Diabetes: a 21st century challenge
Abstract
The number of people with diabetes worldwide has more than doubled during the past 20 years. One of the most worrying features of this rapid increase is the emergence of type 2 diabetes in children, adolescents, and young adults. Although the role of traditional risk factors for type 2 diabetes (eg, genetic, lifestyle, and behavioural risk factors) has been given attention, recent research has focused on identifying the contributions of epigenetic mechanisms and the effect of the intrauterine environment. Epidemiological data predict an inexorable and unsustainable increase in global health expenditure attributable to diabetes, so disease prevention should be given high priority. An integrated approach is needed to prevent type 2 diabetes, taking into account its many origins and heterogeneity. Thus, research needs to be directed at improved understanding of the potential role of determinants such as the maternal environment and other early life factors, as well as changing trends in global demography, to help shape disease prevention programmes.
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The escalating global epidemics of CVD and T2DM and dramatic changes in societies over recent decades are pivotal in the pathogenesis of obesity, T2DM and CVD.
“We see this scenario as pivotal in the pathogenesis of obesity, T2DM and CVD and in the light of the modern epidemics of NCDs 8, 55.”
From The Circadian Syndrome: is the Metabolic Syndrome and much more! (2019) · cites this paper as [8]
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Graf, B. L., Poulev, A., Kuhn, P., Grace, M. H., Lila, M. A., & Raskin, I. (2014) · Food Chemistry · doi:10.1016/j.foodchem.2014.04.088 · Cited by 129 · see citing works
Malyar, N. M., Freisinger, E., Meyborg, M., Lüders, F., Gebauer, K., Reinecke, H., & Lawall, H. (2016) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2016.03.033 · Cited by 112 · see citing works
Furler, J., O’Neal, D., Speight, J., Manski-Nankervis, J.-A., Gorelik, A., Holmes-Truscott, E., Ginnivan, L., Young, D., Best, J., dean, et al. (2017) · BMJ · doi:10.1136/bmj.j783 · Cited by 78 · see citing works
Novel Smartphone Game Improves Physical Activity Behavior in Type 2 Diabetes
Höchsmann, C., Müller, O., Ambühl, M., Klenk, C., Königstein, K., Infanger, D., Walz, S. P., & Schmidt-Trucksäss, A. (2019) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2019.02.017 · Cited by 67 · see citing works
Epidemiology of Diabetes—Status of a Pandemic and Issues Around Metabolic Surgery
Zimmet, P. Z., & Alberti, K. G. M. M. (2016) · Diabetes Care · doi:10.2337/dc16-0273 · Cited by 64 · see citing works
Self-citationUeno, H., Tsuchimochi, W., Wang, H.-W., Yamashita, E., Tsubouchi, C., Nagamine, K., Sakoda, H., & Nakazato, M. (2015) · Diabetes Therapy · doi:10.1007/s13300-015-0113-3 · Cited by 38 · see citing works
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on behalf of the First Nations Lung Health Team, Dyck, R. F., Karunanayake, C., Janzen, B., Lawson, J., Ramsden, V. R., Rennie, D. C., Gardipy, P. J., McCallum, L., Abonyi, S., et al. (2015) · BMC Public Health · doi:10.1186/s12889-015-2551-2 · Cited by 15 · see citing works
What Is the Impact of a Context-Specific Training Program for Home-Based Carers? An Evaluation Study
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Zhou, J., Wang, F., & Li, S. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1646956 · Cited by 3 · see citing works
- Authors
- Zimmet, P. Z., Magliano, D. J., Herman, W. H., & Shaw, J. E.
- Affiliations
- Baker Heart and Diabetes Institute (AU)
- University of Michigan (US)
- Corresponding author
- Zimmet, Paul Z
- Venue
- The Lancet Diabetes & Endocrinology
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 2
- Issue
- 1
- Pages
- 56-64
- ISSN
- 2213-8587 (ISSN-L)
- OpenAlex
- W2112463249
- Semantic Scholar
- 3204479bcb2b932dfeb5f1d61735c887cca9b711
- Cited by
- 1,062
- References
- 82
- Citations by year
- 2026: 38 · 2025: 106 · 2024: 123 · 2023: 97 · 2022: 122 · 2021: 108 · 2020: 95 · 2019: 93 · 2018: 85 · 2017: 69 · 2016: 56 · 2015: 45 · 2014: 22 · 2013: 2
- FWCI
- 6.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Diabetes & Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Health and Medical Research Council fellowship (586623)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092926)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, diabetes prevalence, childhood obesity, epigenetics, intrauterine environment, maternal environment, early life factors, diabetes prevention, health care costs, global demography, risk factors
- MeSH terms
- Diabetes Mellitus, Type 2, Health Promotion, Humans, Risk Factors, Global Health, Prevalence, Health Care Costs, History, 21st Century
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