Epidemiology of Type 2 Diabetes in Mexico

doi:10.1016/j.arcmed.2005.01.006

Archives of Medical Research

Volume 36, Issue 3, May–June 2005, Pages 188-196

https://doi.org/10.1016/j.arcmed.2005.01.006 Get rights and content

The epidemiology of diabetes in Mexico is reviewed. In less than four decades, diabetes has become the main health problem in Mexico. It is the principal cause of death in women and the second among men since the year 2000. It is the primary cause of premature retirement, blindness, and kidney failure. By the year 2025, close to 11.7 million Mexicans are expected to be diagnosed with diabetes. In the year 2000, diabetes was the 11th most frequent cause of hospitalization but the second most common cause of hospital mortality. The number of cases reported in children has also increased since 1995. The results of population-based, nationwide surveys have detected a 25% increment over a 7-year period. Fourteen percent of people with diabetes are <40 years of age, and a large proportion of patients have other conditions that determine the appearance of macrovascular complications and kidney failure. In addition, many cases do not reach treatment goals. In conclusion, the growing number of cases and the significant health burden imposed on affected subjects makes diabetes a disease that needs to be prevented. Well-planned strategies are urgently needed to modify the lifestyle of the population and to increase their physical activity. In addition, an enormous effort will be required to educate the population and physicians to improve the diagnosis and treatment of patients with diabetes.

Introduction

The impact of diabetes on public health in Mexico is a good model for exploring the impact of environmental changes in developing countries composed of genetically predisposed individuals. In less than four decades, diabetes has become the most important health problem in Mexico. It is the principal cause of death in women and the second among men since the year 2000 (1). It is also the primary cause for premature retirement, blindness and kidney failure. By the year 2025, close to 11.7 million Mexicans are expected to have diabetes (2). In addition, behavior modification and treatment of co-morbidities are needed to prevent the complications associated with diabetes. In summary, the challenge that diabetes represents to the Mexican society is enormous. The impact of diabetes on public health is reviewed here.

Section snippets

The Diabetes Epidemic

The diabetes mortality rate started to grow during the 1940s. At that time, crucial social and environmental changes happened. A large proportion of the population moved from rural to urban areas. The percentage of the rural population decreased from 40.5 to 26.8% over a 40-year period (1950 to 1990). As a result, there was a change in diet and amount of physical activity for a large proportion of the population. For example, there are significant differences with respect to dietary composition

Mortality

The diabetes mortality rate beginning in 1922 is shown in Figure 1. The mortality rate continues to grow (1). From 1998 to 2002, the rate changed from 43.3 to 53.2 deaths per 100,000 inhabitants. In contrast, other common causes of death have not undergone a change in their mortality rate (e.g., liver cirrhosis). As a result, diabetes is now the principal cause of death in women and the second only to coronary heart disease in men. Diabetes is responsible for 14% of the total number of deaths

Facing Diabetes Epidemic: Major Challenges to be Contemplated

In addition to the growing number of cases, the characteristics of the affected subjects add complexity to the problem. The prevention of diabetic macrovascular complications includes weight loss, correction of hyperglycemia, treatment of hypertension and lipid abnormalities and the use of aspirin. Prevention of microvascular complications requires periodic evaluations by ophthalmologists, measurement of microalbuminuria and treatment of urinary tract infections. All these interventions are

Nephropathy

Diabetes is the cause of end-stage kidney failure in close to 40% of the peritoneal dialysis cases. A similar proportion has been reported in studies using state registries or in hospital-based cohorts. Among cases on dialysis, those with diabetes have the worst prognosis in prospective series. Usually, they are older, undernourished and have a high peritoneal transport rate. However, the number of cases on peritoneal dialysis underestimates the magnitude of the problem because many cases do

Conclusions

The burden imposed on the health of the affected subjects and the growing number of cases makes diabetes a model of a disease to be prevented. The age distribution of the population and the growing prevalence of childhood obesity and the metabolic syndrome are alarming signs that the worst is still to come. Well-planned strategies are urgently needed to modify the lifestyle of the population and to increase their physical activity. In addition, an enormous effort will be required to educate the

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These estimates are based on data from Mexico between 1995 and 2010, when we observed a significant shift from a traditional Mexican to a Western diet, rich in sugar and fat as well as an increase in obesity rates and related chronic disease (Clark et al., 2012). During this time, the prevalence of overweight (obese) population soared from 30 (10) to more than 70(30) percent, and prevalence in diabetes increased from around 7.5 percent in the early 1990s to more than 15 percent of Mexican adults having diabetes in 2010 (Rull et al., 2005; de Salud, 2010). Decreasing by about 20 percent during this period on average, lower prices of sugary foods may explain about 15 percent of the increase in obesity and diabetes prevalence in Mexico since the mid 1990s.
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The Mexican Diabetes Prevention (MexDiab) Study was a population-based study to evaluate strategies for preventing Type 2 diabetes (T2D) in high-risk individuals and to provide information on the prevalence of metabolic glucose disorders in a Mexican population (3). In Mexico, it is estimated that 10.6 million persons directly suffer from diabetes and its complications (4,6). The disease is characterized as either Type 1 (T1D) or Type 2 (T2D), both having a genetic predisposition that depends on the first-degree relative history of the disease.
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Review articleEpidemiology of Type 2 Diabetes in Mexico

Introduction

Section snippets

The Diabetes Epidemic

Mortality

Facing Diabetes Epidemic: Major Challenges to be Contemplated

Nephropathy

Conclusions

Metabolism

Arch Med Res

Arch Med Res

Arch Med Res

Arch Med Res

Am J Med

Metabolism

Diabetes Res Clin Pract

Kidney Int

Mortalidad 2001 en México

Salud Pública

Global burden of diabetes, 1995–2025

Diabetes Care

Metabolic síndrome among children and adolescents aged 10–18 years

Diabetes Care

Anthropometric cutoff points for predicting chronic diseases in the Mexican National Health Survey 2000

Obes Res

Insulin resístanse and abdominal adiposity in young men with documented malnutrition during the first year of life

Int J Obesity

Primary prevention of type 2 diabetes in high-risk populations

Diabetes Care

Was the historic contribution of Spain to the Mexican gene pool partially responsible for the higher prevalence of type 2 diabetes in mexican-origin populations? The Spanish Insulin Resistance Study Group, the San Antonio Heart Study, and the Mexico City Diabetes Study

Diabetes Care

Diabetes mellitus

Epidemiologia de la diabetes en Mexico

The impact of diabetes on public health in Mexico

The prevalence of NIDDM and associated coronary risk factors in Mexico City

Diabetes Care

Hipercolesterolemia e hipertensión arterial en Mexico: consolidación urbana actual con obesidad, diabetes y tabaquismo

Arch Cardiol Mex

Review article
Epidemiology of Type 2 Diabetes in Mexico