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The headline said it all: Diabetes rates “doubles”. But where, and among whom? According to new research published online in the journal The Lancet global diabetes rates doubled to between 314—382 million in 2008 from 1980 rates. Although researchers at Imperial College and Harvard University analyzed data for both Types 1 and 2 diabetes, the researchers contend that the majority of people in the study (there were 2.7 million participants) were diagnosed with type 2 diabetes. The increase in prevalence since 1980 has been attributed to population growth and aging as well as by increasing age-specific prevalence. The Oceania region saw the largest rise, with prevalence still high in the Caribbean region. One of things the data shows is that rates are high in developing and middle income countries. Could it be that the rise in individual income directly impacts the kinds of food we eat? The type of activities we engage in? How we get around town?

That being said, rates did not rise in all regions, and there were differences among income groups in certain regions. There was almost no change in East and Southeast Asia and Central and Eastern Europe. So what? Well, when it comes to prevention, we need to look as much as what works as well as what doesn’t. I recently read somewhere that too much money is being thrown at understanding risk behaviors and not enough at understanding protective behaviors. I second that. Although I’m uncertain what the outcome would be, I’m interested in knowing why one region has lower rates than others. One factor may be genetic.

But beyond that, what cultural social, environmental factors affect diet, nutrition and physical activity and ultimately obesity and diabetes rates? How does the policy environment impact rates? Does the country include sidewalks when they build highways? Are there an abundance of safe parks or other spaces for play? From young, are kids encouraged to engage in activities that keep them moving? What are their food sources? Beyond behavioral changes, what structural interventions can be implemented?

An overview of The Lancet article can be viewed here: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960679-X/fulltext#article_upsell

The BBC story on the study is available here: http://www.bbc.co.uk/news/uk-13917263

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