[Polish Multicenter Study on Diabetes Epidemiology (PMSDE)--1998-2000]

Area of Science:

• Public Health
• Epidemiology
• Endocrinology

Background:

• The Polish national diabetes program was initiated in 1998 to address the rising burden of diabetes mellitus.
• The program aimed to integrate epidemiology, risk factor identification, education, intervention, and economic aspects of diabetes management.
• Increasing diabetic complications and hospitalizations highlighted the urgent need for a nationwide intervention.

Discussion:

• Type 1 diabetes incidence shows a 2-3 fold increase compared to 1986, with specific rates noted for age groups 0-29.
• Type 2 diabetes prevalence has doubled or tripled since 1986, now exceeding 5.37% in the Polish population, with over 2 million cases.
• A significant proportion (around 50%) of type 2 diabetes cases remain undiagnosed, questioning current diagnostic criteria.

Key Insights:

• Obesity and hyperinsulinemia are identified as the strongest predictors and modifiable risk factors for type 2 diabetes development and complications.
• Visual disability affects approximately 6% of the diabetic population, serving as an indicator of care quality.
• Lower extremity amputations are 15 times more frequent in diabetics, with 10.8% occurring in undiagnosed type 2 diabetes patients.

Outlook:

• Intervention models, including supervised dietician education and physical activity programs, show promise in improving glycemic control and reducing weight.
• The economic impact of diabetes is substantial, with type 2 diabetes accounting for 95% of disability-related lost time.
• Recommendations include developing high-risk strategies for early diagnosis, continuing epidemiological studies, and establishing dedicated diabetes educator roles.