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Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants

By April 10, 2016September 24th, 2020No Comments



NCD Risk Factor Collaboration (NCD-RisC)

Background: One of the global targets for non-communicable diseases is to halt, by
2025, the rise in the age-standardised adult prevalence of diabetes at its
2010 levels. We aimed to estimate worldwide trends in diabetes, how likely
it is for countries to achieve the global target, and how changes in
prevalence, together with population growth and ageing, are affecting the
number of adults with diabetes.
Methods: We pooled data from population-based studies that had collected data on
diabetes through measurement of its biomarkers. We used a Bayesian
hierarchical model to estimate trends in diabetes prevalence-defined as
fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis
with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200
countries and territories in 21 regions, by sex and from 1980 to 2014. We
also calculated the posterior probability of meeting the global diabetes
target if post-2000 trends continue.
Findings: We used data from 751 studies including 4,372,000 adults from 146 of the
200 countries we make estimates for. Global age-standardised diabetes
prevalence increased from 4.3% (95% credible interval 2.4-7.0) in 1980 to
9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7)
in women. The number of adults with diabetes in the world increased from
108 million in 1980 to 422 million in 2014 (28.5% due to the rise in
prevalence, 39.7% due to population growth and ageing, and 31.8% due to
interaction of these two factors). Age-standardised adult diabetes
prevalence in 2014 was lowest in northwestern Europe, and highest in
Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the
Middle East and north Africa. Between 1980 and 2014 there was little change
in age-standardised diabetes prevalence in adult women in continental
western Europe, although crude prevalence rose because of ageing of the
population. By contrast, age-standardised adult prevalence rose by 15
percentage points in men and women in Polynesia and Micronesia. In 2014,
American Samoa had the highest national prevalence of diabetes (>30% in
both sexes), with age-standardised adult prevalence also higher than 25% in
some other islands in Polynesia and Micronesia. If post-2000 trends
continue, the probability of meeting the global target of halting the rise
in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower
than 1% for men and is 1% for women. Only nine countries for men and 29
countries for women, mostly in western Europe, have a 50% or higher
probability of meeting the global target.
Interpretation: Since 1980, age-standardised diabetes prevalence in adults has increased,
or at best remained unchanged, in every country. Together with population
growth and ageing, this rise has led to a near quadrupling of the number of
adults with diabetes worldwide. The burden of diabetes, both in terms of
prevalence and number of adults affected, has increased faster in
low-income and middle-income countries than in high-income countries.
Funding: Wellcome Trust.


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