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BMJ 2002;324:856 ( 6 April )

Reviews

Book

The Epidemiology of Diabetes Mellitus: An International Perspective

Ed Jean-Marie Ekoé

John Wiley and Sons, £120, pp 454 

ISBN 0 471 97448 X

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Rating: star star star star

In 1978, Dr Kelly West published his monograph on the epidemiology of diabetes and its vascular complications, earning himself the name of "father of diabetes epidemiology." Almost a quarter of a century later we have a worthy successor to this text. And, if ever there was a need for a compendium of current epidemiology of diabetes and its complications, it is now. Diabetes mellitus, as readers will quickly discover if they didn't already know, is a worldwide pandemic straining medical resources and capacity.

Within the covers of this book are insights from the studies of diabetes in different populations. For example, the incidence of type 1 diabetes in children is over 35 in 100 000 in Sardinia and Finland but less than 10/100 000 in Italy and France. There are differences in sex ratios in childhood type 1 diabetes---a large excess in girls in Slovenia and an equal but opposite excess in boys in Portugal. Diabetic nephropathy is rapidly declining in some countries (in Sweden, it is virtually disappearing). There are also two populations of African-Americans with type 2 diabetes---one with and one without insulin resistance.

There are pithy, readable sections focusing on the major diabetic complications (for example, nephropathy and neuropathy). Special praise is due to Karvonen et al for a superb perspective on the global epidemiology of diabetes; to Banerji and Lebovitz for insights into type 2 diabetes in African-Americans; and to Ekoé and Shipp for a fascinating compilation regarding the enigma of malnutrition-related diabetes.

Since each review stands on its own, one can dip into this volume at any point to satisfy a particular curiosity. All of the chapters are as up to date as they can be in a multiauthored text and provide guides to the ferment and richness of current studies in this rapidly changing clinical arena.

One hopes that this is just the first edition of what will become the definitive textbook in the field.

Robert Matz, professor of medicine

Mount Sinai School of Medicine, New York robert.matz@mountsinai.org


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