IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040

https://doi.org/10.1016/j.diabres.2017.03.024Get rights and content

Highlights

  • Global diabetes prevalence was estimated for 2015 and 2040.

  • In 2015, prevalence of diabetes in adults was estimated to be 8.8%.

  • In 2015, 16.2% of live births were associated with hyperglycaemia in pregnancy.

  • In 2040, the prevalence of diabetes in adults is predicted to rise to 10.4%.

  • Diabetes prevalence continues to rise across the globe.

Abstract

Aim

To produce current estimates of the national, regional and global impact of diabetes for 2015 and 2040.

Methods

A systematic literature review was conducted to identify data sources on the prevalence of diabetes from studies conducted in the period from 1990 to 2015. An analytic hierarchy process was used to select the most appropriate studies for each country, and estimates for countries without data were modelled using extrapolation from similar countries that had available data. A logistic regression model was used to generate smoothed age-specific estimates, which were applied to UN population estimates.

Results

540 data sources were reviewed, of which 196 sources from 111 countries were selected. In 2015 it was estimated that there were 415 million (uncertainty interval: 340–536 million) people with diabetes aged 20–79 years, 5.0 million deaths attributable to diabetes, and the total global health expenditure due to diabetes was estimated at 673 billion US dollars. Three quarters (75%) of those with diabetes were living in low- and middle-income countries. The number of people with diabetes aged 20–79 years was predicted to rise to 642 million (uncertainty interval: 521–829 million) by 2040.

Conclusion

Diabetes prevalence, deaths attributable to diabetes, and health expenditure due to diabetes continue to rise across the globe with important social, financial and health system implications.

Introduction

Diabetes mellitus describes a group of metabolic disorders characterised by increased blood glucose concentration. People living with diabetes have a higher risk of morbidity and mortality than the general population. The global prevalence of diabetes in adults has been increasing over recent decades. In 1964, it was estimated that 30 million people had diabetes [15]. Less than 40 years later, the WHO estimated that there were 171 million people living with diabetes [51]. The International Diabetes Federation (IDF) estimated the global prevalence to be 151 million in 2000 [28], 194 million in 2003 [27], 246 million in 2006 [26], 285 million in 2009 [25], 366 million in 2011 [24], and 382 million in 2013 [23]. Each estimate was based on the latest data available. The IDF Atlas methodology was substantially updated in 2011 [19] to incorporate an analytic hierarchy process that formalised the methods to prioritise the highest quality data from available sources.

The dramatic increase in diabetes has occurred in all countries, and in rural as well as urban areas. Accurate global, regional, and country-level estimates and projections of diabetes prevalence are necessary for prevention and treatment strategies to be planned and monitored, and to assess progress towards reaching the targets set by the Global Action Plan for Non-Communicable Diseases and the Sustainable Development Goals [55].

This paper provides estimates of the worldwide and regional impact of diabetes for 2015 and 2040, based on the most recent and highest quality epidemiological data. For the first time, the IDF Diabetes Atlas methodology also includes uncertainty intervals to reflect confidence levels around the prevalence estimates. These uncertainty measurements permit the comparison of the IDF Diabetes Atlas estimates with other sources and over time.

Section snippets

Study selection

A literature search of PubMed, Medline, and Google Scholar was conducted, without language restriction, to identify data sources providing the age-specific prevalence of diabetes from studies that were conducted from January 1990 to June 2015. The search terms: (“diabetes” OR “impaired glucose tolerance”) AND “prevalence” AND (“country name” OR “region/continent”); “cardiovascular risk factors” AND (“country name” OR “region/continent”) were used. Additionally, data sources were gathered from

Study selection

The analytic hierarchy process ranked the most important study characteristics as (1) sample representation (nationally representative scoring most highly, followed by regionally representative), (2) diagnostic criteria (oral glucose tolerance test scoring most highly), (3) sample size (5000 people or more scoring most highly), and (4) age of study (less than 5 years old scoring most highly) (Supplementary Table 1).

The literature search identified 540 data sources from 154 countries. Of these,

Discussion

A systematic literature review identified 540 studies on the prevalence of diabetes conducted between the period of 1990 and 2015. Using an analytic hierarchy process, 196 sources from 111 countries were selected. Using extrapolation, logistic regression, and UN population estimates, it was estimated that in 2015 there were 415 million (uncertainty interval: 340–536 million) people with diabetes aged 20–79 years, 5.0 million deaths attributable to diabetes, and a total global health expenditure

Conclusion

The prevalence of diabetes in adults aged 20–79 years was estimated to be 8.8% in 2015 and predicted to rise to 10.4% in 2040.The high prevalence of diabetes in adults has important social, financial and development implications. There is an increasingly urgent need for governments to implement policies to decrease the risk factors for type 2 diabetes and gestational diabetes, and ensure appropriate access to treatment for all people living with diabetes. Tackling the global impact of diabetes

