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Projected burden of type 2 diabetes mellitus-related complications in Singapore until 2050: a Bayesian evidence synthesis
  1. Ken Wei Tan,
  2. Borame Sue Lee Dickens,
  3. Alex R Cook
  1. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
  1. Correspondence to Dr Alex R Cook; ephcar{at}


Objective We examined the effects of age, gender, and ethnicity on the risk of acute myocardial infarction, stroke, and end-stage renal disease according to type 2 diabetes mellitus status among adults aged 40–79 in Singapore.

Methods A Bayesian inference framework was used to derive age-specific, gender-specific and ethnicity-specific prevalence of type 2 diabetes mellitus from the 2010 Singapore National Health Survey, and age-standardized gender and ethnicity-specific incidence rates of acute myocardial infarction, stroke and end-stage renal disease from the National Registry of Diseases Office. Population forecasts were used in tandem with incidence rates to project the future chronic disease burden until 2050.

Results The highest relative risk of acute myocardial infarction was observed in the youngest age group (aged 40–44), with higher relative risk for women (men: 4.3 (2.7–6.4); women: 16.9 (9.3–28.3)). A similar trend was observed for stroke (men: 6.5 (4.2–9.7); women: 10.7 (6.0–17.4)). For end-stage renal disease, the highest relative risk was for men aged 45–50 (11.8 (8.0–16.9)) and women aged 55–60 (16.4 (10.7–24.0)). The annual incidence of acute myocardial infarction is projected to rise from 9300 (in 2019) to 16 400 (in 2050), the number of strokes from 7300 to 12 800, and the number of end-stage renal disease cases from 1700 to 2700.

Conclusions Type 2 diabetes mellitus was associated with an increased risk of complications and is modulated by age and gender. Prevention and early detection of type 2 diabetes mellitus can reduce the increasing burden of secondary complications.

  • disease modeling
  • chronic diabetic complications
  • biostatistics

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  • Contributors KWT performed the literature search and data analysis, produced the figures for the manuscript, and was a major contributor in writing the manuscript. BSLD participated in the study design and was a major contributor in writing the manuscript. ARC participated in the study design and was the principal investigator of the study.

  • Funding The work is supported by the National Research Foundation’s Virtual Singapore grant R-608-000-197-281 and the National Medical Research Council’s Singapore Population Health Improvement Centre.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available. The data that support the findings of this study are available from the National Registry of Diseases Office, Singapore, but restrictions apply to the availability of these data, which were used under license for the current study and so are not publicly available. Data can however be requested from the following website:

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