The Rising Prevalence of Diabetes and Impaired Glucose Tolerance

Dunstan, David W.; Zimmet, Paul; Welborn, T.; Courten, Maximilian P. de; Cameron, Adrian J.; Sicree, Richard; Dwyer, Terry; Colagiuri, Stephen; Jolley, Damien; Knuiman, Matthew; Atkins, Robert C.; Shaw, Jonathan E.

doi:10.2337/diacare.25.5.829

Cited by 732 publications

(593 citation statements)

References 42 publications

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“…Inter99 [11] 47.5% nonresponse, AusDiab [12], 61% non-response). The Danish NDR includes persons on the basis of their registered contacts with the healthcare system, whereas population surveys normally define diabetic patients as persons who confirm that they have been told by a physician to have diabetes.…”

Section: Discussionmentioning

confidence: 99%

The Danish National Diabetes Register: trends in incidence, prevalence and mortality

et al. 2008

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Aims/hypothesis The aim of the study was to describe trends in the incidence rate, prevalence and mortality rate for diabetes in Denmark. Methods Healthcare registers at the National Board of Health were used to compile a register of diabetic patients in the Danish population (5.4 million people). Age-and sex-specific prevalence, incidence rates, mortality rates and standardised mortality ratios relative to the non-diabetic part of the population were calculated. Results The register contains records for about 360,000 persons with diabetes; 230,000 were alive at 1 January 2007, corresponding to an overall prevalence of 4.2%. The prevalence increased by 6% per year. In 2004 the incidence rates were 1.8 per 100,000 at age 40 years and 10.0 per 100,000 at age 70 years. The incidence rate increased 5% per year before 2004 and then stabilised. The mortality rate in the diabetic population decreased 4% per year, compared with 2% per year in the non-diabetic part of the population. The mortality rate decreased 40% during the first 3 years after inclusion in the register. The standardised mortality ratio decreased with age, from 4.0 at age 50 years to 2.5 at age 70 years and just under 2 at age 85 years, identically for men and women. The standardised mortality ratio decreased 1% per calendar year. The lifetime risk of diabetes was 30%. Conclusions/interpretation The prevalence of diabetes in Denmark rose in 1995-2006, but the mortality rate in diabetic patients decreased faster than that of the nondiabetic population. The mortality rate decreased markedly just after inclusion in the register. Incidence rates have shown a tendency to decrease during the last few years, but this finding should be viewed with caution.

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Section: Discussionmentioning

confidence: 99%

The Danish National Diabetes Register: trends in incidence, prevalence and mortality

et al. 2008

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“…In these linked lifetables, the population at a given age (a) and time (t) depend on the population at age (a−1) and time (t−1) and on the incidence of diabetes and the associated mortality between (t−1) and (t). The baseline multi-state life-table population, representing the population age structure in Australia in the year 2000 was created by applying age-specific population numbers for the year 2000 [13], and the age-specific prevalence of diabetes observed in AusDiab [2], to the static life-table structure described above. With each passing year, a new cohort of 25-year-olds entered the model, based on population projections between 2008 and 2025 from the Australian Bureau of Statistics [14], and assuming the same constant prevalence of diabetes at age 25.…”

Section: Methodsmentioning

confidence: 99%

“…In 2007, there were 246 million people living with diabetes [1]. In Australia the prevalence of diabetes doubled between 1981 and 2000 [2] and is expected to increase further as a result of population ageing, urbanisation and increasing obesity rates [1]. To expand the understanding of the burden of diabetes, life-table modelling techniques can use incidence, prevalence and mortality data to estimate the lifetime risk of diabetes, the life expectancy of those with diabetes, and the future prevalence of diabetes.…”

