Week 1 of the Diabetes Prevention Special Issue

PLOS Medicine Senior Research Editor Clare Garvey previews the first week of the Special Issue on Preventing Diabetes, which includes research and commentary on the global burden of diabetes, taxes on energy-dense foods, the benefits of home-cooked meals, and downstream risk of heart disease.

This month, PLOS Medicine publishes its Special Issue on Preventing Diabetes. Over the next 4 weeks we will be publishing research articles and commentary across a spectrum of topics, including taxes intended to reduce consumption of unhealthy foods, and population-scale efforts to increase exercise and physical activity and hence reduce diabetes. The Special Issue will also include reports of clinical trials aimed at reducing gestational diabetes, and a study on the sensitivity of screening criteria for type 2 diabetes. We have worked closely with the Guest Editors for this issue, Professors Nicholas Wareham and William Herman, to select the papers for publication and to bring you relevant and topical commissioned content.

As Professor Juliana Chan (Chinese University of Hong Kong, China) describes in her introductory Perspective article, Diabetes: a Cinderella Subject We Can’t Afford To Ignore, “Of a global population of 7.3 billion, 8.8% of adults (about 415 million) currently have diabetes and a further 6.7% (318 million) have impaired glucose tolerance (IGT). On a yearly basis, 3–10% of people with IGT develop diabetes, and 3–10% of people with diabetes develop comorbidities including cardiovascular–renal disease, cancer and dementia.” This is a global disease epidemic that must be effectively tackled and, in publishing this Special Issue, we aim to highlight areas where research and policy efforts are currently focused to reduce levels of diabetes and where further measures are needed.

In a research article, Dr Lindsey Smith Taillie and colleagues from the University of North Carolina at Chapel Hill, USA report on their evaluation of the effectiveness of Mexico’s tax on purchases of non-essential energy-dense foods, which was introduced in January, 2014. This is one of the first studies to look at the effectiveness of this form of taxation; the authors show that purchases of such high-energy foods were reduced by 5.1% per month after introduction of the tax, while purchases of untaxed foods were unchanged. Interestingly, the decline in sugary food purchases was more pronounced in households of lower socio-economic status. In another study looking at the incidence of diabetes among individuals who reported eating meals prepared at home with different frequencies, Geng Zong and colleagues from the Harvard School of Public Health, USA report that, in a study of over 58,000 US women and 41,000 US men with long follow-up, people who reported eating between 5–7 evening meals prepared at home per week had a 15% lower risk of type 2 diabetes when compared to those who ate 0–2 meals prepared at home per week. Those who reported frequently eating midday meals prepared at home showed a smaller reduction of 9% in risk of diabetes, which was partly explained by less weight gain. The findings from this study clearly indicate the need for public health campaigns focused on the benefits of home cooking, and further warn against the dangers of consuming fast food on a regular basis.

Looking beyond diabetes to downstream health issues that arise as a consequence, Professor Zhengming Chen (University of Oxford, UK) and colleagues reveal the heightened risk of ischemic heart disease for those with type 2 diabetes in China. In their 7-year longitudinal study, in which data from 0.5 million Chinese adults was analysed, Chen and colleagues show that participants had a 1.5–2.5-fold higher risk of stroke or heart disease. The authors say that diabetes accounts for 0.5 million cardiac events per year in China. China is by no means alone in its high population incidence of type 2 diabetes and consequent adverse health outcomes—as Juliana Chan notes in her Perspective, China, the USA and India account for 65% of the global population of people with diabetes: 109.6 million, 29.3 million and 69.2 million individuals respectively. The need for urgent action to prevent diabetes is clear, and throughout July we will continue to bring you research focused on tackling this growing threat to health in all countries, both developed and developing.

We will be publishing new articles for the Special Issue all month! Check back with PLOS Medicine each week in July for new research and commentary on diabetes prevention, and come to Speaking of Medicine for weekly updates. On July 27, join Special Issue Guest Editor Nick Wareham for his PLOS Science Wednesday AMA on redditscience (/r/science). He’ll be tackling the topic of preventing diabetes and answering questions about the Special Issue.

Clare Garvey, PhD, is the Senior Research Editor at PLOS Medicine.