Prevalence and incidence of diabetes

Prevalence

The prevalence of pharmacologically treated diabetes in France was estimated at 4.6% in 2012, across all health insurance schemes (BEH 2014 No. 30-31), and was updated to 5.3% in 2020, representing more than 3.5 million people receiving treatment for diabetes. This increase in the prevalence of diabetes has been observed since the first estimates established by the health insurance system in 2000 (BEH 2010 No. 42-43).

The incidence of diabetes increases with age. One in five men aged 70 to 85 and one in seven women aged 75 to 85 are receiving pharmacological treatment for diabetes

A peak in prevalence is observed among men aged 70 to 85: 1 in 5 men is affected, and among women aged 75 to 85: 1 in 7 women is affected. The prevalence of treated diabetes is highest in the overseas departments, nearly twice as high as the national average. It is higher in certain regions of mainland France, particularly in the North and Northeast and in certain departments of the Île-de-France region, but it is lower in Brittany.

The prevalence of diabetes is higher in the most socioeconomically disadvantaged municipalities, among people of lower socioeconomic status, and in certain socio-professional categories. It is higher among women of North African origin. To the estimate of the frequency of pharmacologically treated diabetes, one must add the prevalence of diagnosed diabetes that is not pharmacologically treated. This prevalence was estimated by the National Nutrition and Health Survey (ENNS) at 0.6% among people aged 18 to 74 living in metropolitan France in 2006–2007 and was updated to 1.2% in the Esteban (2014–2016) among people aged 18 to 74. This same study estimated, for the same age group, using a single fasting venous blood glucose test, that the prevalence of undiagnosed diabetes was 1.7% (95% CI 1.1 to 2.4) among adults aged 18 to 74. This prevalence was higher among men (2.7%, 95% CI 1.4 to 4.0) than among women (0.9%, 95% CI 0.3 to 1.4). The proportion of people with undiagnosed diabetes among all people with diabetes was 23%.

The prevalence of prediabetes (according to WHO fasting blood glucose criteria) was 9.9% (95% CI 8.3 to 11.5) according to the Esteban survey (2014–2016). Prevalence was higher among men (13.2%, 95% CI 10.5–15.8) than among women (7.0%, 95% CI 5.1–8.9). This prevalence has increased by 4.3 percentage points since the ENNS survey (2006–2007).

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Incidence

Between 2012 and 2017, among people aged 45 and older, the crude incidence of pharmacologically treated type 2 diabetes decreased from 10.7 to 9.6 cases per 1,000 person-years and from 7.1 to 6.1 cases per 1,000 person-years among women. These results are observed across all age groups and regions, regardless of sex.

The incidence of type 1 diabetes in children is increasing: the national incidence rate of type 1 diabetes in children was 18.0 in 2013–2015 and 19.5 per 100,000 during the 2015–2017 period.

Over the 2015–2017 period, regional variations were observed, with the highest incidence rates in the regions of Martinique (24.0 per 100,000 person-years), Occitanie (21.9), and Provence-Alpes-Côte d’Azur (21.8). The lowest regional incidence rates were observed in French Guiana (6.2 per 100,000 person-years), Guadeloupe (14.9), and Réunion (16.5)—and in metropolitan France in the regions of Pays de la Loire (16.4), Normandy (17.6), and Nouvelle-Aquitaine (19.0).

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Trends in prevalence and incidence

Based on multivariate models adjusted for age and region, we observe an increasing annual rate of change in prevalence over the 2010–2017 period of +0.9% [95% CI +0.7; +1.0%] among men and +0.4% [95% CI +0.2; +0.6%]) among women. The annual rate of change in incidence is decreasing: -2.6% [95% CI -3.1; -2.0%] among men and -3.9% [95% CI -4.5; -3.4%] among women over the 2012–2017 period. These declining annual rates of change in incidence are more pronounced in regions where prevalence is highest, particularly in the overseas territories.

The prevalence of diabetes continued to rise slightly in France over the 2010–2017 period. However, incidence declined over the 2012–2017 period. The plateau observed in other countries has therefore not been reached in France, but the observed decline in incidence offers a glimmer of hope that will need to be confirmed in the coming years.

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  • Fuentes S, Mandereau-Bruno L, Regnault N, Bernillon P, Bonaldi C, Cosson E, Fosse-Edorh S. Is the type 2 diabetes epidemic plateauing in France? A nationwide population-based study. Diabetes Metab. 2020 Jan 7:S1262-3636(20)30001-X. doi: 10.1016/j.diabet.2019.12.006.