Mortality trends from diabetes mellitus in a high prevalence island population

Abstract

Non‐insulin dependent diabetes mellitus appears to be increasing in prevalence in most developing and developed countries. The Maltese population has been identified as having a high prevalence for NIDDM, this high rate apparently becoming of concern during the twentieth century.

Objective: The study attempts to analyse the cause‐specific mortality trends from diabetes mellitus in the Maltese population during the period 1873–1999.

Results: A definite gradual increase in cause‐specific mortality rates has been identified throughout the late nineteenth and twentieth century, this rise being offset by the social upheaval of the Second World War. A fall in cause‐specific mortality rates appears to have occurred in the last two decades of the period.

Conclusions: The rising cause‐mortality rates probably reflect a trend in an increasing prevalence rate for NIDDM caused by significant changes in the dietary regimen of the population during the period. A fugal diet predisposed the Maltese population to a Thrifty Genotype that was offset by an increasing abundance of fat and refined carbohydrate diet. In the presence of an abundant diet, individuals with a Thrifty Genotype predispose to obesity, insulin resistance and NIDDM disorders.