Epidemiological problems in diabetes mellitus.

Abstract

It is generally accepted that etiology of diabetes mellitus is heterogeneous and term "diabetes mellitus" becomes too oldfashioned and vague to apply for the disease. A new term "hyperglycemosis" which involves all states of chronic blood glucose elevation irrespective of etiology, is proposed and tentative etiological classification of hyperglycemosis is shown. The provalence of diabetes mellitus has increased remarkably in Japan as well as other countries and the factors influencing on this increase are concluded as following: an increase in body mass index probably due to reduction of physical exercise and relative excess of energy intake, an increase of elder population and an accumulation of diabetic patients due to an improvement of prognosis of the disease. The phenomenon observed in Japan is thought to be a model in rapidly modernizing countries. Etiological classification was made in 10272 diabetic autopsy cases collected from Annual Reports of Pathological Autopsy Cases 1958-1980 and the result showed 85.9% of the cases was classified as idiopathic and 14. 1% was classified as other types of WHO classification. This study showed a difficulty to discriminate idiopathic diabetes mellitus in field studies and a reasonability to use an expression of hyperglycemosis instead of diabetes mellitus. Death of diabetic coma has decreased and death of malignant neoplasms and cardiovascular diseases, especially myocardial infarction, have increased. As frequency of the chronic complications is different according to the quality of the population and also to the examination methods, consideration for these points is important in planning of the study. The modern machine civilization has caused an increase of diabetic population and in the long history of the evolution of mankind, this increase is understood as a dysadaptation of the human body to excess food intake, less physical exercise and other diabetogenic environmental factors. The epidemiological study of diabetes will give a guide line of ideal life style of human being and contribute to sound prosperity of human society.