Trends in the incidence of diagnosed diabetes: a multicountry analysis of aggregate data from 22 million diagnoses in high-income and middle-income settings
Magliano, Dianna J; Chen, Lei; Islam, Rakibul; Carstensen, Bendix; Gregg, Edward W.; Pavkov, Meda E.; Andes, Linda J.; Balicer, Ran; Baviera, Marta; Dam, Elise Boersma-van; Booth, Gillian L.; Chan, Juliana C.N.; Chua, Yi Xian; Fosse-Edorh, Sandrine; Fuentes, Sonsoles; Gulseth, Hanne Løvdal; Gurevicius, Romualdas; Ha, Kyoung Hwa; Hird, Thomas R.; Jermendy, György; Khalangot, Mykola; 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, MM; Pang, Deanette; Paul, Sanjoy; 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.
Peer reviewed, Journal article
Published version
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https://hdl.handle.net/11250/2834200Utgivelsesdato
2021Metadata
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Originalversjon
The Lancet Diabetes and Endocrinology. 2021, 9 (4), 203-211. 10.1016/S2213-8587(20)30402-2.Sammendrag
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. Funding: US Centers for Disease Control and Prevention, Diabetes Australia Research Program, and Victoria State Government Operational Infrastructure Support Program.