SummaryBackgroundOne of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes.MethodsWe pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence—defined as fasting plasma glucose of 7·0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs—in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue.FindingsWe used data from 751 studies including 4 372 000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4·3% (95% credible interval 2·4–7·0) in 1980 to 9·0% (7·2–11·1) in 2014 in men, and from 5·0% (2·9–7·9) to 7·9% (6·4–9·7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28·5% due to the rise in prevalence, 39·7% due to population growth and ageing, and 31·8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target.InterpretationSince 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries.FundingWellcome Trust.

Most T2DM patients have MetS but it is uncommon in T1DM. Despite treatment, almost half of patients still met the criteria for MetS. Aggressive treatment of MetS components is required to reduce cardiovascular risk in DM.

Majority of the patients with end stage renal disease (ESRD) are on maintenance hemodialysis (MHD) in Bangladesh. Dialysis patients are at high risk for contracting blood borne infection including hepatitis C virus (HCV) infection. The aim of this study was to evaluate the antibody response of hepatitis C virus infection in patients on MHD by detecting different viral markers in blood. A total of 88 patients with chronic kidney disease (CKD)were recruited from BIRDEM and BSMMU during the period from June 2006 to June 2007. Of them 63 patients on MHD and 25 predialysis patients were taken as cases and controls respectivly. Anti-HCV antibody were positive in 38% of dialysis patients but none of the controls were positive for Anti-HCV. When HCV positive MHD patients (38%) were compared to HCV negative MHD patients (62%), it showed that HCV positive patients had longer duration of dialysis (24±25 vs 9±6 months, p<0.001), increased number blood transfusions (29±34 vs 10±9 units, p<0.004) and elevated serum alanine aminotransferase level (35±23 vs 20±9 U/L, p=0.001). Implementing comprehensive infection control program by routine screening of the CKD patients, safe blood transfusion program, reducing transfusion of blood by use of erythropoietin and proper disinfection and cleaning of hemodialysis units may reduce the infection by HCV Virus. DOI: http://dx.doi.org/10.3329/bjmb.v7i1.18573 Bangladesh J Med Biochem 2014; 7(1): 9-13

Sir,The influence of disease prevalence on screening for AMD I read with interest the article by Jain et al 1 titled 'Screening for age-related macular degeneration using nonstereo digital photographs'. The authors found reasonably high sensitivities and specificities for detection of ARM and age-related macular degeneration (AMD) by graders viewing digital photos. While their results are not in question, I do raise objection to their discussion in which they state that the findings of the study might usefully be extended into a primary care setting. This assumption ignores a pivotal statistical fact and highlights why sensitivities and specificities alone do not tell the whole story when assessing how useful a screening test is. 2 The setting of the study involved a contrived selection of cases from a retinal unit database. In this 'population', the prevalence of neovascular AMD was 31%. In a primary care setting, of course, the real prevalence will be much lower, say 2% in patients over 65 years. While this difference does not affect the sensitivity or specificity of the screening tool, it does impact very significantly on the positive predictive value.In the study, for example, for grader 1, the sensitivity was 82.1% and the specificity was 79.7%. The positive predictive value can be calculated as 64.8% in the study 'population'. If the same sensitivity and specificity are applied to a primary care population, with an AMD prevalence of say 2%, the positive predictive value drops to 7.8%. This means that over 92% of positive results will actually be false positives.This demonstrates that the utility of a screening tool cannot be evaluated without reference to the prevalence of the disease in the population in which it is to be used.