GPH 67: Diabetes

Diabetes has emerged as one of the most significant non-communicable diseases worldwide, with rapidly increasing prevalence across high-, middle-, and low-income countries. Once considered a condition of affluence, it now disproportionately affects disadvantaged populations.This episode examines:• Global epidemiology of type 1 and type 2 diabetes• Pathophysiology of insulin deficiency and insulin resistance• The metabolic syndrome and clustering of risk• Obesity, diet, and physical inactivity• Urbanisation and nutritional transition• Early-life programming and intergenerational risk• Complications - cardiovascular disease, nephropathy, neuropathy, retinopathy• Health system burden and long-term management• Prevention through population-level interventionsType 2 diabetes represents the intersection of biology and environment. Genetic susceptibility interacts with calorie-dense diets, reduced physical activity, and social determinants of health. The result is a chronic condition that demands sustained health system engagement.The episode explores the life-course trajectory of metabolic risk and the importance of prevention strategies that operate beyond individual clinical care - including food systems, urban planning, and fiscal policy.Diabetes is not merely a disorder of glucose regulation. It is a marker of structural change.────────────────────────────Key Takeaways• Diabetes prevalence is increasing globally• Type 2 diabetes is strongly linked to modifiable environmental factors• Early detection reduces long-term complications• Prevention requires structural and policy interventions• Complications drive substantial morbidity and health expenditure• Intergenerational risk transmission is increasingly recognised• Equity considerations are central to effective diabetes control This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe