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EPIDEMIOLOGY OF DIABETES – ITS HISTORY IN THE LAST 50 YEARS. Professor Paul Zimmet , AO, MD, PhD, FRACP, FRCP(UK) International Diabetes Institute, Melbourne, Australia.
Professor Paul Zimmet, AO, MD, PhD, FRACP, FRCP(UK)
International Diabetes Institute, Melbourne, Australia
The application of epidemiology to the study of diabetes mellitus has provided new insights into many aspects of this major public health problem including its natural history, prevalence, incidence, morbidity and mortality in diverse populations around the globe.Abstract
“Diabetes mellitus was seldom seen in “cold” Europe, whereas it was frequently encountered in “warm” Africa.”
“I, too, have not seen it in the West, nor did any of my teachers under whom I studied mention that they had seen diabetes. However, here in Egypt, in the course of approximately ten years, I have seen more than twenty people who suffer from this illness.”
was convened in Geneva in 1964 (6). The report of this group includes one of the first attempts at international consensus on a classification. While there have been a number of sets of nomenclature and diagnostic criteria proposed for diabetes including the 1964 attempt, no systematic categorization existed until just over 20 years ago. The contemporary classification of diabetes and other categories of glucose intolerance, based on scientific research on this heterogeneous syndrome, was developed in 1979 by international workgroups, the National Diabetes Data Group (7) of the National Institutes of Health, USA, and the WHO Expert Committee on Diabetes in 1980 (8).
Yet another important milestone was the first WHO/IDF training course in epidemiology of diabetes held in Cambridge UK in 1980. This was the first of several courses that have boosted the numbers of diabetologists from many countries around the globe becoming “infected” and joining the epidemiology ranks. One of my sole recollections of the first course was missing the televising of the Royal Wedding of Prince Charles and Princess Dianne as a result of being hauled off by the notable anti-Royalist, John Jarrett, to be thrashed on the tennis court!
Another major initiative in diabetes epidemiology, spurred on by Ron LaPorte and the Pittsburgh Group in the early 1980s, was the concept of diabetes registers. Their creativity and enthusiasm saw over the next decade or so the development of Type 1 diabetes and insulin treated diabetes registers established in many countries. I estimate the number of such registers now exceeds well over 200. These registers were not only important in terms of descriptive epidemiology but form the basis of investigative studies on both the genetic and environmental risk factors for Type 1 diabetes.
Epidemiology has come a long way since those early years. The study of epidemiology involves much more than number counting.