Type 2 Diabetes Mellitus and Metabolic Syndrome: Modulators and Prognosis

In this thesis we first of all studied the clinical value of the metabolic syndrome. Furthermore, we studied lifetime risk of type 2 diabetes in the Rotterdam Study. Through the data-analysis in a prospective population-based cohort setting with long-term follow-up and extensive data on both parameters of glucose metabolism and pharmacology, we here provided a unique setting for estimation of the burden of elevated blood glucose levels in the context of overall survival. Also, we compare lifetime risk to progress to diabetes between the definition of prediabetes according to the World Health Organization (WHO) and the American Diabetes Association (ADA), the latter having a lower glucose cut-off value, in both women and men. Finally, this thesis handles with risk factors for type 2 diabetes and its complications on both epidemiological, biochemical and genetical level. In this perspective, we give a decription of the DiaGene study. Furthermore, we find ADAMTS13 and genetic variants in SLC6A20 to be associated with the risk of type 2 diabetes.Through this thesis, we contribute to the improvement of identification, prevention and treatment of type 2 diabetes and associated diseases.