Patterns of disease: diabetes mellitus and the rest

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6979.545 (Published 04 March 1995) Cite this as: BMJ 1995;310:545
  1. Ronald E LaPorte
  1. Professor Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh PA 15261 USA (rlaporte@vms.cis.pitt.edu)

    We should be investigating the relations between diseases

    As early as 400 BC Indian doctors observed that diabetes was a disease of well fed people. In 1895 Bose wrote “Amongst the Zemindars and Talookdars, who consider it a pride and honor to lead an indolent life, diabetes is a common disorder.”1 In 1962 my 76 year old Aunt Nina attributed her diabetes to being old, fat, and inactive.

    Much of what I have read about epidemiology of diabetes in the past 20 years has merely refined what my Aunt Nina said about her non-insulin dependent diabetes. We have learnt more about its causes and have more precise estimates of the relative risks of developing it as a function of age, obesity, level of physical activity, and, from Rimm and colleagues' paper in this week's journal, cigarette smoking and alcohol use (p 555).2 But substantial advances in our understanding of its epidemiology and that of other non-communicable diseases have been rare.

    The epidemiology of diabetes has recently seen a change of focus—apparent in the paper by Perry and colleagues in this issue with its examination of the …

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