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Global and country-specific rates, and trends in the incidence of diagnosed type 2 diabetes and mortality among those with diabetes (GLOBALDIAB)

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. This collaboration will also document changes in patterns of mortality trends among those with diabetes.

We have received funding from the US Centers for Disease Control and Prevention. 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. 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. Further to this we are collecting cause-specific mortality data in several different categories (diabetes [e.g. diabetic ketoacidosis], cardiovascular disease [ischaemic heart disease, stroke, heart failure], cancer, Alzheimer’s disease, infectious disease, kidney disease, chronic liver disease, and chronic lower respiratory disease).

We shall also collect data pertaining to the incidence of ESKD, a key diabetes complications among those with diabetes to ascertain the nature of evolving trends of ESKD across the globe.

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