Samuel N Uwaezuoke
The ‘double burden of malnutrition’ refers to the simultaneous existence of both undernutrition and overnutrition in the same population across the life course. Diabetes mellitus (DM) - a major non-communicable disease - has been linked to both chronic undernutrition and obesity; the latter is now assuming prominence in developing countries. The present review aims to highlight the global burden of this non-communicable disease in children and its relationship with the ‘double burden of malnutrition’. Type 2 DM has rapidly evolved from a disease of the Western world to a global disease; from a disease of affluence to a disease that now afflicts the poor; and from an adult-onset disease to a disease that is gaining prominence in the pediatric population. Estimates from the International Diabetes Federation show that diabetes affects at least 285 million people worldwide out of which two-thirds occur in developing (low-to middle-income) countries. The global epicenter of diabetes epidemic is located in China and India as Asia has undergone rapid economic development, urbanization and transitions in nutritional status. Overweight and obesity are propelling the worldwide diabetes epidemic. Central obesity is correlated with both insulin resistance and type 2 DM. Moreover, the scourge of chronic undernutrition among children in tropical developing countries may predispose them to malnutrition-modulated diabetes mellitus (MMDM) later in life. Children in these regions are thus faced with a health-related dilemma. There is an urgent need to develop a comprehensive prevention program targeted at reducing diabetes risk and promoting proper nutrition among children in these countries.