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National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants

National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants
National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants
Background: Data for trends in glycaemia and diabetes prevalence are needed to understand the effects of diet and lifestyle within populations, assess the performance of interventions, and plan health services. No consistent and comparable global analysis of trends has been done. We estimated trends and their uncertainties in mean fasting plasma glucose (FPG) and diabetes prevalence for adults aged 25 years and older in 199 countries and territories.

Methods: We obtained data from health examination surveys and epidemiological studies (370 country-years and 2·7 million participants). We converted systematically between different glycaemic metrics. For each sex, we used a Bayesian hierarchical model to estimate mean FPG and its uncertainty by age, country, and year, accounting for whether a study was nationally, subnationally, or community representative.

Findings: In 2008, global age-standardised mean FPG was 5·50 mmol/L (95% uncertainty interval 5·37–5·63) for men and 5·42 mmol/L (5·29–5·54) for women, having risen by 0·07 mmol/L and 0·09 mmol/L per decade, respectively. Age-standardised adult diabetes prevalence was 9·8% (8·6–11·2) in men and 9·2% (8·0–10·5) in women in 2008, up from 8·3% (6·5–10·4) and 7·5% (5·8–9·6) in 1980. The number of people with diabetes increased from 153 (127–182) million in 1980, to 347 (314–382) million in 2008. We recorded almost no change in mean FPG in east and southeast Asia and central and eastern Europe. Oceania had the largest rise, and the highest mean FPG (6·09 mmol/L, 5·73–6·49 for men; 6·08 mmol/L, 5·72–6·46 for women) and diabetes prevalence (15·5%, 11·6–20·1 for men; and 15·9%, 12·1–20·5 for women) in 2008. Mean FPG and diabetes prevalence in 2008 were also high in south Asia, Latin America and the Caribbean, and central Asia, north Africa, and the Middle East. Mean FPG in 2008 was lowest in sub-Saharan Africa, east and southeast Asia, and high-income Asia-Pacific. In high-income subregions, western Europe had the smallest rise, 0·07 mmol/L per decade for men and 0·03 mmol/L per decade for women; North America had the largest rise, 0·18 mmol/L per decade for men and 0·14 mmol/L per decade for women.

Interpretation: Glycaemia and diabetes are rising globally, driven both by population growth and ageing and by increasing age-specific prevalences. Effective preventive interventions are needed, and health systems should prepare to detect and manage diabetes and its sequelae.

Funding: Bill & Melinda Gates Foundation and WHO.

31-40
Danaei, Goodarz
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Finucane, Mariel M.
c91240a9-88b4-4e75-b42f-bde9dbd53420
Lu, Yuan
bed28890-51c6-4674-bead-6cd1e5497f31
Singh, Gitanjali M.
85e8f598-66f2-450e-ac33-bd0b3bb2c889
Cowan, Melanie J.
576f8235-cc46-4d48-ae51-842e1482e302
Paciorek, Christopher J.
7f094376-3de4-473d-aa52-dae1618d9a89
Lin, John K.
f5c5e549-2d1f-42e6-bcb8-43d7fe5ce144
Farzadfar, Farshad
a30438b2-ed1e-485d-9949-4fa4bb0a109b
Khang, Young-Ho
9d845498-2da7-4fb3-bd18-b95d320c5db8
Stevens, Gretchen A.
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Rao, Mayuree
f758bcfd-8354-4321-ab9c-19404161b440
Ali, Mohammed K.
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Riley, Leanne M.
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Robinson, Carolyn A.
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Ezzati, Majid
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Fall, Caroline H.D.
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Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Glucose)
Danaei, Goodarz
6b9a29bf-f062-4f95-92b6-36818955189b
Finucane, Mariel M.
c91240a9-88b4-4e75-b42f-bde9dbd53420
Lu, Yuan
bed28890-51c6-4674-bead-6cd1e5497f31
Singh, Gitanjali M.
85e8f598-66f2-450e-ac33-bd0b3bb2c889
Cowan, Melanie J.
576f8235-cc46-4d48-ae51-842e1482e302
Paciorek, Christopher J.
7f094376-3de4-473d-aa52-dae1618d9a89
Lin, John K.
f5c5e549-2d1f-42e6-bcb8-43d7fe5ce144
Farzadfar, Farshad
a30438b2-ed1e-485d-9949-4fa4bb0a109b
Khang, Young-Ho
9d845498-2da7-4fb3-bd18-b95d320c5db8
Stevens, Gretchen A.
67365041-92cb-4d25-b006-b415a9da332f
Rao, Mayuree
f758bcfd-8354-4321-ab9c-19404161b440
Ali, Mohammed K.
db85fb1b-d64c-4e3a-9b70-5e2bfb96cb18
Riley, Leanne M.
be9bb52b-943a-4934-bdb6-5757b6a31b11
Robinson, Carolyn A.
7b3f01bf-684b-427d-a8fa-dcca09509fd8
Ezzati, Majid
7a7b5aaa-39a1-428c-9dcb-06a4e7c6095f
Fall, Caroline H.D.
7171a105-34f5-4131-89d7-1aa639893b18

