Diabetes and macrovascular disease: epidemiology, nutritional and environmental factors

Since Himsworth's pioneer studies relating diabetes mortality to low carbohydrate/high fat dietary intakes, various attempts have been made to identify associations between nutritional factors and the frequency of diabetes and its macrovascular complications. Positive associations are reported between excess energy consumption, obesity, dietary fat intake, and urban factors in relation to prevalence of diabetes. A negative association is seen in some studies between (complex) carbohydrate intake and mortality from diabetes. No single causation has been established and until further studies are conducted, intervention for all the conventional non-diabetic cardiovascular risk factors is recommended as well as continued emphasis on the control of blood glucose levels.