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

Dianna J Magliano, Lei Chen, Rakibul M Islam, Bendix Carstensen, Stephanie Read, Sarah H Wild

Research output: Contribution to journalArticlepeer-review

Abstract

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 multi-country analysis, we ascertained whether the incidence of clinically diagnosed diabetes has changed over time.
Methods: We assembled aggregated data describing trends in diabetes incidence from 24 population-based data sources in 21 countries. Data were from administrative sources, health insurance records, registries and a health-survey. Poisson regression modelled incidence rates using age and calendar time (1995-2018) as variables, describing the effects with restricted cubic splines with 6 knots for age and calendar time.
Findings: Our data comprised approximately 22 million diabetes diagnoses from 5 billion person-years of follow-up. The majority of data were from high-income countries. From approximately 2010 onwards, all centres other than Ukraine, Lithuania, Singapore, Israel and Kaiser Permanente Northwest (US), showed a downward or stable trend in the incidence of diagnosed diabetes, with reductions of up to 10% per year. The findings were robust to sensitivity analyses excluding data centres were the data quality was lower, and were consistent in stratified analyses.
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 using appropriate data sources.
Original languageEnglish
Pages (from-to)203-11
Number of pages9
JournalThe Lancet Diabetes and Endocrinology
Volume9
Issue number4
Early online date23 Feb 2021
DOIs
Publication statusPublished - 1 Apr 2021

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