Danaei, Goodarz, Finucane, Mariel M., Lu, Yuan, Singh, Gitanjali M., Cowan, Melanie J., Paciorek, Christopher J., Lin, John K., Farzadfar, Farshad, Khang, Young-Ho, Stevens, Gretchen A., Rao, Mayuree, Ali, Mohammed K., Riley, Leanne M., Robinson, Carolyn A., Ezzati, Majid and Fall, Caroline H.D. , Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Glucose) (2011) National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. The Lancet, 378 (9785), 31-40. (doi:10.1016/S0140-6736(11)60679-X). (PMID:21705069)

Record type: Article

Abstract

Background: Data for trends in glycaemia and diabetes prevalence are needed to understand the effects of diet and lifestyle within populations, assess the performance of interventions, and plan health services. No consistent and comparable global analysis of trends has been done. We estimated trends and their uncertainties in mean fasting plasma glucose (FPG) and diabetes prevalence for adults aged 25 years and older in 199 countries and territories.

Methods: We obtained data from health examination surveys and epidemiological studies (370 country-years and 2·7 million participants). We converted systematically between different glycaemic metrics. For each sex, we used a Bayesian hierarchical model to estimate mean FPG and its uncertainty by age, country, and year, accounting for whether a study was nationally, subnationally, or community representative.

Findings: In 2008, global age-standardised mean FPG was 5·50 mmol/L (95% uncertainty interval 5·37–5·63) for men and 5·42 mmol/L (5·29–5·54) for women, having risen by 0·07 mmol/L and 0·09 mmol/L per decade, respectively. Age-standardised adult diabetes prevalence was 9·8% (8·6–11·2) in men and 9·2% (8·0–10·5) in women in 2008, up from 8·3% (6·5–10·4) and 7·5% (5·8–9·6) in 1980. The number of people with diabetes increased from 153 (127–182) million in 1980, to 347 (314–382) million in 2008. We recorded almost no change in mean FPG in east and southeast Asia and central and eastern Europe. Oceania had the largest rise, and the highest mean FPG (6·09 mmol/L, 5·73–6·49 for men; 6·08 mmol/L, 5·72–6·46 for women) and diabetes prevalence (15·5%, 11·6–20·1 for men; and 15·9%, 12·1–20·5 for women) in 2008. Mean FPG and diabetes prevalence in 2008 were also high in south Asia, Latin America and the Caribbean, and central Asia, north Africa, and the Middle East. Mean FPG in 2008 was lowest in sub-Saharan Africa, east and southeast Asia, and high-income Asia-Pacific. In high-income subregions, western Europe had the smallest rise, 0·07 mmol/L per decade for men and 0·03 mmol/L per decade for women; North America had the largest rise, 0·18 mmol/L per decade for men and 0·14 mmol/L per decade for women.

Interpretation: Glycaemia and diabetes are rising globally, driven both by population growth and ageing and by increasing age-specific prevalences. Effective preventive interventions are needed, and health systems should prepare to detect and manage diabetes and its sequelae.

Funding: Bill & Melinda Gates Foundation and WHO.

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Published date: 24 June 2011
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 198085
URI: http://eprints.soton.ac.uk/id/eprint/198085
PURE UUID: e8dc41a6-d35d-4a30-8bd5-905ca1c1ca5f
ORCID for Caroline H.D. Fall: ORCID iD orcid.org/0000-0003-4402-5552

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Date deposited: 30 Sep 2011 13:28
Last modified: 18 Feb 2021 16:37

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Contributors

Author: Goodarz Danaei
Author: Mariel M. Finucane
Author: Yuan Lu
Author: Gitanjali M. Singh
Author: Melanie J. Cowan
Author: Christopher J. Paciorek
Author: John K. Lin
Author: Farshad Farzadfar
Author: Young-Ho Khang
Author: Gretchen A. Stevens
Author: Mayuree Rao
Author: Mohammed K. Ali
Author: Leanne M. Riley
Author: Carolyn A. Robinson
Author: Majid Ezzati
Corporate Author: Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Glucose)

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