Gómez-Díaz Rita Angélica, Garibay-Nieto Nayely, Wacher-Rodarte Niels, Aguilar-Salinas Carlos Alberto
Departamento de Endocrinologia y Metabolismo. Instituto Nacional de Ciencias Medicas y Nutricion. Vasco de Quiroga 15. Mexico City 14000, Mexico.
Curr Diabetes Rev. 2014 Mar;10(2):75-85. doi: 10.2174/1573399810666140223183936.
Latin America is among the regions with the highest diabetes-related burden. Research and treatment programs have increased in number and complexity in recent years, but they are focused in type 2 diabetes, because this condition explains a large proportion of the cases. In contrast, the information regarding the epidemiology of type 1 diabetes is scant in this area. Here, we analyze the available information on this topic and identify potential areas of opportunity to generate new knowledge through the study of type 1 diabetes in Latin Americans. Both, the prevalence and the incidence of type 1 diabetes, are lower in Latin American countries compared to that reported in Europe, North America, southern Asia and northern Africa. Biologic and methodological factors may explain the smaller contribution of type 1. The presence of some putative 'protective' environmental exposures or the absence of those prevalent in a region may explain the lower type 1 diabetes prevalence observed in most Latin American countries. However, the number and quality of the diabetes registries are not enough in this region. During the past decade, the incidence of type 1 diabetes has grown worldwide. The same trend has been reported in Latin America. This epidemiologic transition is a unique opportunity to identify interactions between rapidly changing environmental factors in subjects with different genetic backgrounds (such as the admixed Latin American populations). Finally, on-going therapeutic initiatives in this region are highlighted.
拉丁美洲是糖尿病相关负担最高的地区之一。近年来,研究和治疗项目在数量和复杂性上都有所增加,但它们主要集中在2型糖尿病,因为这种疾病占了很大一部分病例。相比之下,该地区关于1型糖尿病流行病学的信息却很少。在此,我们分析了关于这一主题的现有信息,并确定了通过对拉丁美洲人1型糖尿病的研究来产生新知识的潜在机会领域。与欧洲、北美、南亚和北非报告的情况相比,拉丁美洲国家1型糖尿病的患病率和发病率都较低。生物学和方法学因素可能解释了1型糖尿病所占比例较小的原因。某些假定的“保护性”环境暴露的存在或某一地区普遍存在的暴露因素的缺失,可能解释了大多数拉丁美洲国家1型糖尿病患病率较低的现象。然而,该地区糖尿病登记处的数量和质量都不够。在过去十年中,全球1型糖尿病的发病率一直在上升。拉丁美洲也报告了同样的趋势。这种流行病学转变是一个独特的机会,可以确定在具有不同遗传背景的人群(如拉丁美洲混合人群)中快速变化的环境因素之间的相互作用。最后,还强调了该地区正在进行的治疗举措。