Abstract EN:

This geographical study of diabetes mellitus aims at localizing "pathogenous spaces" at different levels, and at showing the evolution of mortality ascribable to diabetes mellitus. Distinct differences linked to death incidence, ages at death, progression and regression in time and space, appear on a world scale between developped and develping countries. The low mortality rate in the poorest countries has been increasing for a decade, whereas it tends to decrease en developped countries. From one region to the other, disparities of such extent do exist. In the north and north-east of france, people of all ages know a very high mortality rate, whereas in the mediterranean, a region also concerned by diabetes mellitus, people obviously die older. Besides, country people seem to be much more affected than townspeople, which underlines the social aspect of risk factors. Life styles and living standard and particularly dietary behaviour account to a counsiderable extent for these inter-regional disparities in the mortality rate. The importance of a study at a much smaller scale (local level ?) seems then to give the whole investigation its full meaning. But the data available do not always turn out to be reliable and sufficient or appropriate. The obvious close links between diabets mellitus, environment and behaviours (individual and collective) clearly show the very necessity for making regional studies of morbidity as well as socio-economic surveys.