /, Hyperinsulinism, Diabetes mellitus type 2 /, Insulin resistance /,

Abstract :

Diabetes is one of the most prevalent non-communicable diseases worldwide which can lead to significant macrovascular and microvascular complications. A majority of patients with diabetes suffer from type 2 diabetes and its prevalence and incidence continue to increase globally. Its underlying pathophysiology is complicated. Both genetic predisposition and lifestyle risk factors can result in relative insulin deficiency and the development of type 2 diabetes. Patients with type 2 diabetes can present with polyuria, polydipsia, polyphagia, blurred vision, and recurrent infections. However, many patients may be initially asymptomatic, resulting in late diagnosis. Delayed diagnosis can also result in presenting with already established complications at the time of diagnosis. There are various diagnostic methods and these include measurements of glycated hemoglobin, fasting plasma glucose, or random plasma glucose together with classical signs and symptoms of hyperglycemia. Alternatively, an oral glucose tolerance test can be carried out to confirm the diagnosis. Lifestyle modification and pharmacotherapy are the backbones of type 2 diabetes treatment. Metformin is considered to be the first-line therapy of choice. However, if the desired glucose control is not achieved, then metformin is combined with other anti-diabetic medications. As type 2 diabetes is largely a preventable disease, its primary prevention is of utmost significance. The aim of primary prevention is to reduce the modifiable risk factors such as obesity, unhealthy diet, physical inactivity, and smoking.

References:

1. Tan SY, Wong JLM, Sim YJ, Wong SS, Elhassan SAM, Tan SH. Type 1 and 2 diabetes mellitus: A review on current treatment approach and gene therapy as potential intervention. Diabetes and Metabolic Syndrome. 2019;13(1):364-72.


2. Kamalzadeh Yazdi R, Shakeri G, Hatami Marbini M, Abbasi B. Effect of selenium supplementation on glycemic control and lipid profile in patients with type 2 diabetes: A review on current evidence. Food and Health 2018;1(2):29-34.


3. Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. Lancet. 2017;389(10085):2239-51.


4. English E, Lenters-Westra E. HbA1c method performance: the great success story of global standardization. Critical Reviews in Clinical Laboratory Sciences. 2018;55(6):408-19.


5. Centers for Disease Control & Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. 2011;201(1):2568-9.


6. Pippitt K, Li M, Gurgle HE. Diabetes mellitus: screening and diagnosis. American Family Physician. 2016;93(2):103-9.


7. Xu H, Verre MC. Type 2 diabetes mellitus in children. American Family Physician. 2018;98(9):590-4.


8. Ramachandran A. Know the signs and symptoms of diabetes. Indian Journal of Medical Research. 2014;140(5):579.


9. Almourani R, Chinnakotla B, Patel R, Kurukulasuriya LR, Sowers J. Diabetes and cardiovascular disease: an update. Division of Endocrinology, Metabolism & Lipid Research. 2019;19(12):1-13.


10. Einarson TR, Acs A, Ludwig C, Panton UHJCd. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. 2018;17(1):1-19.


11. Abbasi B, Mirlohi M, Daniali M, Ghiasvand R. Effects of probiotic soymilk on lipid panel in type 2 diabetic patients with nephropathy: A double-blind randomized clinical trial. Progress in Nutrition. 2018;20:70-8.


12. Doshi SM, Friedman AN. Diagnosis and management of type 2 diabetic kidney disease. Clinical Journal of the American Society of Nephrology. 2017;12(8):1366-73.


13. Yusufu M, Zhang X, Sun X, Raat H, Wang N. How to perform better intervention to prevent and control diabetic retinopathy among patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Diabetes Research and Clinical Practice. 2019;156:107834.


14. Lechner J, O'Leary OE, Stitt AW. The pathology associated with diabetic retinopathy. Vision Research.2017;139:7-14.


15. Feldman EL, Callaghan BC, Pop-Busui R, Zochodne DW, Wright DE, Bennett DL, et al. Diabetic Neuropathy. 2019;5(1):1-18.


16. Owora AH. Diagnostic validity and clinical utility of HbA1c tests for type 2 diabetes mellitus. Current Diabetes Reports. 2018;14(2):196.


17. Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology. 2018;14(2):88-98.


18. Lin X, Xu Y, Pan X, Xu J, Ding Y, Sun X. Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025. Scientific Reports. 2020;10(1):1-11.


19. Atlas DJIDA, 7th edn. Brussels, Belgium: International Diabetes Federation. International Diabetes Federation. 2015.


20. Dakota N, Carolina S, Dakota S, Virginia W. National and State Diabetes Trends.


21. Dyson P, Twenefour D, Breen C, Duncan A, Elvin E, Goff L. Diabetes UK evidence‐based nutrition guidelines for the prevention and management of diabetes. Diabetic Medicine. 2018;35(5):541-7.


22. Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of type 2 diabetes–global burden of disease and forecasted trends. The Journal of Epidemiology and Global Health. 2020;10(1):107.


