While the prevalence of diabetes, especially type 2, has grown in recent years, new evidence suggests its incidence may be decreasing.
That is to say, in 2017, 425 million adults between 20 and 79 years old were living with diabetes; by 2045, the International Diabetes Federation expects this figure will swell to 629 million. But recent research suggests, at the same time, the rate of new cases each year will shrink.
What Did the Study Find?
The research — presented at the annual meeting of the European Association for the Study of Diabetes and published in BMJ — examined 275 studies that reported incidence of diabetes or type 2 diabetes in adults and included at least two years of follow-up.
Based on this data, the authors, from the Baker Heart and Diabetes Institute in Melbourne, Australia, found the “overall crude annualized diabetes incidence” in the 1970s was roughly 0.53 percent (5.3 new cases per 1,000 persons per year). It rose to 1 percent (10 new cases per 1,000 persons per year) in 2010.
Similarly, studies with a mid-point year between 2000 and 2009 had a 20 percent higher incidence rate than those with a mid-point in the 1990s. But research from 2010 or later had a 5 percent lower incidence rate.
As the authors explained it: “It therefore appears that following the rise in incidence from 1990s, there was a flattening or even a possible decline in the rate of new cases of type 2 diabetes in the last few years.”
It is important to note, though, that the data was “mainly from high-income countries, and patterns of incidence in other countries may indeed be different,” co-author Dianna Magliano, PhD, MPH, tells Florence Health.
The BMJ study also looked at diabetes incidence by ethnicity. Compared to people with European ancestry, the incidence of diabetes was 80 percent higher in Latinos, 60 percent higher in people of African descent, and 30 percent higher in Asians.
Why Does the Study Matter?
“These findings suggest that we may be seeing the benefits of the diabetes prevention and healthy lifestyle awareness, which has taken place globally,” says Dr. Magliano. “Our intake of saturated fats has decreased, and smoking incidence continues to decrease. These, along with interventions such as changes in food formulations and labeling, probably won’t drive diabetes incidence down much, but they contribute to what we are seeing.”
She also stresses that, despite her study’s focus on incidence, researchers must look at prevalence and incidence of diabetes together to understand the epidemic fully. In the past, both the prevalence and the incidence of diabetes were rising, but now “incidence is probably not,” she explains.
The prevalence of diabetes is affected by factors like survival, aging and better medical care, Dr. Magliano adds: “Those with diabetes now are more likely to survive longer with the condition and hence, in an aging population in a developed country, the prevalence of diabetes will continue to rise, even when the incidence is stable or falling.”
If you’re healthcare provider who works regularly with patients who have or are at risk of developing diabetes, Dr. Magliano’s research doesn’t change much, she explains.
“We need to continue to encourage a good healthy diet, plenty of physical activity, and regular checkups,” she says. “We know we can prevent or delay diabetes, and we now have some encouraging data that suggests our actions have some longer-term gain.”
And while it is fine to be optimistic, “We do still need to be cautious and we cannot stop these prevention activities,” Dr. Magliano clarifies. “We want the community to continue to work toward the goals of a healthy lifestyle.”
Diabetes facts & figures, International Diabetes Federation.