global health: where are we going?countries, where infectious disease is rarer, being overweight
or obese, coupled with tobacco and alcohol use, are the primary
causes of cancer.^12
Diabetes
The WHO estimates that more than 220 million people world-
wide have diabetes. This number is likely to exceed 366 million by
the year 2030.^13
In general, diabetes is a chronic disease in which the cells do
not absorb sugar efficiently to be used as energy, and subsequently
blood sugar and insulin rise. Both can have adverse consequences
on health. There are three primary types of diabetes: type 1, type
2, and gestational diabetes. There is also a fourth abnormal blood
sugar condition called pre-diabetes.
- Type 1 diabetes results from the body’s failure to produce
insulin, the hormone that “unlocks” the cells of the body, from
the pancreas, allowing glucose to enter and fuel them. It is
estimated that 5 to 10 percent of the world’s diabetics have
type 1 diabetes. This is the type that usually occurs in chil-
dren. It requires insulin to be administered in conjunction
with diet and exercise.^14 - Type 2 diabetes is the most common form of diabetes in the
United States and worldwide, accounting for about 85 to 95
percent of all diabetics. Type 2 diabetes results from insu-
lin resistance (a condition in which the body fails to prop-
erly use insulin), combined with relative insulin deficiency.
Though there is a genetic component, and there may be
environmental pollutants and abnormal microflora that in-
crease the development of type 2 diabetes, this condition is
very much associated with excess weight and calories and a
sedentary lifestyle. Type 2 diabetes occurs more frequently
with aging. This form of diabetes is predominantly a lifestyle
disease and can be prevented and reversed with aggressive
lifestyle management.^15 - Gestational diabetes is the high blood sugar (hyperglycemia)
that occurs during pregnancy. It may be caused by hormones
released during pregnancy that inhibit insulin’s actions.