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The article presents research reviewing data in epidemiologic trends, risk factors, and complications of type 2 diabetes in Asia. The design of the review, which used the term diabetes and related key words to identify meta-analysis, systematic reviews, surveys, and cohort studies of type 2 diabetes in Asian countries, is described. Researchers conclude that type 2 diabetes is an increasing epidemic in Asia, characterized by rapid onset at a relatively young age and accompanied by a low body mass index. The need to make diabetes control and prevention a top public health priority in Asia is expressed.

Context: With increasing globalization and East-West exchanges, the increasing epidemic of type 2 diabetes in Asia has far-reaching public health and socioeconomic implications.Objective: To review recent data in epidemiologic trends, risk factors, and complications of type 2 diabetes in Asia.Evidence Acquisition: Search of MEDLINE using the term diabetes and other relevant keywords to identify meta-analyses, systematic reviews, large surveys, and cohort studies. Separate searches were performed for specific Asian countries. The review was limited to English-language articles published between January 1980 and March 2009; publications on type 1 diabetes were excluded.Evidence Synthesis: The prevalence of diabetes in Asian populations has increased rapidly in recent decades. In 2007, more than 110 million individuals in Asia were living with diabetes, with a disproportionate burden among the young and middle aged. Similarly, rates of overweight and obesity are increasing sharply, driven by economic development, nutrition transition, and increasingly sedentary lifestyles. The "metabolically obese" phenotype (ie, normal body weight with increased abdominal adiposity) is common in Asian populations. The increased risk of gestational diabetes, combined with exposure to poor nutrition in utero and overnutrition in later life in some populations, may contribute to the increasing diabetes epidemic through "diabetes begetting diabetes" in Asia. While young age of onset and long disease duration place Asian patients with diabetes at high risk for cardiorenal complications, cancer is emerging as an important cause of morbidity and mortality.Conclusions: Type 2 diabetes is an increasing epidemic in Asia, characterized by rapid rates of increase over short periods and onset at a relatively young age and low body mass index. Prevention and control of diabetes should be a top public health priority in Asian populations. [ABSTRACT FROM AUTHOR]

Inconsistent data suggest that endogenous sex hormones may have a role in sex-dependent etiologies of type 2 diabetes, such that hyperandrogenism may increase risk in women while decreasing risk in men. Objective To systematically assess studies evaluating the association of plasma levels of testosterone, sex hormone-binding globulin (SHBG), and estradiol with risk of type 2 diabetes. Data Sources Systematic search of EMBASE and MEDLINE (1966-June 2005) for English-language articles using the keywords diabetes, testosterone, sex-hormone-binding-globulin, and estradiol; references of retrieved articles; and direct author contact. Study Selection From 80 retrieved articles, 43 prospective and cross-sectional studies were identified, comprising 6974 women and 6427 men and presenting relative risks (RRs) or hormone levels for cases and controls. Data Extraction Information on study design, participant characteristics, hormone levels, and risk estimates were independently extracted by 2 investigators using a standardized protocol. Data Synthesis Results were pooled using random effects and meta-regressions. Cross-sectional studies indicated that testosterone level was significantly lower in men with type 2 diabetes (mean difference, -76.6 ng/dL; 95% confidence interval [CI], -99.4 to -53.6) and higher in women with type 2 diabetes compared with controls (mean difference, 6.1 ng/dL; 95% CI, 2.3 to 10.1) (P< .001 for sex difference). Similarly, prospective studies showed that men with higher testosterone levels (range, 449.6-605.2 ng/dL) had a 42% lower risk of type 2 diabetes (RR, 0.58; 95% CI, 0.39 to 0.87), while there was suggestion that testosterone increased risk in women (P = .06 for sex difference). Cross-sectional and prospective studies both found that SHBG was more protective in women than in men (P .01 for sex difference for both), with prospective studies indicating that women with higher SHBG levels (7gt;60 vs 60 nmol/L) had an 80% lower risk of type 2 diabetes (RR, 0.20; 95% CI, 0.12 to 0.30), while men with higher SHBG levels (> 28.3 vs 28.3 nmol/L) had a 52% lower risk (RR, 0.48; 95% CI, 0.33 to 0.69). Estradiol levels were elevated among men and postmenopausal women with diabetes compared with controls (P = .007). Conclusions This systematic review indicates that endogenous sex hormones may differentially modulate glycemic status and risk of type 2 diabetes in men and women. High testosterone levels are associated with higher risk of type 2 diabetes in women but with lower risk in men; the inverse association of SHBG with risk was stronger in women than in men. [ABSTRACT FROM AUTHOR]

The authors argue that the U.S. Food and Drug Administration's amendment to the Nutrition Facts Label, which deals with an obesity epidemic in America, dietary factors, and risks regarding chronic diseases, needs to evolve to reflect changes in nutritional sciences and consumer behaviors. Food label data about added sugar content and trans fatty acid (trans fat) is examined, along with the U.S. Nutrition Labeling and Education Act of 1990 and Daily Value (DV) nutritional guidelines.

A response by Vasanti S. Malik to a letter to the editor about their article "The Revised Nutrition Facts Label: A Step Forward and More Room for Improvement" in a 2016 issue is presented.

A response by Juliana C. N. Chan, Vasanti Malik and Frank B. Hu to a letter to the editor about their article "Diabetes in Asia: Epidemiology, Risk Factors, and Pathophysiology" published in a 2009 issue is presented.

The article presents a letter to the editor in response to the article "Nutritively sweetened beverage consumption and obesity: the need for solid evidence on a fluid issue" by D. B. Allison and R. D. Mattes published in a 2009 issue.