Regional Differences in Diabetes Mellitus Type 2 (T2DM) Morbidity and Mortality in North America and Europe: Reality or Measurement Artefact?

Andrea Werdecker, University of Marburg
Ulrich O. Mueller, University of Marburg

Cancer, metabolic syndrome, dementia and depression are the dominant health problems in aging societies, T2DM advancing all four. The considerable regional differences in T2DM prevalence and estimations of undiagnosed T2DM cases may be questioned. OECD f.e. multiplies observed prevalence for the UK by 1,5 and doubles for other European countries. In the US, lowest diabetes prevalence is found in Midwest, Northeast, highest in Southern, Appalachian states, with variation 150% compared to lowest, applying for men and women, younger and older (60+) alike. In European Union, prevalence variation is even higher at 180-200% highest in Portugal, Germany vs. UK, Sweden. However, when correlated with regional obesity rates or ischemic heart disease and stroke mortality, this variation is plausible and good news, justifying regional prevention strategies. Estimating undiagnosed T2DM cases by elevated Plasma Glucose and Glycenated Hemoglobin alone, however, leads to much lower total prevalence rates than still assumed in authoritative sources.