Over the past several decades, the prevalence of diabetes in developed and developing countries has risen dramatically, making diabetes a key health priority globally. The rising prevalence of diabetes (i.e. the proportion of the population that has diabetes at a single point in time) is often interpreted as meaning that more people are developing diabetes, and that interventions to prevent diabetes are failing. However, increasing prevalence may also be due to improved survival of people with diabetes, because this increases the length of time that each individual remains within the population. As treatment of diabetes improves and mortality falls, prevalence therefore becomes an unreliable marker of population change. Only incidence (i.e. the annual rate of new cases of diabetes) can measure the risk for the population, as well as indicate the success or otherwise of population-level prevention initiatives. Unfortunately, accurate and up-to-date diabetes incidence data are rare. This is because the standard longitudinal cohort studies, that have been the main source of incidence data, are unable to provide regular annual incidence estimates. However, the availability of large registry and administrative databases is starting to change this, and provides a means of analysing trends in diabetes incidence.
We have established an international collaboration which is the first global systematic approach to ascertain whether the incidence of type 2 diabetes is falling, stabilising or increasing.
The principal aims of this project are to assess country-specific rates and trends from 1995–2016 in incidence and mortality of diagnosed type 2 diabetes in adults, in both high and middle-income countries, and to quantify the relative contribution of changes in mortality and incidence on the observed prevalence.
We have received funding from the Centers for Disease Control (CDC) and Prevention, in the United States, to commence this project, with a literature review, and the establishment of the network of collaborating centres. The current application extends this CDC-funded work to facilitate data extraction from the centres and to undertake the analyses detailed below.
Our overall approach is to request aggregate data for diabetes incidence and diabetes mortality by 5 year age group and sex from as many data sources as possible around the world. Once collected this data will be used to analyse trends in diabetes incidence and mortality to ascertain whether trends are rising, falling or have stabilised over time