Type 2 diabetes: the epidemic of the new millennium

The increasing prevalence of obesity, which has reached epidemic proportions, raises the likelihood that a similar increase in diabetes will follow. Linkage between the two conditions is clear. Overweight is not only an important risk factor for the development of diabetes, but also has a significant impact on progression and complications. Diagnostic criteria for the recognition of diabetes and for monitoring of the disease process will become increasingly important. The role of laboratory evaluation needs to be reassessed in light of new concepts regarding classification and diagnostic criteria. The relative utility of glucose and glycosylated protein measurements should be addressed, particularly the relationship between laboratory findings and clinical guidelines. Blood glucose monitoring depends on establishment of the threshold for diagnosis. Additional issues are bedside monitoring, the goal of noninvasive glucose sensors and targeting of therapy. The laboratory scientist is likely to play a key role in the application of advances in the detection and management of diabetes.