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

• Published in: The Lancet
• Main Authors: Zhou, Bin, Lu, Yuan, Hajifathalian, Kaveh, Bentham, James, Di Cesare, Mariachiara, Danaei, Goodarz, Bixby, Honor, Cowan, Melanie J., Ali, Mohammed K., Taddei, Cristina, Lo, Wei-Cheng, Reis-Santos, Barbara, Stevens, Gretchen A., Riley, Leanne M., Miranda, J. Jaime, Bjerregaard, Peter, Rivera, Juan A., Fouad, Heba M., Ma, Guansheng, Mbanya, Jean Claude N., McGarvey, Stephen T., Mohan, Viswanathan, Onat, Altan, Ramachandran, Ambady, Ben Romdhane, Habiba, Paciorek, Christopher J., Bennett, James E., Ezzati, Majid, Abdeen, Ziad A., Kadir, Khalid Abdul, Abu-Rmeileh, Niveen M., Acosta-Cazares, Benjamin, Adams, Robert, Aekplakorn, Wichai, Aguilar-Salinas, Carlos A., Agyemang, Charles, Ahmadvand, Alireza, Al-Othman, Amani Rashed, Alkerwi, Ala'a, Amouyel, Philippe, Amuzu, Antoinette, Andersen, Lars Bo, Anderssen, Sigmund A., Anjana, Ranjit Mohan, Aounallah-Skhiri, Hajer, Aris, Tahir, Arlappa, Nimmathota, Arveiler, Dominique, Assah, Felix K., Avdicova, Maria, Azizi, Fereidoun, Balakrishna, Nagalla, Bandosz, Piotr, Barbagallo, Carlo M., Barcelo, Alberto, Batieha, Anwar M., Baur, Louise A., Benet, Mikhail, Bernabe-Ortiz, Antonio, Bharadwaj, Sumit, Bhargava, Santosh K., Bi, Yufang, Bjertness, Espen, Bjertness, Marius B., Bjorkelund, Cecilia, Blokstra, Anneke, Bo, Simona, Boehm, Bernhard O., Boissonnet, Carlos P., Bovet, Pascal, Brajkovich, Imperia, Breckenkamp, Juergen, Brenner, Hermann, Brewster, Lizzy M., Brian, Garry R., Bruno, Graziella, Bugge, Anna, Cabrera de Leon, Antonio, Can, Gunay, Candido, Ana Paula C., Capuano, Vincenzo, Carlsson, Axel C., Carvalho, Maria J., Casanueva, Felipe F., Casas, Juan-Pablo, Caserta, Carmelo A., Castetbon, Katia, Chamukuttan, Snehalatha, Chaturvedi, Nishi, Chen, Chien-Jen, Chen, Fangfang, Chen, Shuohua, Cheng, Ching-Yu, Chetrit, Angela, Chiou, Shu-Ti, Cho, Yumi, Chudek, Jerzy, Cifkova, Renata, Claessens, Frank, Concin, Hans, Cooper, Cyrus, Cooper, Rachel, Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Crujeiras, Ana B., D'Arrigo, Graziella, Dallongeville, Jean, Dankner, Rachel, Dauchet, Luc, de Gaetano, Giovanni, De Henauw, Stefaan, Deepa, Mohan, Dehghan, Abbas, Deschamps, Valerie, Dhana, Klodian, Di Castelnuovo, Augusto F., Djalalinia, Shirin, Doua, Kouamelan, Drygas, Wojciech, Du, Yong, Dzerve, Vilnis, Egbagbe, Eruke E., Eggertsen, Robert, El Ati, Jalila, Elosua, Roberto, Erasmus, Rajiv T., Erem, Cihangir, Ergor, Gul, Eriksen, Louise, Escobedo-de la Pena, Jorge, Fall, Caroline H., Farzadfar, Farshad, Felix-Redondo, Francisco J., Ferguson, Trevor S., Fernandez-Berges, Daniel, Ferrari, Marika, Ferreccio, Catterina, Feskens, Edith J. M., Finn, Joseph D., Foeger, Bernhard, Foo, Leng Huat, Forslund, Ann-Sofie, Francis, Damian K., Franco, Maria do Carmo, Franco, Oscar H., Frontera, Guillermo, Furusawa, Takuro, Gaciong, Zbigniew, Garnett, Sarah P., Gaspoz, Jean-Michel, Gasull, Magda, Gates, Louise, Geleijnse, Johanna