Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants
Year: 2016
Type: article
Study design: Systematic Review
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. FUNDING: Wellcome Trust.
Source: The Lancet
Authors: B Zhou, Y Lu, K Hajifathalian, J Bentham, M Di Cesare, G Danaei, H Bixby, MJ Cowan, MK Ali, C Taddei, WC Lo, B Reis-Santos, GA Stevens, LM Riley, JJ Miranda, P Bjerregaard, JA Rivera, HM Fouad, G Ma, JC Mbanya, ST McGarvey, V Mohan, A Onat, A Pilav, A Ramachandran, HB Romdhane, CJ Paciorek, JE Bennett, M Ezzati, ZA Abdeen, K Abdul Kadir, NM Abu-Rmeileh, B Acosta-Cazares, R Adams, W Aekplakorn, CA Aguilar-Salinas, C Agyemang, A Ahmadvand, AR Al-Othman, A Alkerwi, P Amouyel, A Amuzu, LB Andersen, SA Anderssen, RM Anjana, H Aounallah-Skhiri, T Aris, N Arlappa, D Arveiler, FK Assah, M Avdicová, F Azizi, N Balakrishna, P Bandosz, CM Barbagallo, A Barceló, AM Batieha, LA Baur, HB Romdhane, M Benet, A Bernabe-Ortiz, S Bharadwaj, SK Bhargava, Y Bi, P Bjerregaard, E Bjertness, MB Bjertness, C Björkelund, A Blokstra, S Bo, BO Boehm, CP Boissonnet, P Bovet, I Brajkovich, J Breckenkamp, H Brenner, LM Brewster, GR Brian, G Bruno, A Bugge, A Cabrera de León, G Can, AP Cândido, V Capuano, AC Carlsson, MJ Carvalho, FF Casanueva, JP Casas, CA Caserta, K Castetbon, S Chamukuttan, N Chaturvedi, CJ Chen, F Chen, S Chen, CY Cheng, A Chetrit, ST Chiou, Y Cho, J Chudek, R Cifkova, F Claessens, H Concin, C Cooper, R Cooper, S Costanzo, D Cottel, C Cowell, AB Crujeiras, G D'Arrigo, J Dallongeville, R Dankner, L Dauchet, G de Gaetano, S De Henauw, M Deepa, A Dehghan, V Deschamps, K Dhana, AF Di Castelnuovo, S Djalalinia, K Doua, W Drygas, Y Du, V Dzerve, EE Egbagbe, R Eggertsen, J El Ati, R Elosua, RT Erasmus, C Erem, G Ergor, L Eriksen, J Escobedo-de la Peña, CH Fall, F Farzadfar, FJ Felix-Redondo, TS Ferguson, D Fernández-Bergés, M Ferrari, C Ferreccio, EJ Feskens, JD Finn, B Föger, LH Foo, AS Forslund, HM Fouad, DK Francis, C Franco Mdo, OH Franco, G Frontera, T Furusawa, Z Gaciong, SP Garnett, JM Gaspoz, M Gasull, L Gates, JM Geleijnse, A Ghasemian, A Ghimire, S Giampaoli, F Gianfagna, J Giovannelli, A Giwercman, MG Gross, JP González Rivas, MB Gorbea, F Gottrand, D Grafnetter, T Grodzicki, A Grøntved, G Gruden, D Gu, OP Guan, R Guerrero, I Guessous, AL Guimaraes, L Gutierrez, IR Hambleton, R Hardy, R Hari Kumar, J Hata, J He, C Heidemann, S Herrala, IT Hihtaniemi, SY Ho, SC Ho, A Hofman, CM Hormiga, BL Horta, L Houti, C Howitt, TT Htay, AS Htet, MM Htike, Y Hu, AS Hussieni, I Huybrechts, N Hwalla, L Iacoviello, AG Iannone, MM Ibrahim, N Ikeda, MA Ikram, VE Irazola, M Islam, M Iwasaki, JM Jacobs, T Jafar, KM Jamil, G Jasienska, CQ Jiang, JB Jonas, P Joshi, A Kafatos, O Kalter-Leibovici, A Kasaeian, J Katz, P Kaur, M Kavousi, S Keinänen-Kiukaanniemi, R Kelishadi, AP Kengne, M Kersting, YS Khader, D Khalili, YH Khang, S Kiechl, J Kim, P Kolsteren, P Korrovits, W Kratzer, D Kromhout, UM Kujala, K Kula, C Kyobutungi, T Laatikainen, C Lachat, Y Laid, TH Lam, O Landrove, V Lanska, G Lappas, A Laxmaiah, C Leclercq, J Lee, J Lee, T Lehtimäki, R Lekhraj, LM León-Muñoz, Y Li, WY Lim, MF Lima-Costa, HH Lin, X Lin, L Lissner, R Lorbeer, JE Lozano, D Luksiene, A Lundqvist, P Lytsy, G Ma, GL Machado-Coelho, S Machi, S Maggi, DJ Magliano, M Makdisse, K Mallikharjuna Rao, Y Manios, E Manzato, P Margozzini, P Marques-Vidal, R Martorell, SR Masoodi, EB Mathiesen, TE Matsha, JC Mbanya, SR McFarlane, ST McGarvey, S McLachlan, BA McNulty, S Mediene-Benchekor, A Meirhaeghe, AM Menezes, S Merat, II Meshram, J Mi, JF Miquel, JJ Miranda, MK Mohamed, K Mohammad, N Mohammadifard, V Mohan, MF Mohd Yusoff, NC Møller, D Molnár, CK Mondo, A Morejon, LA Moreno, K Morgan, G Moschonis, M Mossakowska, A Mostafa, J Mota, J Motta, TT Mu, ML Muiesan, M Müller-Nurasyid, J Mursu, G Nagel, J