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

NCD Risk Factor Collaboration (NCD-RisC)

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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 aff ecting 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 4372000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-17.0) 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 aff ected, has increased faster in low-income and middle-income countries than in high-income countries.

Original languageEnglish
JournalThe Lancet
Volume387
Issue number10027
DOIs
Publication statusPublished - Apr 9 2016

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Population
Micronesia
Polynesia
Population Growth
American Samoa
Melanesia
Northern Africa
Eastern Africa
Middle East
Hypoglycemic Agents
Islands
Fasting
Biomarkers
Insulin
Glucose

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Worldwide trends in diabetes since 1980 : A pooled analysis of 751 population-based studies with 4.4 million participants. / NCD Risk Factor Collaboration (NCD-RisC).

In: The Lancet, Vol. 387, No. 10027, 09.04.2016.

Research output: Contribution to journalArticle

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title = "Worldwide trends in diabetes since 1980: A pooled analysis of 751 population-based studies with 4.4 million participants",
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 aff ecting 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 4372000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3{\%} (95{\%} credible interval 2.4-17.0) 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 aff ected, has increased faster in low-income and middle-income countries than in high-income countries.",
author = "{NCD Risk Factor Collaboration (NCD-RisC)} and Bin Zhou and Yuan Lu and Kaveh Hajifathalian and James Bentham and {Di Cesare}, Mariachiara and Goodarz Danaei and Honor Bixby and Cowan, {Melanie J.} and Ali, {Mohammed K.} and Cristina Taddei and Lo, {Wei Cheng} and Barbara Reis-Santos and Stevens, {Gretchen A.} and Riley, {Leanne M.} and Miranda, {J. Jaime} and Peter Bjerregaard and Rivera, {Juan A.} and Fouad, {Heba M.} and Guansheng Ma and Mbanya, {Jean Claude N.} and McGarvey, {Stephen T.} and Viswanathan Mohan and Altan Onat and Aida Pilav and Ambady Ramachandran and {Ben Romdhane}, Habiba and Paciorek, {Christopher J.} and Bennett, {James E.} and Majid Ezzati and Abdeen, {Ziad A.} and Kadir, {Khalid Abdul} and Abu-Rmeileh, {Niveen M.} and Benjamin Acosta-Cazares and Robert Adams and Wichai Aekplakorn and Aguilar-Salinas, {Carlos A.} and Charles Agyemang and Alireza Ahmadvand and Al-Othman, {Amani Rashed} and Ala'a Alkerwi and Philippe Amouyel and Antoinette Amuzu and {Bo Andersen}, Lars and Anderssen, {Sigmund A.} and Anjana, {Ranjit Mohan} and Hajer Aounallah-Skhiri and Tahir Aris and Nimmathota Arlappa and Dominique Arveiler and Assah, {Felix K.}",
year = "2016",
month = "4",
day = "9",
doi = "10.1016/S0140-6736(16)00618-8",
language = "English",
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journal = "The Lancet",
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TY - JOUR

T1 - Worldwide trends in diabetes since 1980

T2 - A pooled analysis of 751 population-based studies with 4.4 million participants

AU - NCD Risk Factor Collaboration (NCD-RisC)

AU - Zhou, Bin

AU - Lu, Yuan

AU - Hajifathalian, Kaveh

AU - Bentham, James

AU - Di Cesare, Mariachiara

AU - Danaei, Goodarz

AU - Bixby, Honor

AU - Cowan, Melanie J.

AU - Ali, Mohammed K.

AU - Taddei, Cristina

AU - Lo, Wei Cheng

AU - Reis-Santos, Barbara

AU - Stevens, Gretchen A.

AU - Riley, Leanne M.

AU - Miranda, J. Jaime

AU - Bjerregaard, Peter

AU - Rivera, Juan A.

AU - Fouad, Heba M.

AU - Ma, Guansheng

AU - Mbanya, Jean Claude N.

AU - McGarvey, Stephen T.

AU - Mohan, Viswanathan

AU - Onat, Altan

AU - Pilav, Aida

AU - Ramachandran, Ambady

AU - Ben Romdhane, Habiba

AU - Paciorek, Christopher J.

AU - Bennett, James E.

AU - Ezzati, Majid

AU - Abdeen, Ziad A.

AU - Kadir, Khalid Abdul

AU - Abu-Rmeileh, Niveen M.

AU - Acosta-Cazares, Benjamin

AU - Adams, Robert

AU - Aekplakorn, Wichai

AU - Aguilar-Salinas, Carlos A.

AU - Agyemang, Charles

AU - Ahmadvand, Alireza

AU - Al-Othman, Amani Rashed

AU - Alkerwi, Ala'a

AU - Amouyel, Philippe

AU - Amuzu, Antoinette

AU - Bo Andersen, Lars

AU - Anderssen, Sigmund A.

AU - Anjana, Ranjit Mohan

AU - Aounallah-Skhiri, Hajer

AU - Aris, Tahir

AU - Arlappa, Nimmathota

AU - Arveiler, Dominique

AU - Assah, Felix K.

PY - 2016/4/9

Y1 - 2016/4/9

N2 - 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 aff ecting 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 4372000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-17.0) 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 aff ected, has increased faster in low-income and middle-income countries than in high-income countries.

AB - 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 aff ecting 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 4372000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-17.0) 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 aff ected, has increased faster in low-income and middle-income countries than in high-income countries.

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DO - 10.1016/S0140-6736(16)00618-8

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AN - SCOPUS:84994417475

VL - 387

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 10027

ER -