M., Ghasemian, Anoosheh, Ghimire, Anup, Giampaoli, Simona, Gianfagna, Francesco, Giovannelli, Jonathan, Giwercman, Aleksander, Gonzalez Gross, Marcela, Gonzalez Rivas, Juan P., Bonet Gorbea, Mariano, Gottrand, Frederic, Grafnetter, Dusan, Grodzicki, Tomasz, Grontved, Anders, Gruden, Grabriella, Gu, Dongfeng, Guan, Ong Peng, Guerrero, Ramiro, Guessous, Idris, Guimaraes, Andre L., Gutierrez, Laura, Hambleton, Ian R., Hardy, Rebecca, Kumar, Rachakulla Hari, Hata, Jun, Heidemann, Christin, Herrala, Sauli, Hihtaniemi, Ilpo Tapani, Ho, Sai Yin, Ho, Suzanne C., Hofman, Albert, Hormiga, Claudia M., Horta, Bernardo L., Houti, Leila, Howitt, Christina, Htay, Thein Thein, Htet, Aung Soe, Htike, Maung Maung Than, Hu, Yang, Hussieni, Abdullatif S., Huybrechts, Inge, Hwalla, Nahla, Iacoviello, Licia, Iannone, Anna G., Ibrahim, M. Mohsen, Ikeda, Nayu, Ikram, M. Arfan, Irazola, Vilma E., Islam, Muhammad, Iwasaki, Masanori, Jacobs, Jeremy M., Jafar, Tazeen, Jamil, Kazi M., Jasienska, Grazyna, Jiang, Chao Qiang, Jonas, Jost B., Joshi, Pradeep, Kafatos, Anthony, Kalter-Leibovici, Ofra, Kasaeian, Amir, Katz, Joanne, Kaur, Prabhdeep, Kavousi, Maryam, Kelishadi, Roya, Kengne, Andre P., Kersting, Mathilde, Khader, Yousef Saleh, Khalili, Davood, Khang, Young-Ho, Kiechl, Stefan, Kim, Jeongseon, Kolsteren, Patrick, Kratzer, Wolfgang, Kromhout, Daan, Kujala, Urho M., Kula, Krzysztof, Kyobutungi, Catherine, Laatikainen, Tiina, Lachat, Carl, Laid, Youcef, Lam, Tai Hing, Landrove, Orlando, Lanska, Vera, Lappas, Georg, Laxmaiah, Avula, Leclercq, Catherine, Lee, Jeannette, Lee, Jeonghee, Lehtimaki, Terho, Lekhraj, Rampal, Leon-Munoz, Luz M., Li, Yanping, Lim, Wei-Yen, Fernanda Lima-Costa, M., Lin, Hsien-Ho, Lin, Xu, Lissner, Lauren, Lorbeer, Roberto, Eugenio Lozano, Jose, Luksiene, Dalia, Lundqvist, Annamari, Lytsy, Per, Machado-Coelho, George L. L., Machi, Suka, Maggi, Stefania, Magliano, Dianna J., Makdisse, Marcia, Rao, Kodavanti Mallikharjuna, Manios, Yannis, Manzato, Enzo, Margozzini, Paula, Marques-Vidal, Pedro, Martorell, Reynaldo, Masoodi, Shariq R., Mathiesen, Ellisiv B., Matsha, Tandi E., McFarlane, Shelly R., McLachlan, Stela, McNulty, Breige A., Mediene-Benchekor, Sounnia, Meirhaeghe, Aline, Menezes, Ana Maria B., Merat, Shahin, Meshram, Indrapal I., Mi, Jie, Francisco Miquel, Juan, Jaime Miranda, J., Mohamed, Mostafa K., Mohammad, Kazem, Mohammadifard, Noushin, Yusoff, Muhammad Fadhli Mohd, Moller, Niels C., Molnar, Denes, Mondo, Charles K., Morejon, Alain, Moreno, Luis A., Morgan, Karen, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota, Jorge, Motta, Jorge, Mu, Thet Thet, Muiesan, Maria Lorenza, Mueller-Nurasyid, Martina, Mursu, Jaakko, Nagel, Gabriele, Namesna, Jana, Nang, Ei Ei K., Nangia, Vinay B., Maria Navarrete-Munoz, Eva, Ndiaye, Ndeye Coumba, Nenko, Ilona, Nervi, Flavio, Nguyen, Nguyen D., Quang Ngoc Nguyen, Nieto-Martinez, Ramfi S. E., Ning, Guang, Ninomiya, Toshiharu, Noale, Marianna, Noto, Davide, Al Nsour, Mohannad, Ochoa-Aviles, Angelica M., Oh, Kyungwon, Ordunez, Pedro, Osmond, Clive, Otero, Johanna