Global burden of diabetes: regional disparities in prevalence, incidence, and mortality

Objectives
To study the trends in diabetes prevalence, incidence, and mortality over time and by region of the world.

Material and methods
An online literature search was carried out in PubMed for studies reporting data on the time trends of the prevalence and of the incidence of diabetes. Studies reporting the most recent trends were selected to represent each region of the world and with the aim to cover a time span as long as possible. For mortality trends, diabetes deaths registered in the World Health Organisation (WHO) mortality database by November 2018 were extracted by gender and five-year age group for a selection of countries and for the longest period available (from 1950 to 2013).

Results
Thirty-two and 11 articles were included in the analysis of trends of diabetes prevalence and incidence, respectively. The prevalence and incidence of diabetes are increasing globally. A study of the trends on a finer geographic scale revealed contrasting results and confirmed a lack of trend data, notably in Eastern Europe and other low- and middle-income regions. Mortality is increasing in South and Central America and Africa, but is stabilising in the other regions of the world.

Conclusions
Trends in diabetes prevalence and incidence showed disparities among different groups of populations, which could be explained by disparities in lifestyle and access to medical facilities or could be related to the obesity epidemic. This study revealed important data gaps that have to be bridged to obtain a more complete and more accurate picture of the worldwide diabetes epidemic.