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

Author:
  • Bin Zhou
  • Yuan Lu
  • Kaveh Hajifathalian
  • James Bentham
  • Mariachiara Di Cesare
  • Goodarz Danaei
  • Honor Bixby
  • Melanie J. Cowan
  • Mohammed K. Ali
  • Cristina Taddei
  • Wei Cheng Lo
  • Barbara Reis-Santos
  • Gretchen A. Stevens
  • Leanne M. Riley
  • J. Jaime Miranda
  • Peter Bjerregaard
  • Juan A. Rivera
  • Heba M. Fouad
  • Guansheng Ma
  • Jean Claude N Mbanya
  • Stephen T. McGarvey
  • Viswanathan Mohan
  • Altan Onat
  • Aida Pilav
  • Ambady Ramachandran
  • Habiba Ben Romdhane
  • Christopher J. Paciorek
  • James E. Bennett
  • Majid Ezzati
  • Ziad A. Abdeen
  • Khalid Abdul Kadir
  • Niveen M. Abu-Rmeileh
  • Benjamin Acosta-Cazares
  • Robert Adams
  • Wichai Aekplakorn
  • Carlos A. Aguilar-Salinas
  • Charles Agyemang
  • Alireza Ahmadvand
  • Amani Rashed Al-Othman
  • Ala'a Alkerwi
  • Philippe Amouyel
  • Antoinette Amuzu
  • Lars Bo Andersen
  • Sigmund A. Anderssen
  • Ranjit Mohan Anjana
  • Hajer Aounallah-Skhiri
  • Tahir Aris
  • Nimmathota Arlappa
  • Dominique Arveiler
  • Felix K. Assah
  • Mária Avdicová
  • Fereidoun Azizi
  • Nagalla Balakrishna
  • Piotr Bandosz
  • Carlo M. Barbagallo
  • Alberto Barceló
  • Anwar M. Batieha
  • Louise A. Baur
  • Mikhail Benet
  • Antonio Bernabe-Ortiz
  • Sumit Bharadwaj
  • Santosh K. Bhargava
  • Yufang Bi
  • Espen Bjertness
  • Marius B. Bjertness
  • Cecilia Björkelund
  • Anneke Blokstra
  • Simona Bo
  • Bernhard O. Boehm
  • Carlos P. Boissonnet
  • Pascal Bovet
  • Imperia Brajkovich
  • Juergen Breckenkamp
  • Hermann Brenner
  • Lizzy M. Brewster
  • Garry R. Brian
  • Graziella Bruno
  • Anna Bugge
  • Antonio Cabrera De León
  • Günay Can
  • Ana Paula C Cåndido
  • Vincenzo Capuano
  • Axel C. Carlsson
  • Maria J. Carvalho
  • Felipe F. Casanueva
  • Juan Pablo Casas
  • Carmelo A. Caserta
  • Katia Castetbon
  • Snehalatha Chamukuttan
  • Nishi Chaturvedi
  • Chien Jen Chen
  • Fangfang Chen
  • Shuohua Chen
  • Ching Yu Cheng
  • Angela Chetrit
  • Shu Ti Chiou
  • Yumi Cho
  • Jerzy Chudek
  • Renata Cifkova
  • Frank Claessens
  • Hans Concin
  • Cyrus Cooper
  • Rachel Cooper
  • Simona Costanzo
  • Dominique Cottel
  • Chris Cowell
  • Ana B. Crujeiras
  • Graziella D'Arrigo
  • Jean Dallongeville
  • Rachel Dankner
  • Luc Dauchet
  • Giovanni De Gaetano
  • Stefaan De Henauw
  • Mohan Deepa
  • Abbas Dehghan
  • Valerie Deschamps
  • Klodian Dhana
  • Augusto F. Di Castelnuovo
  • Shirin Djalalinia
  • Kouamelan Doua
  • Wojciech Drygas
  • Yong Du
  • Vilnis Dzerve
  • Eruke E. Egbagbe
  • Robert Eggertsen
  • Jalila El Ati
  • Roberto Elosua
  • Rajiv T. Erasmus
  • Cihangir Erem
  • Gul Ergor
  • Louise Eriksen
  • Jorge Escobedo-De La Peña
  • Caroline H. Fall
