Surge in Prevalence of Diabetes Mellitus Among Turkish Adults: Excess Coronary Risk in Subjects with Impaired Glucose Tolerance

In the second follow-up of the Turkish Adult Risk Factor Study 1998, a total of 2575 adults (comprising 1838 subjects of the original cohort and 737 persons newly enrolled) were examined. This report describes the data pertaining to the prevalence of diabetes and glucose intolerance and analyzes relevant changes incurred over the past 8 years by utilizing sex- and age-specific data of official population censure or estimates. Utilized criteria for identifying diabetes were: persons known to be diabetic, a fasting glucose concentration in venous plasma of (=140, or a postprandial value (=200 mg/dl. The prevalence of diabetes in the entire cohort was 4.5% and 7.3% in men and women, that of glucose intolerance was 2.6% and 1.6%, respectively. These rates correspond to a prevalence of adult diabetes of 1.66 million (of which 1.05 million in females) - up from 1.0 million in 1990. When adjustment for both population increase and aging was made, namely when compared to the standard 1990 population, diabetes was now more frequent by 13% among men, and by 27% among women. This rapid rise was in keeping with the observed increase in the prevalence of obesity and of physical inactivity. Annual rise in the total prevalence of diabetes appeared to be an astounding 6.5%. Overall prevalence of glucose intolerance was estimated as 570.000. While the prevalence of coronary heart disease in the original and new cohort among subjects with normal glucose tolerance was %5.8, it was three-fold (17.2%) in 203 participants with overall glucose in-tolerance. Elevated coronary risk among individuals with glucose intolerance appeared to be dependent on age-related factors in women, whereas in men part of the excess risk was independent from age. It was concluded that the Turkish community should lend much more emphasis on lifestyle modifications in the strategies pertaining to the prevention of diabetes mellitus.