Trends in the incidence of diagnosed diabetes: a multicountry analysis of aggregate data from 22 million diagnoses in high-income and middle-income settings

Publié le 1 avril 2021
Mis à jour le 26 avril 2021

Background: diabetes prevalence is increasing in most places in the world, but prevalence is affected by both risk of developing diabetes and survival of those with diabetes. Diabetes incidence is a better metric to understand the trends in population risk of diabetes. Using a multicountry analysis, we aimed to ascertain whether the incidence of clinically diagnosed diabetes has changed over time. Methods: in this multicountry data analysis, we assembled aggregated data describing trends in diagnosed total or type 2 diabetes incidence from 24 population-based data sources in 21 countries or jurisdictions. Data were from administrative sources, health insurance records, registries, and a health survey. We modelled incidence rates with Poisson regression, using age and calendar time (1995-2018) as variables, describing the effects with restricted cubic splines with six knots for age and calendar time. Findings: our data included about 22 million diabetes diagnoses from 5 billion person-years of follow-up. Data were from 19 high-income and two middle-income countries or jurisdictions. 23 data sources had data from 2010 onwards, among which 19 had a downward or stable trend, with an annual estimated change in incidence ranging from -1·1% to -10·8%. Among the four data sources with an increasing trend from 2010 onwards, the annual estimated change ranged from 0·9% to 5·6%. The findings were robust to sensitivity analyses excluding data sources in which the data quality was lower and were consistent in analyses stratified by different diabetes definitions. Interpretation: the incidence of diagnosed diabetes is stabilising or declining in many high-income countries. The reasons for the declines in the incidence of diagnosed diabetes warrant further investigation with appropriate data sources.

Auteur : Magliano Dianna J, Chen Lei, Islam Rakibul M, Carstensen Bendix, Gregg Edward W, Pavkov Meda E, Andes Linda J, Balicer Ran, Baviera Marta, Boersma-van Dam Elise, Booth Gillian L, Chan Juliana C N, Chua Yi Xian, Fosse-Edorh Sandrine, Fuentes Sonsoles, Gulseth Hanne L, Gurevicius Romualdas, Ha Kyoung Hwa, Hird Thomas R, Jermendy György, Khalangot Mykola D, Kim Dae Jung, Kiss Zoltán, Kravchenko Victor I, Leventer-Roberts Maya, Lin Chun-Yi, Luk Andrea O Y, Mata-Cases Manel, Mauricio Didac, Nichols Gregory A, Nielen Mark M, Pang Deanette, Paul Sanjoy K, Pelletier Catherine, Pildava Santa, Porath Avi, Read Stephanie H, Roncaglioni Maria Carla, Lopez-Doriga Ruiz Paz, Shestakova Marina, Vikulova Olga, Wang Kang-Ling, Wild Sarah H, Yekutiel Naama, Shaw Jonathan E
The lancet. Diabetes & Endocrinology, 2021, vol. 9, n°. 4, p. 203-211