  • Farshad Farzadfar
  • Francisco J. Felix-Redondo
  • Trevor S. Ferguson
  • Daniel Fernández-Bergés
  • Marika Ferrari
  • Catterina Ferreccio
  • Edith J M Feskens
  • Joseph D. Finn
  • Bernhard Föger
  • Leng Huat Foo
  • Ann Sofie Forslund
  • Damian K. Francis
  • Maria Do Carmo Franco
  • Oscar H. Franco
  • Guillermo Frontera
  • Takuro Furusawa
  • Zbigniew Gaciong
  • Sarah P. Garnett
  • Jean Michel Gaspoz
  • Magda Gasull
  • Louise Gates
  • Johanna M. Geleijnse
  • Anoosheh Ghasemian
  • Anup Ghimire
  • Simona Giampaoli
  • Francesco Gianfagna
  • Jonathan Giovannelli
  • Aleksander Giwercman
  • Marcela Gonzalez Gross
  • Juan P González Rivas
  • Mariano Bonet Gorbea
  • Frederic Gottrand
  • Dušan Grafnetter
  • Tomasz Grodzicki
  • Anders Grøntved
  • Grabriella Gruden
  • Dongfeng Gu
  • Ong Peng Guan
  • Ramiro Guerrero
  • Idris Guessous
  • Andre L. Guimaraes
  • Laura Gutierrez
  • Ian R. Hambleton
  • Rebecca Hardy
  • Rachakulla Hari Kumar
  • Jun Hata
  • Jiang He
  • Christin Heidemann
  • Sauli Herrala
  • Ilpo Tapani Hihtaniemi
  • Sai Yin Ho
  • Suzanne C. Ho
  • Albert Hofman
  • Claudia M. Hormiga
  • Bernardo L. Horta
  • Leila Houti
  • Christina Howitt
  • Thein Thein Htay
  • Aung Soe Htet
  • Maung Maung Than Htike
  • Yang Hu
  • Abdullatif S. Hussieni
  • Inge Huybrechts
  • Nahla Hwalla
  • Licia Iacoviello
  • Anna G. Iannone
  • M. Mohsen Ibrahim
  • Nayu Ikeda
  • M. Arfan Ikram
  • Vilma E. Irazola
  • Muhammad Islam
  • Masanori Iwasaki
  • Jeremy M. Jacobs
  • Tazeen Jafar
  • Kazi M. Jamil
  • Grazyna Jasienska
  • Chao Qiang Jiang
  • Jost B. Jonas
  • Pradeep Joshi
  • Anthony Kafatos
  • Ofra Kalter-Leibovici
  • Amir Kasaeian
  • Joanne Katz
  • Prabhdeep Kaur
  • Maryam Kavousi
  • Sirkka Keinänen-Kiukaanniemi
  • Roya Kelishadi
  • Andre P. Kengne
  • Mathilde Kersting
  • Yousef Saleh Khader
  • Davood Khalili
  • Young Ho Khang
  • Stefan Kiechl
  • Jeongseon Kim
  • Patrick Kolsteren
  • Paul Korrovits
  • Wolfgang Kratzer
  • Daan Kromhout
  • Urho M. Kujala
  • Krzysztof Kula
  • Catherine Kyobutungi
  • Tiina Laatikainen
  • Carl Lachat
  • Youcef Laid
  • Tai Hing Lam
  • Orlando Landrove
  • Vera Lanska
  • Georg Lappas
  • Avula Laxmaiah
  • Catherine Leclercq
  • Jeannette Lee
  • Jeonghee Lee
  • Terho Lehtimäki
  • Rampal Lekhraj
  • Luz M. León-Muñoz
  • Yanping Li
  • Wei Yen Lim
  • M. Fernanda Lima-Costa
  • Hsien Ho Lin
  • Xu Lin
  • Lauren Lissner
  • Roberto Lorbeer
  • José Eugenio Lozano
  • Dalia Luksiene
  • Annamari Lundqvist
  • Per Lytsy
  • George L L Machado-Coelho
  • Suka Machi
  • Stefania Maggi
  • Dianna J. Magliano
  • Marcia Makdisse
  • Kodavanti Mallikharjuna Rao
  • Yannis Manios
  • Enzo Manzato
  • Paula Margozzini
  • Pedro Marques-Vidal
