By John Gever, Senior Editor, MedPage Today
Published: June 25, 2011
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco. |
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Goodarz Danaei MD a *, Mariel M Finucane PhD b *, Yuan Lu MSc c, Gitanjali M Singh PhD c, Melanie J Cowan MPH d, Christopher J Paciorek PhD b f, John K Lin AB c, Farshad Farzadfar MD c, Prof Young-Ho Khang MD g, Gretchen A Stevens DSc e, Mayuree Rao BAc, Mohammed K Ali MBChB h, Leanne M Riley MSc d, Carolyn A Robinson MSc i, Prof Majid Ezzati PhD j k , on behalf of the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Glucose)† SummaryBackgroundData 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. MethodsWe 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. FindingsIn 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. |
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