23. Harreiter J, Kautzky-Willer A. Sex and gender differences in prevention of type 2 diabetes. Frontiers in Endocrinology. 2018;9:220.


24. Aguayo‐Mazzucato C, Diaque P, Hernandez S, Rosas S, Kostic A, Caballero AE. Understanding the growing epidemic of type 2 diabetes in the Hispanic population living in the United States. Diabetes/Metabolism Research and Reviews. 2019;35(2):e3097.


25. Bellou V, Belbasis L, Tzoulaki I, Evangelou E. Risk factors for type 2 diabetes mellitus: an exposure-wide umbrella review of meta-analyses. PLoS One. 2018;13(3):e0194127.


26. Brunton S. Pathophysiology of type 2 diabetes: the evolution of our understanding. The Journal of Family Practice. 2016;65(4 Suppl):supp_az_0416.


27. Hudish LI, Reusch JE, Sussel L. β Cell dysfunction during progression of metabolic syndrome to type 2 diabetes. Journal of Clinical Investigation. 2019;129(10):4001-8.


28. Strain WD, Paldánius P. Diabetes, cardiovascular disease and the microcirculation. Cardiovascular Diabetology. 2018;17(1):1-10.


29. Motaib SA. Investigating the mechanisms of action of metformin at pharmacological dose. 2021. Available at
    https://www.lib.ncsu.edu/resolver/1840.20/39231


30. Romero R, Erez O, Hüttemann M, Maymon E, Panaitescu B, Conde-Agudelo A, et al. Metformin, the aspirin of the 21st century: its role in gestational diabetes, prevention of preeclampsia and cancer, and the promotion of longevity. American Journal of Obstetrics and Gynecology. 2017;217(3):282-302.


31. Lytrivi M, Castell A-L, Poitout V, Cnop M. Recent insights into mechanisms of β-cell lipo-and glucolipotoxicity in type 2 diabetes. Journal of Molecular Biology. 2020;432(5):1514-34.


32. Jearath V, Vashisht R, Rustagi V, Raina S, Sharma R. Pioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction. Journal of Pharmacology and Pharmacotherapeutics. 2016;7(1):41.


33. Gallwitz B. Clinical use of DPP-4 inhibitors. Frontiers in Endocrinology. 2019;10:389.


34. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;38(1):140-9.


35. Maruthur NM, Tseng E, Hutfless S, Wilson LM, Suarez-Cuervo C, Berger Z, et al. Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: a systematic review and meta-analysis. Annals of Internal Medicine. 2016;164(11):740-51.


36. Novo Nordisk A/S. A research study comparing a new medicine oral Semaglutide to placebo in people with type 2 diabetes (pioneer 11). Clinical Trialsgov identifier. NCT0410954. 2020.


37. Deora H, Garg K, Tripathi M, Mishra S, Chaurasia B. Residency perception survey among neurosurgery residents in lower-middle-income countries: grassroots evaluation of neurosurgery education. Neurosurgical Focus. 2020;48(3):E11.


38. Bhattacharya PK, Roy A. Primary prevention of diabetes mellitus: current strategies and future trends. The Italian Journal of Medicine. 2017;11(1):15-22.


39. Hemmingsen B, Gimenez‐Perez G, Mauricio D, I Figuls MR, Metzendorf MI, Richter B. Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus. The Cochrane Library. 2017(12).


40. Guess ND. Dietary interventions for the prevention of type 2 diabetes in high-risk groups: current state of evidence and future research needs. Nutrients. 2018;10(9):1245.


41. Barbosa-Yañez RL, Markova M, Dambeck U, Honsek C, Machann J, Schüler R, et al. Predictive effect of GIPR SNP rs10423928 on glucose metabolism liver fat and adiposity in prediabetic and diabetic subjects. Peptides. 2020;125:170237.


42. Angermayr L, Melchart D, Linde K. Multifactorial lifestyle interventions in the primary and secondary prevention of cardiovascular disease and type 2 diabetes mellitus—a systematic review of randomized controlled trials. Annals of Behavioral Medicine. 2010;40(1):49-64.


43. Abid A, Ahmad S, Waheed A. Screening for type II diabetes mellitus in the United States: The present and the future. Clinical Medicine Insights: Endocrinology and Diabetes. 2016;9: 19-22.


44. Pagidipati NJ, Navar AM, Pieper KS, Green JB, Bethel MA, Armstrong PW, et al. Secondary prevention of cardiovascular disease in patients with type 2 diabetes mellitus: international insights from the TECOS Trial. Circulation. 2017;136(13):1193-203.


45. Ting DSW, Cheung GCM, Wong TY. Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clinical & Experimental Ophthalmology. 2016;44(4):260-77.


46. Geiss LS, Li Y, Hora I, Albright A, Rolka D, Gregg EW. Resurgence of diabetes-related nontraumatic lower-extremity amputation in the young and middle-aged adult US population. Diabetes Care. 2019;42(1):50-4.