Diabetes mellitus is a complex, progressive disease, which is accompanied by multiple complications. It is a metabolic disorder of the endocrine system and listed among the most common disorders in both developed and developing countries. It has a global metabolic epidemic and it is estimated that the number of people affected by the disease will rise from the current 150 to 230 million by 2025. Hyperglycaemia is a characteristic feature of diabetes mellitus and chronic hyperglycaemia could lead to long-term complications in the eyes, kidneys, nerves, heart and blood vessels.
The prevalence of diabetes mellitus is growing at epidemic
proportions in the United States and worldwide (1). Most
alarming is the steady increase in type 2 diabetes, especially
among young and obese persons. An estimated 7% of
Americans are afflicted with diabetes, and with the longevity
of this population increasing, the prevalence of diabetesrelated
complications will continue to rise.
Foot disorders are a major source of morbidity and a leading
cause of hospitalization for persons with diabetes.
As the global epidemic of diabetes continues to expand, the prevalence of type 2 diabetes is predicted to double in
the next 20 years. Continued population growth, increasing age, and worldwide globalization leading to changes in
diet and patterns of physical inactivity have resulted in staggering numbers of individuals affected by the disease.
A haphazard approach to treatment for a problem of this magnitude could easily overburden the healthcare system,
particularly in areas of the world with limited resources.
General symptoms include morning stiffness of more than 60 minutes, fatigue, sometimes
even slightly elevated temperature, but the main initial symptom is low back pain at night
and in the morning. All patients with low back pain should be questioned about a positive
family history concerning rheumatic diseases, as the risk of developing this illness is higher
in patients where family members already have been diagnosed with ankylosing
The nucleocapsid complex is surrounded
by a protein shell called capsid to form the viral core. A layer of matrix protein, which is
formed outside the capsid, interacts with the envelope (env) which consists of lipid
envelope derived from the host cell and viral envelope glycoproteins. Viral glycoproteins
are made of two units: a transmembrane portion, which attaches the protein into the lipid
bilayer, and a surface portion, which binds to the cellular receptor.
The growing worldwide epidemic of metabolic syndrome and other chronic degenerative
diseases continues to expand, with a rapid decrease in the age at which they are being
diagnosed (Guarnieri et al.; 2010; Hsueh & Wyne, 2011). Metabolic syndrome is a multifactorial
disorder, strongly influenced by several lifestyle factors, with symptoms clustering
on abnormalities that include obesity, hypertension, dyslipidemia, glucose intolerance and
insulin resistance (Guarnieri et al.; 2010; Tanaka et al.; 2006).
Obesity and its associated disorders, including diabetes and cardiovascular
disease, have now reached epidemic proportions in the Western world,
resulting in dramatic increases in healthcare costs. Understanding the pro-cesses and metabolic perturbations that contribute to the expansion of adi-pose depots accompanying obesity is central to the development of
appropriate therapeutic strategies.
We live in an era in which public health is debated all around us, every day. Big questions
emerge constantly: What’s the best way to deliver health care or respond to natural disaster?
How will climate change affect health? What can we do to ensure clean, safe water for a
planet of seven billion?
Some of the puzzles that we in public health try to solve are fairly recent, such as the obesity
and diabetes epidemics. Other quandaries have been around longer. The HIV/AIDS epidemic
is three decades old now. Cigarettes have been identified as killers for more than half a century.
A lot of focus has been put on lifestyle changes since the
last prevention policy paper was published. Key objectives
have been defined with ambitious targets to reduce
smoking, the harmful use of alcohol, overweight, diabetes
and depression. There is, of course, a reason for this: there
is a close relationship between today’s major chronic
diseases and people’s behaviour. The focus on lifestyle and
health promotion is therefore an obvious consequence of
disease prevention. But lifestyle changes are not easy to
Obesity in America, and indeed in the world, is reaching epidemic
proportions. At this writing, more than 65 percent of
American adults and nearly one-quarter of our children are
overweight or obese. Data from the surgeon general’s office
have linked more than four hundred thousand premature
deaths annually to the direct health effects of obesity (second
only to smoking)—and the numbers continue to climb.
As the proportion of both minority populations and people aged 60 and older increases in the United States, and the
obesity epidemic continues, people with diabetes are becoming a larger part of the practices of family physicians and
other primary care clinicians. Health care professionals involved in new or expanding diabetes care practices can use
these guiding principles to ensure that they provide essential components of comprehensive diabetes care.
Furthermore, in order to boost innovative drugs and health solutions in Europe the Health
Theme makes a major effort into investigator-driven clinical trials in various fields. With a
focus on brain-related diseases, diabetes, and cancer (incorporating life style issues and social
determinants of health) the 2011 work programme addresses major health-related societal
challenges. Finally, with a focus on antimicrobial drug resistance and emerging epidemics,
the Health Theme continues to address global health issues of utmost importance.
The nation faces a growing epidemic of childhood obesity that
threatens the immediate health of our children and youth and their
prospects of growing up to be healthy adults. During the past 30 years,
obesity in the United States has more than doubled among children aged
25 years and adolescents aged 1219 years, and it has more than tripled
among children aged 611 years. Currently, more than 9 million children
and youth over the age of 6 years are obese.