Conflicts of interest

KO, JDdRF, YH, UL, LG, DC and LEM are current or former employees of the International Diabetes Federation, which has received funding from AstraZeneca, Bayer HealthCare, BD, Boehringer Ingelheim, Lilly Diabetes, Medtronic, Merck Sharp and Dohme, Novartis, Novo Nordisk, Sanofi Diabetes, Servier, and Takeda. JES has received honoraria for talks and consultancy from Astra Zeneca, Takeda, Merck Sharp and Dohme, Novartis, Eli Lilly, Bristol-Myers Squibb, Novo Nordisk, and Sanofi-Aventis. LEM has

Contributions

KO and JDdRF contributed to the study conception and design, acquisition of data, analysis and interpretation of data, drafting and critical revision of the manuscript. YH contributed to the analysis and interpretation of data, drafting and critical revision of the manuscript. UL and LG contributed to the study conception and design, acquisition of data, and critical revision of the manuscript. NHC contributed to the study conception and design, and critical revision of the manuscript. DC

Acknowledgements

The authors would like to thank George Alberti, Peter Bennett, Nita Forouhi, Ian Hambleton, Maria Hein Hegelund, Beatriz Yáñez Jiménez, Rui Li, Dianna Magliano, Azeem Majeed, Belma Malanda, Jean Claude Mbanya, Pablo Aschner Montoya, Ayesha Motala, K.M. Venkat Narayan, Farheen Oomatia, Ambady Ramachandran, Wolfgang Rathmann, Gojka Roglic, Martin Silink, David Whiting, Ping Zhang, and Paul Zimmet for their assistance.

This work was supported by funding from AstraZeneca, Lilly Diabetes, Merck Sharp

References (56)

  • American Diabetes Association

    Economic costs of diabetes in the U.S. in 2012

    Diabetes Care

    (2013)
  • S. Basu et al.

    The relationship of sugar to population-level diabetes prevalence: an econometric analysis of repeated cross-sectional data

    PLoS ONE

    (2013)
  • M. Baxter et al.

    Estimating the impact of better management of glycaemic control in adults with Type 1 and Type 2 diabetes on the number of clinical complications and the associated financial benefit

    Diabet Med

    (2016)
  • A. Ben-Haroush et al.

    Epidemiology of gestational diabetes mellitus and its association with Type 2 diabetes

    Diabet Med

    (2004)
  • J.P. Boyle et al.

    Estimating prevalence of type 1 and type 2 diabetes in a population of African Americans with diabetes mellitus

    Am J Epidemiol

    (1999)
  • G. Bruno et al.

    Incidence of type 1 and type 2 diabetes in adults aged 30–49 years: the population-based registry in the province of Turin, Italy

    Diabetes Care

    (2005)
  • B. Buijsse et al.

    Risk assessment tools for identifying individuals at risk of developing type 2 diabetes

    Epidemiol Rev

    (2011)
  • Central Intelligence Agency

    Country profiles, World factbook

    (2015)
  • D. Dabelea et al.

    Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant sibships

    Diabetes

    (2000)
  • L. Degli Esposti et al.

    Glycemic control and diabetes-related health care costs in type 2 diabetes; retrospective analysis based on clinical and administrative databases

    Clin Outcomes Res CEOR

    (2013)
  • Diabetes UK. The cost of diabetes. Diabetes UK, London, United Kingdom;...
  • P.S. Entmacher et al.

    Diabetes in 1964; a world survey

    Diabetes

    (1965)
  • J.M. Evans et al.

    Socio-economic status, obesity and prevalence of Type 1 and Type 2 diabetes mellitus

    Diabet Med J Br Diabet Assoc

    (2000)
  • B. Farran et al.

    Predictive models to assess risk of type 2 diabetes, hypertension and comorbidity: machine-learning algorithms and validation using national health data from Kuwait–a cohort study

    BMJ Open

    (2013)
  • B.J. Gray et al.

    Different type 2 diabetes risk assessments predict dissimilar numbers at “high risk”: a retrospective analysis of diabetes risk-assessment tools

    Br J Gen Pract J R Coll Gen Pract

    (2015)
  • W.H. Herman et al.

    Effectiveness and cost-effectiveness of diabetes prevention among adherent participants

    Am J Manage Care

    (2013)
  • N. Holman et al.

    Current prevalence of Type 1 and Type 2 diabetes in adults and children in the UK

    Diabet Med J Br Diabet Assoc

    (2015)
  • IDF Diabetes Atlas Group

    Update of mortality attributable to diabetes for the IDF Diabetes Atlas: estimates for the year 2011

    Diabetes Res Clin Pract

    (2013)
  • Cited by (2825)

    View all citing articles on Scopus
    View full text