Section: Introductionmentioning

confidence: 99%

Lifetime risk and projected population prevalence of diabetes

et al. 2008

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Aims/hypothesis With incidence rates for diabetes increasing rapidly worldwide, estimates of the magnitude of the impact on population health are required. We aimed to estimate the lifetime risk of diabetes, the number of years lived free of, and the number of years lived with diabetes for the Australian adult population from the year 2000, and to project prevalence of diabetes to the year 2025. Methods Multi-state life-tables were constructed to simulate the progress of a cohort of 25-year-old Australians. National mortality rates were combined with incidence rates of diabetes and the RR of mortality in people with diabetes derived from the Australian Diabetes, Obesity and Lifestyle study (a national, population-based study of 11,247 adults aged ≥25 years).Results If the rates of mortality and diabetes incidence observed over the period 2000-2005 continue, 38.0% (95% uncertainty interval 36.6-38.9) of 25-year-olds would be expected to develop diabetes at some time throughout their life. On average, a 25-year-old Australian will live a further 56 years, 48 of these free of diabetes. On average, a 45-year-old person with diabetes can expect to live 6 years less than a person free of diabetes. The prevalence of diabetes is projected to rise from 7.6% in 2000 to 11.4% by 2025. Conclusions/interpretation If we maintain current diabetes incidence rates, more than a third of individuals will develop diabetes within their lifetime and in Australia there will an additional 1 million cases of diabetes by the year 2025.

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“…[1][2][3][4] Evidence for this comes from comparisons of time trends in PA and in obesity and diabetes, and also from both cross-sectional and prospective cohort data on the associations in individuals. 2,5,6 The extent of the contribution of PA to obesity, however, has been difficult to quantify because questionnaire measures of PA, which have been the means of measuring PA, 7 are not able to adequately capture the more dispersed incidental activity, such as short periods of walking around the home or workplace.…”

Section: Introductionmentioning

confidence: 99%

“…We do this by using data available on these measures and related factors, such as television watching time and alcohol intake, from the Tasmania sample of those who were enrolled in the AusDiab study. 4 …”

Section: Introductionmentioning

confidence: 99%

The inverse relationship between number of steps per day and obesity in a population-based sample – the AusDiab study

Dwyer

Hosmer

et al. 2006

Int J Obes

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Background: Physical activity (PA) is inversely associated with obesity but the effect has been difficult to quantify using questionnaires. In particular, the shape of the association has not yet been well described. Pedometers provide an opportunity to better characterize the association. Methods: Residents of households over the age of 25 years in randomly selected census districts in Tasmania were eligible to participate in the AusDiab cross-sectional survey conducted in 1999-2000. 1848 completed the AusDiab survey and 1126 of these (609 women and 517 men) wore a pedometer for 2-weekdays. Questionnaire data on recent PA, TV time and other factors were obtained. The outcomes were waist circumference (in cm) and body mass index (BMI) (kg/m 2 ). Results: Increasing daily steps were associated with a decline in the obesity measures. The logarithmic nature of the associations was indicated by a sharper decline for those with lower daily steps. For example, an additional 2000 steps for those taking only 2000 steps per day was associated with a reduction of 2.8 (95% confidence interval (CI): 2.1,4.4) cm in waist circumference among men (for women; 2.2 (95% CI: 0.6, 3.9 cm)) with a baseline of only 2000, steps compared to a 0.7 (95% CI 0.3, 1.1) cm reduction (for women; 0.6 (95% CI: 0.2, 1.0)) for those already walking 10 000 steps daily. In the multivariable analysis, clearer associations were detected for PA and these obesity measures using daily step number rather than PA time by questionnaire. Interpretation: Pedometer measures of activity indicate that the inverse association between recent PA and obesity is logarithmic in form with the greatest impact for a given arithmetic step number increase seen at lower levels of baseline activity. The findings from this study need to be examined in prospective settings.

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The Rising Prevalence of Diabetes and Impaired Glucose Tolerance

Cited by 732 publications

References 42 publications

The Danish National Diabetes Register: trends in incidence, prevalence and mortality

The Danish National Diabetes Register: trends in incidence, prevalence and mortality

Lifetime risk and projected population prevalence of diabetes

The inverse relationship between number of steps per day and obesity in a population-based sample – the AusDiab study

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