medwireNews: A systematic review in The BMJ suggests the incidence of diabetes may be falling in many countries, with researchers suggesting preventive strategies may be proving effective.
The findings from 47 published studies of five time periods between the 1960s and the mid-2000s in mainly high-income countries showed that the trend for increasing incidence of total or type 2 diabetes peaked between 1990 and 1999, after which the rate fell or stabilized in two thirds of the countries assessed.
The authors led by Dianna Magliano (Monash University, Melbourne, Victoria, Australia) say: “Preventive strategies and public health education and awareness campaigns could have contributed to this recent trend.”
The data showed that for the period from 1960 to 1989, 36% of the 22 applicable populations had increasing trends in the incidence of diabetes, while in 55% this had leveled out and in 9% it was declining.
From 1990 to 2005, there was a trend of increasing diabetes incidence in two thirds of the 50 populations studied, with this stable in 32% and decreasing in 2%.
But subsequently from 2006 to 2014, the incidence of diabetes increased among just a third of the 33 populations studied, with 30% having a stable incidence and 36% a decline.
The decreasing trend in diabetes incidence after 2005 was observed in populations from the USA, Israel, Switzerland, Hong Kong, Sweden, and Korea. Those with an increased incidence after 2005 included Portugal, Denmark, and Germany, while a stable incidence was seen in Canada, Italy, Norway, USA (non-Hispanic White), and the UK.
The authors note, however, that the findings mostly apply to type 2 diabetes and clinically diagnosed diabetes, and were mostly in Europid populations and high-income countries, leaving global trends in incidence unclear.
In an accompanying article, Louise McCombie (University of Glasgow, UK) and fellow editorialists caution that, “[a]s with most systematic reviews, this study seeks to answer a different question from that posed by the source studies.”
They add: “While we all long for signs that diabetes is in retreat, this sensibly optimistic systematic review does not provide definitive evidence that true incidence is finally falling.”
By Anita Chakraverty
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