A., Owusu-Dabo, Ellis, Pahomova, Elena, Palmieri, Luigi, Panda-Jonas, Songhomitra, Panza, Francesco, Parsaeian, Mahboubeh, Peixoto, Sergio Viana, Peltonen, Markku, Peters, Annette, Peykari, Niloofar, Son Thai Pham, Pilav, Aida, Pitakaka, Freda, Piwonska, Aleksandra, Piwonski, Jerzy, Plans-Rubio, Pedro, Porta, Miquel, Portegies, Marileen L. P., Poustchi, Hossein, Pradeepa, Rajendra, Price, Jacqueline F., Punab, Margus, Qasrawi, Radwan F., Qorbani, Mostafa, Radisauskas, Ricardas, Rahman, Mahmudur, Raitakari, Olli, Rao, Sudha Ramachandra, Ramke, Jacqueline, Ramos, Rafel, Rampal, Sanjay, Rathmann, Wolfgang, Redon, Josep, Reganit, Paul Ferdinand M., Rigo, Fernando, Robinson, Sian M., Robitaille, Cynthia, Rodriguez-Artalejo, Fernando, del Cristo Rodriguez-Perez, Maria, Rodriguez-Villamizar, Laura A., Rojas-Martinez, Rosalba, Ronkainen, Kimmo, Rosengren, Annika, Rubinstein, Adolfo, Rui, Ornelas, Sandra Ruiz-Betancourt, Blanca, Russo Horimoto, Andrea R. V., Rutkowski, Marcin, Sabanayagam, Charumathi, Sachdev, Harshpal S., Saidi, Olfa, Sakarya, Sibel, Salanave, Benoit, Salonen, Jukka T., Salvetti, Massimo, Sanchez-Abanto, Jose, Santos, Diana, dos Santos, Renata Nunes, Santos, Rute, Saramies, Jouko L., Sardinha, Luis B., Sarrafzadegan, Nizal, Saum, Kai-Uwe, Scazufca, Marcia, Schargrodsky, Herman, Scheidt-Nave, Christa, Sein, Aye Aye, Sharma, Sanjb K., Shaw, Jonathan E., Shibuya, Kenji, Shin, Youchan, Shiri, Rahman, Siantar, Rosalynn, Sibai, Abla M., Simon, Mary, Simons, Judith, Simons, Leon A., Sjostrom, Michael, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, Snijder, Marieke B., So, Hung-Kwan, Sobngwi, Eugene, Soderberg, Stefan, Solfrizzi, Vincenzo, Sonestedt, Emily, Soumare, Aicha, Staessen, Jan A., Stathopoulou, Maria G., Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D., Stessman, Jochanan, Stoeckl, Doris, Stokwiszewski, Jakub, Stronks, Karien, Strufaldi, Maria Wany, Sun, Chien-An, Sundstrom, Johan, Sung, Yn-Tz, Suriyawongpaisal, Paibul, Sy, Rody G., Tai, E. Shyong, Tamosiunas, Abdonas, Tang, Line, Tarawneh, Mohammed, Tarqui-Mamani, Carolina B., Taylor, Anne, Theobald, Holger, Thijs, Lutgarde, Thuesen, Betina H., Tolonen, Hanna K., Tolstrup, Janne S., Topbas, Murat, Torrent, Maties, Traissac, Pierre, Trinh, Oanh T. H., Tulloch-Reid, Marshall K., Tuomainen, Tomi-Pekka, Turley, Maria L., Tzourio, Christophe, Ueda, Peter, Ukoli, Flora A. M., Ulmer, Hanno, Uusitalo, Hannu M. T., Valdivia, Gonzalo, Valvi, Damaskini, van Rossem, Lenie, van Valkengoed, Irene G. M., Vanderschueren, Dirk, Vanuzzo, Diego, Vega, Tomas, Velasquez-Melendez, Gustavo, Veronesi, Giovanni, Verschuren, W. M. Monique, Verstraeten, Roosmarijn, Viet, Lucie, Vioque, Jesus, Virtanen, Jyrki K., Viswanathan, Bharathi, Vollenweider, Peter, Voutilainen, Sari, Vrijheid, Martine, Wade, Alisha N., Wagner, Aline, Walton, Janette, Mohamud, Wan Nazaimoon Wan, Wang, Feng, Wang, Ming-Dong, Wang, Qian, Wang, Ya Xing, Wannamethee, S. Goya, Weerasekera, Deepa, Whincup, Peter H., Widhalm, Kurt, Wijga, Alet H., Wilks, Rainford J., Willeit, Johann, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C., Wu, Shou Ling, Xu, Haiquan, Yan, Weili, Yang, Xiaoguang, Ye, Xingwang, Yoshihara, Akihiro, Younger-Coleman, Novie O., Zambon, Sabina, Zargar, Abdul Hamid, Zdrojewski, Tomasz, Zhao, Wenhua, Zheng, Yingfeng, Zuniga Cisneros, Julio
