Epidemiological problems in diabetes mellitus.

Area of Science:

• Endocrinology
• Epidemiology
• Pathology

Background:

• The term "diabetes mellitus" is considered vague due to the heterogeneous etiology of the disease.
• Prevalence of diabetes mellitus has significantly increased globally, particularly in Japan, influenced by modern lifestyle factors.
• An aging population and improved disease prognosis contribute to the rising number of diabetic patients.

Purpose of the Study:

• To propose a new term, "hyperglycemosis," encompassing all states of chronic blood glucose elevation.
• To present a tentative etiological classification of hyperglycemosis.
• To analyze trends in diabetes mellitus in Japan as a model for rapidly modernizing societies.

Main Methods:

• Etiological classification of 10,272 diabetic autopsy cases from 1958-1980.
• Analysis of factors contributing to the increased prevalence of diabetes mellitus.
• Review of changes in mortality causes among diabetic patients.

Main Results:

• 85.9% of autopsy cases were classified as idiopathic, highlighting the difficulty in precise etiological discrimination in field studies.
• The proposed term "hyperglycemosis" is suggested as a more appropriate descriptor than "diabetes mellitus."
• Mortality from diabetic coma has decreased, while deaths from malignant neoplasms and cardiovascular diseases have increased.

Conclusions:

• The term "hyperglycemosis" offers a more inclusive and accurate description for chronic hyperglycemia.
• Modern societal changes, including excess food intake and reduced physical activity, are key diabetogenic factors.
• Epidemiological studies of diabetes can inform ideal lifestyle choices for societal well-being.