  • Reynaldo Martorell
  • Shariq R. Masoodi
  • Ellisiv B. Mathiesen
  • Tandi E. Matsha
  • Shelly R. McFarlane
  • Stela McLachlan
  • Breige A. McNulty
  • Sounnia Mediene-Benchekor
  • Aline Meirhaeghe
  • Ana Maria B Menezes
  • Shahin Merat
  • Indrapal I. Meshram
  • Jie Mi
  • Juan Francisco Miquel
  • Mostafa K. Mohamed
  • Kazem Mohammad
  • Noushin Mohammadifard
  • Muhammad Fadhli Mohd Yusoff
  • Niels C. Møller
  • Dénes Molnár
  • Charles K. Mondo
  • Alain Morejon
  • Luis A. Moreno
  • Karen Morgan
  • George Moschonis
  • Malgorzata Mossakowska
  • Aya Mostafa
  • Jorge Mota
  • Jorge Motta
  • Thet Thet Mu
  • Maria Lorenza Muiesan
  • Martina Müller-Nurasyid
  • Jaakko Mursu
  • Gabriele Nagel
  • Jana Námešná
  • Ei Ei K Nang
  • Vinay B. Nangia
  • Eva Maria Navarrete-Muñoz
  • Ndeye Coumba Ndiaye
  • Ilona Nenko
  • Flavio Nervi
  • Nguyen D. Nguyen
  • Quang Ngoc Nguyen
  • Ramfis E. Nieto-Martínez
  • Guang Ning
  • Toshiharu Ninomiya
  • Marianna Noale
  • Davide Noto
  • Mohannad Al Nsour
  • Angélica M. Ochoa-Avilés
  • Kyungwon Oh
  • Pedro Ordunez
  • Clive Osmond
  • Johanna A. Otero
  • Ellis Owusu-Dabo
  • Elena Pahomova
  • Luigi Palmieri
  • Songhomitra Panda-Jonas
  • Francesco Panza
  • Mahboubeh Parsaeian
  • Sergio Viana Peixoto
  • Markku Peltonen
  • Annette Peters
  • Niloofar Peykari
  • Son Thai Pham
  • Freda Pitakaka
  • Aleksandra Piwonska
  • Jerzy Piwonski
  • Pedro Plans-Rubió
  • Miquel Porta
  • Marileen L P Portegies
  • Hossein Poustchi
  • Rajendra Pradeepa
  • Jacqueline F. Price
  • Margus Punab
  • Radwan F. Qasrawi
  • Mostafa Qorbani
  • Ricardas Radisauskas
  • Mahmudur Rahman
  • Olli Raitakari
  • Sudha Ramachandra Rao
  • Jacqueline Ramke
  • Rafel Ramos
  • Sanjay Rampal
  • Wolfgang Rathmann
  • Josep Redon
  • Paul Ferdinand M Reganit
  • Fernando Rigo
  • Sian M. Robinson
  • Cynthia Robitaille
  • Fernando Rodríguez-Artalejo
  • María Del CristoRodriguez-Perez
  • Laura A. Rodríguez-Villamizar
  • Rosalba Rojas-Martinez
  • Kimmo Ronkainen
  • Annika Rosengren
  • Adolfo Rubinstein
  • Ornelas Rui
  • Blanca Sandra Ruiz-Betancourt
  • Andrea R V Russo Horimoto
  • Marcin Rutkowski
  • Charumathi Sabanayagam
  • Harshpal S. Sachdev
  • Olfa Saidi
  • Sibel Sakarya
  • Benoit Salanave
  • Jukka T. Salonen
  • Massimo Salvetti
  • Jose Sánchez-Abanto
  • Diana Santos
  • Renata Nunes Dos Santos
  • Rute Santos
  • Jouko L. Saramies
  • Luis B. Sardinha
  • Nizal Sarrafzadegan
  • Kai Uwe Saum
  • Marcia Scazufca
  • Herman Schargrodsky
  • Christa Scheidt-Nave
  • Aye Aye Sein
  • Sanjb K. Sharma
  • Jonathan E. Shaw
  • Kenji Shibuya
  • Youchan Shin
  • Rahman Shiri
  • Rosalynn Siantar
  • Abla M. Sibai
  • Mary Simon
  • Judith Simons
  • Leon A. Simons
  • Michael Sjostrom
