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New Global Diabetes Cases Ebb

Newly diagnosed diabetes cases have been slowing down worldwide, according to multinational registry data.

Among 19 high-income and two middle-income countries, nearly all saw either a decline or stabilization in new diabetes cases starting in about 2010, according to Dianna Magliano, PhD, of the Baker Heart and Diabetes Institute in Melbourne, Australia, and colleagues.

Out of all the locations included, the only areas that showed an uptick in new diabetes cases were Lithuania, Singapore, Israel, and the Northwestern U.S., the group wrote in the Lancet Diabetes & Endocrinology.

In these areas, the annual estimated increase in new diabetes cases since 2010 ranged from 0.9% to 5.6%.

Looking solely at the U.S., which had three data sources to draw upon, new diabetes cases declined overall among Medicare beneficiaries and respondents to the National Health Interview Survey. The uptick in cases was only seen in the patients in the Kaiser Permanente Northwest insurance dataset.

All other countries and jurisdictions included in the analysis saw a decline in new diabetes cases, with drops from 1.1% to 10.8% since 2010: Australia, Canada, Denmark, France, Hong Kong, the Lombardy region of Italy, Latvia, the Netherlands, Norway, Russia, Scotland, South Korea, Spain, Taiwan, the U.K., and Ukraine.

Nearly all of these countries and jurisdictions looked specifically at type 2 diabetes cases, although a few areas included incidence of both type 1 and type 2 diabetes cases.

Registry data for the analysis extended to 2015 or 2016 for most of the countries studied.

Magliano’s group pointed out that although the root causes for the vast decline in global diabetes cases are “uncertain,” it likely points back to heightened prevention efforts.

Another factor that likely impacted the rates of diagnosed diabetes cases was the formal introduction of HbA1c to diagnose diabetes — the earliest of which occurred in the U.S. in 2010.

“There is evidence to suggest that HbA1c detects fewer people with diabetes than does the oral glucose tolerance test (OGTT),” the researchers wrote. “However, the OGTT is used infrequently in clinical practice, and fasting glucose, the most commonly used test to diagnose diabetes, produces a similar prevalence of diabetes as does HbA1c.”

Magliano and co-authors noted that two countries who never officially adopted screening with HbA1c — France and Latvia — also saw a decline in new cases.

One other possible explanation for these declining or stabilizing diabetes cases could point back to when the diagnostic threshold for fasting plasma glucose was reduced from 7.8 mmol/L (140 mg/dL) to 7.0 mmol/L (126 mg/dL) in 1997. This diagnostic change would’ve resulted in a slew of new cases diagnosed picked up in the subsequent years, resulting in an eventual decline or stabilization by 2010.

For the analysis, the researchers drew upon data from 22 million new diabetes diagnoses, encompassing 5 billion person-years of follow-up. All countries and jurisdictions included were considered “high-income,” while only two were considered “middle-income” (Russia and Ukraine).

This was highlighted in an accompanying commentary by Mohammed K. Ali, MBChB, MSc, MBA, of Emory University in Atlanta, and colleagues, who said that the absolute rate of global diabetes cases continues to slowly rise.

“Importantly, the findings are limited to mostly high-income populations and cannot speak to diabetes incidence patterns in low-income and middle-income countries, where 79% of people with diabetes worldwide reside,” Ali’s group wrote.

The commentators also pointed out that the analysis only suggested that new diagnosed diabetes cases are tapering off among those with access to healthcare or those who had administrative records on their health, and therefore likely don’t count many lower socioeconomic or uninsured individuals.

  • Kristen Monaco is a staff writer, focusing on endocrinology, psychiatry, and dermatology news. Based out of the New York City office, she’s worked at the company for nearly five years.

Disclosures

The study was funded by the CDC, Diabetes Australia Research Program, and Victoria State Government Operational Infrastructure Support Program.

Magliano and co-authors reported no disclosures.

Ali and co-authors reported relationships with Merck and the Georgia Center for Diabetes Translation.

Source: MedicalNewsToday.com