Projecting diabetes prevalence among Mexicans aged 50 years and older: the Future Elderly Model-Mexico (FEM-Mexico)

Abstract

ObjectiveDiabetes has been growing as a major health problem and a significant burden on the population and on health systems of developing countries like Mexico that are also ageing fast. The goal of the study was to estimate the future prevalence of diabetes among Mexico’s older adults to assess the current and future health and economic burden of diabetes.DesignA simulation study using longitudinal data from three waves (2001, 2003 and 2012) of the Mexican Health and Aging Study and adapting the Future Elderly Model to simulate four scenarios of hypothetical interventions that would reduce diabetes incidence and to project the future diabetes prevalence rates among populations 50 years and older.ParticipantsData from 14 662 participants with information on self-reported diabetes, demographic characteristics, health and mortality.Outcome measuresWe obtained, for each scenario of diabetes incidence reduction, the following summary measures for the population aged 50 and older from 2012 to 2050: prevalence of diabetes, total population with diabetes, number of medical visits.ResultsIn 2012, there were approximately 20.7 million persons aged 50 and older in Mexico; 19.3% had been diagnosed with diabetes and the 2001–2003 diabetes incidence was 4.3%. The no-intervention scenario shows that the prevalence of diabetes is projected to increase from 19.3% in 2012 to 34.0% in 2050. Under the 30% incidence reduction scenario, the prevalence of diabetes will be 28.6% in 2050. Comparing the no-intervention scenario with the 30% and 60% diabetes incidence reduction scenarios, we estimate a total of 816 320 and 1.6 million annual averted cases of diabetes, respectively, for the year 2020.DiscussionOur study underscores the importance of diabetes as a disease by itself and also the potential healthcare demands and social burden of this disease and the need for policy interventions to reduce diabetes prevalence.

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“…27 Looking just at adults 50 and older, the prevalence could rise from 19.3% in 2012 to 34% in 2050. 28 This increase is critical since there are enormous challenges related to reducing T2D mortality in adults aged 50 to 69. 29 Mexico has a rapidly aging population, so it can be expected that T2D will continue to play a central role in the nation's epidemiological profile.…”

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“…The high prevalence of comorbidities in Mexico must be highlighted. Recent models have proposed that, for 2020, 26.3% of the population 50 years and older will have been medically diagnosed with diabetes, for instance 30 .…”

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“…2004). The model, re-estimated on Mexican data, has also been used for predicting diabetes rates in Mexico under varying assumptions about obesity (Gonzalez-Gonzalez et al 2017). FEM has also been adapted to reflect the demographics of LA-country in an analysis on the long-term effect of modest sodium reduction on health and healthcare costs (Vidyanti and Basurto-Davila 2015).…”

“…In its prediction, however, it did not model any concrete intervention, but assumed that risk factors somehow change. Similar models have now been extended to multiple countries (Webber et al 2014, Gonzalez-Gonzalez et al 2017. This study takes the next step by integrating information about an intervention that was recently implemented-into a simulation model to assess its possible long run effects on population health.…”