Námešná, EE Nang, VB NangThetia, EM Navarrete-Muñoz, NC Ndiaye, I Nenko, F Nervi, ND Nguyen, QN Nguyen, RE Nieto-Martínez, G Ning, T Ninomiya, M Noale, D Noto, MA Nsour, AM Ochoa-Avilés, K Oh, A Onat, P Ordunez, C Osmond, JA Otero, E Owusu-Dabo, E Pahomova, L Palmieri, S Panda-Jonas, F Panza, M Parsaeian, SV Peixoto, C Pelletier, M Peltonen, A Peters, N Peykari, ST Pham, A Pilav, F Pitakaka, A Piwonska, J Piwonski, P Plans-Rubió, M Porta, ML Portegies, H Poustchi, R Pradeepa, JF Price, M Punab, RF Qasrawi, M Qorbani, R Radisauskas, M Rahman, O Raitakari, SR Rao, A Ramachandran, J Ramke, R Ramos, S Rampal, W Rathmann, J Redon, PF Reganit, F Rigo, SM Robinson, C Robitaille, F Rodríguez-Artalejo, C Rodriguez-Perez Mdel, LA Rodríguez-Villamizar, R Rojas-Martinez, K Ronkainen, A Rosengren, A Rubinstein, O Rui, BS Ruiz-Betancourt, RV Russo Horimoto, M Rutkowski, C Sabanayagam, HS Sachdev, O Saidi, S Sakarya, B Salanave, JT Salonen, M Salvetti, J Sánchez-Abanto, D Santos, RN dos Santos, R Santos, JL Saramies, LB Sardinha, N Sarrafzadegan, KU Saum, M Scazufca, H Schargrodsky, C Scheidt-Nave, AA Sein, SK Sharma, JE Shaw, K Shibuya, Y Shin, R Shiri, R Siantar, AM Sibai, M Simon, J Simons, LA Simons, M Sjostrom, J Slowikowska-Hilczer, P Slusarczyk, L Smeeth, MB Snijder, HK So, E Sobngwi, S Söderberg, V Solfrizzi, E Sonestedt, A Soumare, JA Staessen, MG Stathopoulou, J Steene-Johannessen, P Stehle, AD Stein, J Stessman, D Stöckl, J Stokwiszewski, K Stronks, MW Strufaldi, CA Sun, J Sundström, YT Sung, P Suriyawongpaisal, RG Sy, ES Tai, A Tamosiunas, L Tang, M Tarawneh, CB Tarqui-Mamani, A Taylor, H Theobald, L Thijs, BH Thuesen, HK Tolonen, JS Tolstrup, M Topbas, M Torrent, P Traissac, OT Trinh, MK Tulloch-Reid, TP Tuomainen, ML Turley, C Tzourio, P Ueda, FA Ukoli, H Ulmer, HM Uusitalo, G Valdivia, D Valvi, L van Rossem, IG van Valkengoed, D Vanderschueren, D Vanuzzo, T Vega, G Velasquez-Melendez, G Veronesi, WM Verschuren, R Verstraeten, L Viet, J Vioque, JK Virtanen, S Visvikis-Siest, B Viswanathan, P Vollenweider, S Voutilainen, M Vrijheid, AN Wade, A Wagner, J Walton, WN Wan Mohamud, F Wang, MD Wang, Q Wang, YX Wang, SG Wannamethee, D Weerasekera, PH Whincup, K Widhalm, A Wiecek, AH Wijga, RJ Wilks, J Willeit, T Wilsgaard, B Wojtyniak, TY Wong, J Woo, M Woodward, FC Wu, SL Wu, H Xu, W Yan, X Yang, X Ye, A Yoshihara, NO Younger-Coleman, S Zambon, AH Zargar, T Zdrojewski, W Zhao, Y Zheng, J Zuñiga Cisneros
Institutions: Imperial College London, Inserm
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,325
Funders: World Health Organization, Styrelsen för Internationellt Utvecklingssamarbete, Brown University, Emory University, Univerzita Karlova v Praze, Universitetet i Tromsø, American University of Beirut, Itä-Suomen Yliopisto, Tulane University, Johns Hopkins University, Deutsches Krebsforschungszentrum, Ministry of Health and Welfare, Uniwersytet Jagielloński Collegium Medicum, Wellcome Trust, Public Health Agency of Canada, Royal College of Surgeons in Ireland, Birzeit University, Fred Hollows Foundation, Université de Lille, Duke-NUS Medical School, Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Universidade Federal de Pelotas, National Institute for Health and Care Research, British Heart Foundation, University of Southampton, Imperial College London, University College London, South African Medical Research Council, National University of Singapore, Indian Council of Medical Research, India Diabetes Research Foundation, Singapore Eye Research Institute, Nanyang Technological University, Public Health Agency, University College Dublin, Universität Heidelberg, Institut National de la Santé et de la Recherche Médicale, University of New South Wales, Monash University, University of Adelaide, Universiteit van Amsterdam, Academia Sinica, Ain