Page 9 - 51 the significance--29.2_opt

generation of reactive oxygen species. Interestingly, β-cells have a
16
very low antioxidant capacity.
23

Figure 3. β-cell failure 24 25
Reduced incretin effect

The incretin system and the defects therein observed in people with
T2DM are reviewed in Chapter 4. Incretins are a quantitatively im-
portant stimulus to insulin secretion after meals, so that defects in this
entero-insular axis will contribute to relative insulin deficiency in type 2
diabetes.
The scope of the T2DM problem

Epidemiology

T2DM is a huge public health problem, the growth of which shows no
signs of abating. The epidemiological statistics of this disease are stag-
gering. Every ten seconds two people develop diabetes. Globally, it is
26
estimated that 285 million people have this disease (just over 6% of the
global population) and by 2030, there are projected to be more than
430 million people with this disease. The rise of T2DM as a global epi-
26
demic has accompanied the rapid cultural and social changes - shift-
ing demographics, increasing urbanization, dietary changes, reduced
physical activity and other unhealthy lifestyle and behavioural patterns
- that have taken place over the last five decades or so. 26

Globally, diabetes is the fourth leading cause of death. Every year,
diabetes kills nearly four million people, almost half of whom are less
than 70 years old. An even greater number die from cardiovascular
26
disease made worse by diabetes-related complications. T2DM alone
26
9