Obesity and type 2 diabetes mellitus

The incidence and prevalence of overweight and obesity have increased dramatically in the United States during the last generation (4). Figure 1 shows the prevalence of obesity among US adult men and women, based on representative samples of the population, from 1960 to 2000. The prevalence of obesity doubled during this time, although the figure makes it clear that the increases have been mainly attributable to the period since 1980. In 2000, it was estimated that approximately 65% of the US population could be classified as overweight (BMI 25.0-29.9kg/m2) or obese (BMI >30kg/m2). Obesity is the strongest risk factor for the development of type 2 diabetes mellitus, with the top decile of BMI in the population showing a 40-fold to 50fold increased risk compared with the lowest decile (4). Therefore, it is not surprising that the incidence of type 2 diabetes mellitus has been rising in concert with that of obesity. Data released by the National Institute of Diabetes and Digestive and Kidney Diseases indicate that approximately 73 million adult Americans, or roughly one-third

Fig. 1. Prevalence of obesity among US adult men and women, based on representative samples of the population, from 1960 to 2000. Adapted from Manson et al. (4).

of the adult population, have impaired fasting glucose (>100mg/dL) or frank diabetes mellitus (5).

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