Rising prevalence of diabetes: evidence from a Danish pharmacoepidemiological database.

doi:10.1016/S0140-6736(03)14116-5

The Lancet

Volume 362, Issue 9383, 16 August 2003, Pages 537-538

https://doi.org/10.1016/S0140-6736(03)14116-5 Get rights and content

Summary

The prevalence of diabetes has increased worldwide. We have undertaken an epidemiological analysis of drug-treated diabetes in a well defined community. We present estimates of prevalence, incidence, and mortality of patients with such diabetes during 1993–99, based on data for all 470 000 people living in the county of Fyn, Denmark. Although prevalence increased (odds ratio: female, 1·026 [95% CI 1·020–1·032]; male, 1·041 [1·036–1·047]), mortality in those treated declined (rate ratio: female, 0·976 [95% CI 0·952–1·001]; male, 0·966 [0·943–0·990]). We did not identify a clear trend for incidence. Future research into the causes of rising diabetes prevalence should take this fall in mortality into account to avoid incorrect conclusions about the relation between western lifestyle and the growing number of diabetics.

References (5)

MI Harris et al.
Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in US population aged 20-74 years
Diabetes
(1987)
P Zimmet et al.
Global and Societal implications of the diabetes epidemic
Nature
(2001)

There are more references available in the full text version of this article.

Cited by (86)

Prevalence of and secular trends in diagnosed diabetes in Italy: 1980–2013
2018, Nutrition, Metabolism and Cardiovascular Diseases
The aim of this research was to examine the prevalence of diabetes in Italy over a 34-year period.
Self-reported diabetes was assessed in eight health interview surveys of representative samples of Italian population aged 20 years and over. Crude and standardised prevalence were calculated by age, sex, educational level and area of residence. Logistic models were fitted to calculate the contribution of age and BMI to the trend in prevalence. In 2013 nearly 3.4 million Italians had a diagnosis of diabetes, more than twice as many as in 1980. The crude prevalence of diabetes in men rose from 3.3% in 1980 to 7.1% in 2013 (+115%), and from 4.7% to 6.8% in women (+45%). The prevalence was almost stable during the eighties, and started to rise from the beginning of the nineties. One third of the increase in men and two thirds in women is due to the ageing of the population, since the age-standardised prevalence increased by 79% in men and 14% in women. The prevalence of overweight and obesity increased less steeply than diabetes, and their contribution to the trend in diabetes is less relevant than age. Prevalence rose more in the elderly, in low-educated men, and in high-educated women.
Given that the ageing population plays a considerable role in explaining the trend, and that the number of people in the oldest age groups will continue to grow, the rise in the number of individuals with diabetes will represent a severe challenge for the national health system.
Be Careful What You Ask For: Effects of Benefit Descriptions on Diabetes Patients’ Benefit-Risk Tradeoff Preferences
2017, Value in Health
As more studies report on patient preferences for diabetes treatment, identifying diabetes outcomes other than glycated hemoglobin (HbA_1c) to describe effectiveness is warranted to understand patient-relevant, benefit-risk tradeoffs.
The aim of the study was to evaluate how preferences differ when effectiveness (glycemic control) is presented as long-term sequela (LTS) risk mitigation rather than an asymptomatic technical marker (HbA_1c).
People with type 2 diabetes and using insulin (n = 3160) were randomly assigned to four self-administered, discrete-choice experiments that differed by their presentation of effectiveness. Epidemiologic reviews were conducted to ensure a close approximation of LTS risk relative to HbA_1c levels. The relative importance of treatment benefit-risk characteristics and maximum acceptable risk tradeoffs was estimated using an error-component logit model. Log-likelihood ratio tests were used to compare parameter vectors.
In total, 1031 people responded to the survey. Significantly more severe hypoglycemic events were accepted for a health improvement in terms of LTS mitigation versus HbA_1c improvement (0.7 events per year; 95% confidence interval [CI]: 0.4–1.0 vs. 0.2 events per year 95% CI: –0.02 to 0.5) and avoidance of treatment-related heart attack risk (1.4 severe hypoglycemic events per year; 95% CI: 0.8–1.9 vs. 1 event per year; 95% CI: 0.6–1.3). This finding is supported by a log-likelihood test that rejected at the 0.05 level that respondent preference structures are similar across the different experimental arms of the discrete-choice experiment.
We found evidence that benefit descriptions influence elicited preferences for the benefit-risk characteristics of injectable diabetes treatment. These findings argue for using carefully defined effectiveness measures to accurately take account of the patient perspective in benefit-risk assessments.
Estimation of Kendall's tau for bivariate doubly truncated data
2016, Journal of the Korean Statistical Society
In this article, we consider the estimation of Kendall’s tau for bivariate doubly truncated data, where two correlated event times are potentially observed only if both fall within subject specific intervals of times. Using the inverse-probability-weighted (IPW) approach, we propose two nonparametric estimators of Kendall’s tau for bivariate doubly truncated data. The first estimator is based on V-statistics and the second estimator is based on weighted comparable pairs. The asymptotic properties of the proposed estimators are established. Simulation studies are conducted to investigate their finite sample performance.
The burden of hospitalization related to diabetes mellitus: A population-based study
2012, Nutrition, Metabolism and Cardiovascular Diseases
To estimate the impact of diabetes and its complications, overall and in different age classes, on the likelihood of hospital admission for specific causes.
We carried out a record-linkage analysis of administrative registers including data on 8,940,420 citizens in 21 Local Health Authorities in Italy. Individuals with pharmacologically treated diabetes (≥2 prescriptions of antidiabetic agents during the year 2008) were paired in a 1:1 proportion with those who did not receive such drugs (controls) based on propensity-score matching. Odds Ratios (ORs) of hospitalization for macro and microvascular conditions in individuals with diabetes as compared to controls were estimated. The system identified 498,825 individuals with diabetes pharmacologically treated (prevalence of 5.6%). Prevalence of diabetes in people aged <14 years, 14–39 years, 40–65 years, and ≥65 years was 0.1%, 0.6%, 6.4%, and 18.2%, respectively. Overall, 23.9% of subjects with diabetes and 11.5% of controls had had at least a hospital admission during 12 months for the causes considered. Diabetes increased the likelihood of hospitalization by two to six times for the different causes examined. In absolute terms, diabetes was responsible for an excess of over 12,000 hospital admissions per 100,000 individuals/year.
Despite the availability of effective treatments to prevent or delay major complications, diabetes still places an enormous burden on both patients and the health care system. Given the continuous rise in diabetes prevalence both in middle-aged and elderly individuals, we can expect an additional, hardly sustainable increase in the demand for health care in the near future.
Insulin-like Growth Factor 2 mRNA-Binding Protein 2-a Potential Link between Type 2 Diabetes Mellitus and Cancer
2021, Journal of Clinical Endocrinology and Metabolism
Components of diabetes prevalence in Denmark 1996-2016 and future trends until 2030
2020, BMJ Open Diabetes Research and Care

View all citing articles on Scopus

View full text

Research LettersRising prevalence of diabetes: evidence from a Danish pharmacoepidemiological database.

Summary

Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in US population aged 20-74 years

Diabetes

Global and Societal implications of the diabetes epidemic

Nature

Research Letters
Rising prevalence of diabetes: evidence from a Danish pharmacoepidemiological database.