Shams University, Chinese Academy of Sciences, Cairo University, Universidad ICESI, Seoul National University, Erasmus Medisch Centrum, Bundesministerium für Gesundheit, Lunds Universitet, Università degli Studi di Padova, Universitat de València, Universidad Politécnica de Madrid, Istituto Superiore di Sanità, Jordan University of Science and Technology, KU Leuven, Karadeniz Teknik Üniversitesi, Karolinska Institutet, Mahidol University, Warszawski Uniwersytet Medyczny, Universiteit Gent, Universiti Malaya, University of Crete, Università degli Studi di Firenze, Tehran University of Medical Sciences and Health Services, Cape Peninsula University of Technology, Universiti Putra Malaysia, Universidad Autónoma de Madrid, Universiti Sains Malaysia, Ministère de la Santé, Chinese University of Hong Kong, Instituto Mexicano del Seguro Social, Università degli Studi di Palermo, Jyväskylän Yliopisto, Universitetet i Oslo, Università degli Studi dell'Insubria, Latvijas Universitate, Turun Yliopisto, Universidade de São Paulo, Universität Bielefeld, Göteborgs Universitet, Dokuz Eylül Üniversitesi, Shahid Beheshti University of Medical Sciences, Syddansk Universitet, Hôpitaux Universitaires de Genève, Université de Lausanne, Centre Hospitalier Universitaire Vaudois, Uniwersytet Warszawski, National Taiwan University, Fundação Oswaldo Cruz, Università degli Studi di Torino, Universidade do Porto, Universidad de Zaragoza, Università degli Studi di Brescia, Universidade Federal de Juiz de Fora, University of the Philippines, Sociedade Beneficente Israelita Brasileira Albert Einstein, Madras Diabetes Research Foundation, Peking University, Jikei University School of Medicine, Universität Ulm, Universidad Industrial de Santander, Harokopio University, African Population and Health Research Center, Pécsi Tudományegyetem, Universidade Federal de Ouro Preto, Śląski Uniwersytet Medyczny w Katowicach, Tays, Monash University Malaysia, University of Chinese Academy of Sciences, Kwame Nkrumah University of Science and Technology, Norges Idrettshøgskole, Alborz University of Medical Sciences, Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Kementerian Kesihatan Malaysia, Junta de Castilla y León, Terveyden ja hyvinvoinnin laitos, Instituto Nacional De Salud Pública, Uniwersytet Śląski w Katowicach, Centre hospitalier régional universitaire de Lille, World Heart Federation, Lietuvos Sveikatos Mokslų Universitetas, Universidad de Cuenca, Consiglio per la ricerca in agricoltura e l’analisi dell’economia agraria, Robert Koch Institut, Centers for Disease Control and Prevention, Johns Hopkins Bloomberg School of Public Health, Pan American Health Organization, Medical Research Council, Japan Society for the Promotion of Science, Korea Centers for Disease Control and Prevention, Wageningen University and Research, Sahlgrenska Akademin, Institute of Molecular and Cell Biology, Helmholtz Zentrum München
Awards: G2107972360, Wellcome Trust - Imperial College Centre for Global Health Research, G2354406520, Study on Health, Ecology, and Society in the Relocation of Oceanian Island Residents Threatened by Rises in the Sea-Level, Development and application of statistical methods to correct for nonresponse bias in the Japan National Health and Nutrition Survey, NIHR Senior Investigator Award, NIHR Senior Investigator Award, G5390765522, G6276181198, G680566116, NIHR Senior Investigator Award, Why Do People Eat Sea Worms? Integrated Area Studies on Food Choice in Asia Pacific Islands, and High resolution analysis of biological and environmental determinants of cardiovascular risk factors and cardiovascular events in older women, Relationship of growth in infancy and childhood to adult endothelial function and body composition: the New Delhi birth cohort
OpenAlex ID: W2338167986