  • Jolanta Slowikowska-Hilczer
  • Przemyslaw Slusarczyk
  • Liam Smeeth
  • Marieke B. Snijder
  • Hung Kwan So
  • Eugène Sobngwi
  • Stefan Söderberg
  • Vincenzo Solfrizzi
  • Emily Sonestedt
  • Aicha Soumare
  • Jan A. Staessen
  • Maria G. Stathopoulou
  • Jostein Steene-Johannessen
  • Peter Stehle
  • Aryeh D. Stein
  • Jochanan Stessman
  • Doris Stöckl
  • Jakub Stokwiszewski
  • Karien Stronks
  • Maria Wany Strufaldi
  • Chien An Sun
  • Johan Sundström
  • Yn Tz Sung
  • Paibul Suriyawongpaisal
  • Rody G. Sy
  • E. Shyong Tai
  • Abdonas Tamosiunas
  • Line Tang
  • Mohammed Tarawneh
  • Carolina B. Tarqui-Mamani
  • Anne Taylor
  • Holger Theobald
  • Lutgarde Thijs
  • Betina H. Thuesen
  • Hanna K. Tolonen
  • Janne S. Tolstrup
  • Murat Topbas
  • Maties Torrent
  • Pierre Traissac
  • Oanh T H Trinh
  • Marshall K. Tulloch-Reid
  • Tomi Pekka Tuomainen
  • Maria L. Turley
  • Christophe Tzourio
  • Peter Ueda
  • Flora A M Ukoli
  • Hanno Ulmer
  • Hannu M T Uusitalo
  • Gonzalo Valdivia
  • Damaskini Valvi
  • Lenie Van Rossem
  • Irene G M Van Valkengoed
  • Dirk Vanderschueren
  • Diego Vanuzzo
  • Tomas Vega
  • Gustavo Velasquez-Melendez
  • Giovanni Veronesi
  • W. M Monique Verschuren
  • Roosmarijn Verstraeten
  • Lucie Viet
  • Jesus Vioque
  • Jyrki K. Virtanen
  • Sophie Visvikis-Siest
  • Bharathi Viswanathan
  • Peter Vollenweider
  • Sari Voutilainen
  • Martine Vrijheid
  • Alisha N. Wade
  • Aline Wagner
  • Janette Walton
  • Wan Nazaimoon Wan Mohamud
  • Feng Wang
  • Ming Dong Wang
  • Qian Wang
  • Ya Xing Wang
  • S. Goya Wannamethee
  • Deepa Weerasekera
  • Peter H. Whincup
  • Kurt Widhalm
  • Andrzej Wiecek
  • Alet H. Wijga
  • Rainford J. Wilks
  • Johann Willeit
  • Tom Wilsgaard
  • Bogdan Wojtyniak
  • Tien Yin Wong
  • Jean Woo
  • Mark Woodward
  • Frederick C. Wu
  • Shou Ling Wu
  • Haiquan Xu
  • Weili Yan
  • Xiaoguang Yang
  • Xingwang Ye
  • Akihiro Yoshihara
  • Novie O. Younger-Coleman
  • Sabina Zambon
  • Abdul Hamid Zargar
  • Tomasz Zdrojewski
  • Wenhua Zhao
  • Yingfeng Zheng
  • Julio Zuñiga Cisneros
Publishing year: 2016-04-09
Language: English
Pages: 1513-1530
Publication/Series: The Lancet
Volume: 387
Issue: 10027
Document type: Journal article
Publisher: Elsevier Limited

Abstract english

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.

Keywords

  • Endocrinology and Diabetes

Other

Published
  • Diabetes - Cardiovascular Disease
  • ISSN: 0140-6736
Emily Sonestedt
E-mail: emily [dot] sonestedt [at] med [dot] lu [dot] se

Associate senior lecturer

Nutrition Epidemiology

+46 40 39 13 25

+46 73 700 71 45

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Jan Waldenströms gata 35, CRC 60:13, Malmö

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