The epidemiology of diabetes in Mexico is reviewed. In less than four decades, diabetes has become the main health problem in Mexico. It is the principal cause of death in women and the second among men since the year 2000. It is the primary cause of premature retirement, blindness, and kidney failure. By the year 2025, close to 11.7 million Mexicans are expected to be diagnosed with diabetes. In the year 2000, diabetes was the 11th most frequent cause of hospitalization but the second most common cause of hospital mortality. The number of cases reported in children has also increased since 1995. The results of population-based, nationwide surveys have detected a 25% increment over a 7-year period. Fourteen percent of people with diabetes are <40 years of age, and a large proportion of patients have other conditions that determine the appearance of macrovascular complications and kidney failure. In addition, many cases do not reach treatment goals. In conclusion, the growing number of cases and the significant health burden imposed on affected subjects makes diabetes a disease that needs to be prevented. Well-planned strategies are urgently needed to modify the lifestyle of the population and to increase their physical activity. In addition, an enormous effort will be required to educate the population and physicians to improve the diagnosis and treatment of patients with diabetes.

BACKGROUND:Our objective was to describe the prevalence of the metabolic syndrome using World Health Organization (WHO) and National Cholesterol Education Program (NCEP-III) definitions in a population-based survey. METHODS:We performed an analysis of data from a Mexican nationwide, population-based study. The population was composed of 2,158 men and women aged 20-69 years sampled after a 9-12 h fasting period. Prevalence of the metabolic syndrome as defined by the NCEP-III definition and WHO criteria was estimated and case characteristics were assessed. RESULTS:Age-adjusted prevalence was 13.61% for WHO criteria and 26.6% for the NCEP-III definition. Prevalence was 9.2 and 21.4%, respectively, in subjects without diabetes. Thirty five percent of affected cases were <40 years of age. In addition to criteria used for diagnosis, ca. 90% were either overweight or obese. In cases detected using WHO criteria, antihypertensive treatment or blood pressure reading >140/90 was found in 61.8%. The proportion of subjects who qualified for hypolipemiant treatment was lower: lifestyle modifications were needed in 42.1% and drug therapy was required in 18.9%. The same trends were found for cases detected using the NCEP definition. CONCLUSIONS:Prevalence of the metabolic syndrome in Mexico is high. A large proportion of affected cases qualify for preventive actions for complications of the metabolic syndrome (i.e., weight loss, antihypertensive or hypolipemiant treatment). These results provide data for planning therapeutic programs for Mexican patients with the metabolic syndrome.

Our objective was to evaluate the diagnostic proficiency of the World Health Organization (WHO) and the National Cholesterol Education Program (NCEP)-III definitions (1,2) for the metabolic syndrome in a Mexican nationwide, population-based survey. Details of the sampling procedures have been previously described (3). The population was composed of 2,158 men and women aged 20–69 years sampled after a 9- to 12-h fasting period. For the WHO criteria, insulin resistance was diagnosed if a nondiabetic …

OBJECTIVE: To investigate the prevalence and characteristics of patients with type 2 diabetes diagnosed before the age of 40 years (early-onset disease) in a nationwide, population-based study.METHODS: Using a multistage sampling procedure, we enrolled a representative sample of Mexican urban adults aged 20 to 69 years. Weight, height, blood pressure, and plasma levels of glucose, insulin, and other metabolic parameters were measured in all subjects.RESULTS: We identified 993 subjects with type 2 diabetes, including 143 subjects aged 20 to 39 years (14% of those with diabetes). Subjects with early-onset diabetes had a greater prevalence of obesity and higher plasma insulin and lipid levels than did age-matched controls, and a greater prevalence of high-density lipoprotein cholesterol levels <35 mg/dL and severe hypertriglyceridemia than did older subjects with diabetes. Those (n = 32) with a normal body mass index (20 to 25 kg/m(2)) tended to have insulin deficiency as the main abnormality, whereas the "metabolic syndrome" characterized the remaining 111 subjects with early-onset diabetes.CONCLUSION: Most patients with early-onset type 2 diabetes in Mexico are obese or overweight, suggesting that obesity treatment and prevention programs may be effective in reducing the prevalence of this disease. (C)2002 by Excerpta Medica, Inc.

The prevalence of lipid abnormalities revealed in a survey done in 417 Mexican cities is described. Information was obtained on 15,607 subjects, aged 20 to 69 years. In this report, only samples obtained after a 9- to 12-h fast were included (2,256 cases: 953 men and 1,303 women). The population is representative of Mexican urban adults. Mean lipid concentrations were: cholesterol, 4.80 mmol/l; triglycerides, 2.39 mmol/l; HDL cholesterol, 1.00 mmol/l; and LDL cholesterol, 3.06 mmol/l. The most prevalent abnormality was HDL cholesterol below 0.9 mmol/l (46.2% for men and 28.7% for women). Hypertriglyceridemia (>2.26 mmol/l) was the second most prevalent abnormality (24.3%). Severe hypertriglyceridemia (>11.2 mmol/l) was observed in 0.42% of the population. Increased LDL cholesterol (≥4.21 mmol/l) was observed in 11.2% of the sample. Half of the hypertriglyceridemic subjects had a mixed dyslipidemia or low HDL cholesterol. More than 50% of the low HDL cholesterol cases were not related to hypertriglyceridemia. Insulin resistance was found in 59% of them. In conclusion, the prevalence of hypoalphalipoproteinemia and other forms of dyslipidemia in Mexican adults is very high and it is among the highest previously reported worldwide. —Aguilar-Salinas, C. A., G. Olaiz, V. Valles, J. M. Ríos Torres, F. J. Gómez Pérez, J. A. Rull, R. Rojas, A. Franco, and J. Sepulveda. High prevalence of low HDL cholesterol concentrations and mixed hyperlipidemia in a Mexican nationwide survey.