AETIOLOGY OF NIDDM
Increasing age is well recognized as the Diabetes is a potentially devastating promajor element in the genesis of NIDDM. gressive disease and one of the most prevalent Indeed, NIDDM seems most likely to appear chronic conditions. Lifetime treatment of the when genetic susceptibility and/or age interact disease and its associated complications with additional environmental factors. 3 The accounts for a significant proportion of health most important of these are obesity and physicare budgets worldwide, making diabetes a cal inactivity, both of which are potentially subject of major global concern. Non-insulinreversible and are the key to future primary dependent diabetes mellitus (NIDDM) accounts prevention. for approximately 80-90% of all cases 1 and is Various clinical studies have implicated arguably the fastest growing global threat to obesity as a risk factor for NIDDM 4 although public health. Left unchecked, the current trend the underlying mechanism for its role in the is likely to result in an estimated 215 million pathogenesis of the disease is still unclear. sufferers from NIDDM worldwide by the Population studies show that body mass index, year 2010. 2 and particularly the distribution of fat, are inde-Despite the importance of genetic predispendent predictors of risk for glucose intolerposition, our increasing understanding of the ance, which precedes NIDDM. 4 Obesity aetiology and pathogenesis of NIDDM has amongst people who subsequently develop highlighted a number of potentially reversible NIDDM, as well as those with existing NIDDM, and contributory environmental factors which is associated with diminished glucose utilizgive credence to the view that NIDDM is largation of hepatic and peripheral tissues ely preventable.
(particularly muscle) to insulin. 5 Fatty acid metabolism is increased in obesity and in NIDDM, and this may affect glucose utilization by interfering with central and peripheral actions of insulin.