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier Science Inc 2016
• Subjects: Alvarado; Argentina; Canada; Greenland; Hernandez; Indian; Lulea; New Zealand; Norway; Orleans; Palermo; Pasteur; Rene; Rua; Sida; Tromso; Villanueva
• Online Access: https://repositorio.unifesp.br/handle/11600/56055; https://doi.org/10.1016/S0140-6736(16)00618-8

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. Copyright (C) NCD Risk Factor Collaboration. Open Access article distributed under the terms of CC BY. 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Buenos Aires, Buenos Aires, DF, Argentina Robert Koch Inst, Berlin, Germany Univ Tokyo, Tokyo, Japan Singapore Eye Res Inst, Singapore, Singapore Amer Univ Beirut, Beirut, Lebanon Univ New S Wales, Sydney, NSW 2052, Australia Karolinska Inst, S-10401 Stockholm, Sweden Med Univ Lodz, Lodz, Poland London Sch Hyg & Trop Med, London, England Univ Amsterdam, Acad Med Ctr, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands Chinese Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China Univ Yaounde I, Yaounde, Cameroon Umea Univ, Umea, Sweden Univ Bari, Bari, Italy Lund Univ, Lund, Sweden Univ Bordeaux, Bordeaux, France Univ Leuven, Leuven, Belgium INSERM, F-75654 Paris 13, France Univ Bonn, Bonn, Germany Emory Univ, Atlanta, GA 30322 USA Hadassah Univ, Med Ctr, Jerusalem, Israel Helmholtz Zentrum mUNCHEN, Munich, Germany Univ Amsterdam, Amsterdam, Netherlands Univ Fed Sao Paulo, Sao Paulo, Brazil Fu Jen Catholic Univ, Taipei, Taiwan Uppsala Univ, Uppsala, Sweden Chinese Univ Hong Kong, Hong 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Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil Univ Insubria, Insubria, Italy Natl Inst Publ Hlth & Environm, Amsterdam, Netherlands Inst Trop Med, Brussels, Belgium Natl Inst Publ Hlth & Environm, Amsterdam, Netherlands Univ Miguel Hernandez, Elche, Spain Univ Eastern Finland, Joensuu, Finland INSERM, F-75654 Paris 13, France Minist Hlth, Victoria, Seychelles Univ Lausanne Hosp, Lausanne, Switzerland Univ Eastern Finland, Tampere, Finland Ctr Res Environm Epidemiol, Barcelona, Spain Univ Witwatersrand, ZA-2050 Johannesburg, South Africa Univ Strasbourg, Strasbourg, France Univ Coll Cork, Cork, Ireland Inst Med Res, Kuala Lumpur, Malaysia Peking Univ, Hosp 6, Beijing, Peoples R China Publ Hlth Agcy Canada, Toronto, ON, Canada Xinjiang Med Univ, Urumqi, Xinjiang, Peoples R China Beijing Tongren Hosp, Beijing, Peoples R China UCL, London WC1E 6BT, England Minist Hlth, Auckland, New Zealand St Georges Univ London, London, England|Med Univ Vienna, Vienna, Austria Med Univ Silesia, 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