Epidemiology of diabetes

• the International Diabetes Federation (IDF) (the world organisation to which diabetes organisations in 134 countries in the world are affiliated) estimates that there are around 151 million people in the age group 20-79 years with clinically diagnosed diabetes in these 134 countries
  • gives an overall global prevalence of 4.6% - the vast majority of these patients having type 2 diabetes
  • the number of people worldwide with diabetes is expected to double over the 13-year period 1997-2010, so that there is expected to be over 221 million people with diabetes in the world by 2010
  • a Lancet commentary (3) stated that Type 2 diabetes targets the rich in poor countries and the poor in rich countries; it affects some 10% of those with a western lifestyle who survive into later life, rising to 30% or more depending on family history or ethnic background
    
    
• NICE states (4)
  • in 2013, over 3.2 million adults were diagnosed with diabetes, with prevalence rates of 6% and 6.7% in England and Wales respectively
    • estimated that about 90% of adults currently diagnosed with diabetes have type 2 diabetes
    • type 2 diabetes is more common in people of African, African-Caribbean and South Asian family origin
    • can occur in all age groups and is increasingly being diagnosed in children

There are also issues regarding the identification of, as yet, undiagnosed type 2 diabetics:

• the possible scale of unidentified type 2 diabetes is illustrated by a study by Greaves et al (5). This study has examined a pragmatic system for identifying patients with type 2 diabetes and impaired fasting glycaemia (IFG)
  • a clustered observational survey of the prevalence of diabetes and IFG was carried out in randomly selected patients from four at-risk groups
  • sixteen practices in South West England screened 1287 Caucasian patients from four groups with progressive levels of theoretical risk (age >70 and BMI >or=33, age >65 and BMI >or=31, age >60 and BMI >or=29, and age >50 and BMI >or=27). Fasting plasma glucose was measured and repeated if abnormal to determine the prevalence of new cases in each group. BMI and age data were validated against measures taken at the clini
  • response rate was 60.6% and the prevalence of new cases of type 2 diabetes in each group was 4.7% [95% confidence interval (CI) 2.8-7.7], 5.7% (95% CI 4.0-8.2), 3.8% (95% CI 2.4-6.0) and 2.6% (95%CI 1.4-4.7), respectively. An additional 5.2-8.4% had IFG
  • the authors concluded that screening of patients with a BMI of >or=27 and aged >50 by fasting glucose identified a substantial prevalence of undetected type 2 diabetes and IFG

Reference:

1. Diabetes Atlas 2000, International Diabetes Federation, Brussels IDF, July 2000
2. A.F. Amos, D.J. McCarthy and P. Zimmet, The rising global burden of diabetes and its complications: estimates and projections to the year 2010. Diabet. Med. 14 (1997), pp. S1-S85.
3. Gale EA. Is there really an epidemic of type 2 diabetes? Lancet. 2003 Aug 16;362(9383):503-4.
4. NICE (December 2015). Type 2 diabetes in adults: management
5. Greaves CJ et al. A simple pragmatic system for detecting new cases of type 2 diabetes and impaired fasting glycaemia in primary care. Fam Pract. 2004 Feb;21(1):57-62