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

Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants
Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants
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.
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NCD Risk Factor Collaboration (NCD-RisC)
Zhou, B.
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Lu, Y.
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Bentham, J.
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Di Cesare, M.
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Danaei, G.
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Bixby, H.
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Teddei, C.
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Ma, G.
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Mbanya, J.C.
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Osmond, C.
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Robinson, S
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NCD Risk Factor Collaboration (NCD-RisC) (2016) Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet, 387 (10027), 1513-1530. (doi:10.1016/S0140-6736(16)00618-8). (PMID:27061677)

Record type: Article

Abstract

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.

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Accepted/In Press date: 1 March 2016
e-pub ahead of print date: 6 April 2016
Published date: 9 April 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 394655
URI: http://eprints.soton.ac.uk/id/eprint/394655
ISSN: 0140-6736
PURE UUID: fff1c2ee-ed2d-4276-beea-e679c0f99856
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for C.H. Fall: ORCID iD orcid.org/0000-0003-4402-5552
ORCID for C. Osmond: ORCID iD orcid.org/0000-0002-9054-4655
ORCID for S Robinson: ORCID iD orcid.org/0000-0003-1766-7269

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Date deposited: 23 May 2016 15:30
Last modified: 18 Feb 2021 16:48

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Contributors

Author: B. Zhou
Author: Y. Lu
Author: K. Hajifathalian
Author: J. Bentham
Author: M. Di Cesare
Author: G. Danaei
Author: H. Bixby
Author: M.J. Cowan
Author: M.K. Ali
Author: C. Teddei
Author: W.C. Lo
Author: B. Reis-Santos
Author: G.A. Stevens
Author: L.M. Reily
Author: J.J. Miranda
Author: P. Bjerregaard
Author: J.A. Rivera
Author: H.M. Fouad
Author: G. Ma
Author: J.C. Mbanya
Author: S.T. McGarvey
Author: V. Mohan
Author: A. Onat
Author: A. Pilav
Author: A. Ramachandran
Author: H.B. Romdhane
Author: C.J. Paciorek
Author: J.E. Bennett
Author: M. Ezzati
Author: Z.A. Abdeen
Author: K. Abdul Kadir
Author: N.M. Abu-Rmeileh
Author: B. Acosta-Cazares
Author: R. Adams
Author: W. Aekplakorn
Author: C.A. Aguilar-Salinas
Author: C. Agyemang
Author: A. Ahmadvand
Author: A.R. Al-Othman
Author: A. Alkerwi
Author: P. Amouyel
Author: A. Amuzu
Author: L.B. Andersen
Author: S.A. Anderssen
Author: R.M. Anjana
Author: H. Aounallah-Skhiri
Author: C. Cooper ORCID iD
Author: C.H. Fall ORCID iD
Author: C. Osmond ORCID iD
Author: S Robinson ORCID iD
Corporate Author: NCD Risk Factor Collaboration (NCD-RisC)

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