Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis

BMC Public Health

Andrew P Hills¹  Prasad Katulanda⁴  Mario J Soares²  Nuala M Byrne⁵  Priyanga Ranasinghe³  Ranil Jayawardena⁴ 

[1] Mater Mother’s Hospital, Mater Medical Research Institute and Griffith Health Institute, Griffith University, Brisbane, QLD, Australia;Curtin Health Innovation Research Institute, School of Public Health, Curtin University, Perth, Australia;Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka;Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka;Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia

关键词: Risk factors;    Trends;    Prevalence;    Epidemiology;    South Asia;    Diabetes Mellitus;   

Others  :  1163595
DOI  :  10.1186/1471-2458-12-380

 received in 2012-01-08, accepted in 2012-05-07,  发布年份 2012

【 摘 要 】

Background

Diabetes mellitus has reached epidemic proportions worldwide. South Asians are known to have an increased predisposition for diabetes which has become an important health concern in the region. We discuss the prevalence of pre-diabetes and diabetes in South Asia and explore the differential risk factors reported.

Methods

Prevalence data were obtained by searching the Medline® database with; ‘prediabetes’ and ‘diabetes mellitus’ (MeSH major topic) and ‘Epidemology/EP’ (MeSH subheading). Search limits were articles in English, between 01/01/1980–31/12/2011, on human adults (≥19 years). The conjunction of the above results was narrowed down with country names.

Results

The most recent reported prevalence of pre-diabetes:diabetes in regional countries were; Bangladesh–4.7%:8.5% (2004–2005;Rural), India–4.6%:12.5% (2007;Rural); Maldives–3.0%:3.7% (2004;National), Nepal–19.5%:9.5% (2007;Urban), Pakistan–3.0%:7.2% (2002;Rural), Sri Lanka–11.5%:10.3% (2005–2006;National). Urban populations demonstrated a higher prevalence of diabetes. An increasing trend in prevalence of diabetes was observed in urban/rural India and rural Sri Lanka. The diabetes epidemicity index decreased with the increasing prevalence of diabetes in respective countries. A high epidemicity index was seen in Sri Lanka (2005/2006–52.8%), while for other countries, the epidemicity index was comparatively low (rural India 2007–26.9%; urban India 2002/2005–31.3%, and urban Bangladesh–33.1%). Family history, urban residency, age, higher BMI, sedentary lifestyle, hypertension and waist-hip ratio were associated with an increased risks of diabetes.

Conclusion

A significant epidemic of diabetes is present in the South Asian region with a rapid increase in prevalence over the last two decades. Hence there is a need for urgent preventive and curative strategies .

【 授权许可】

   
2012 Jayawardena et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]Wild S, Roglic G, Green A, Sicree R, King H: Global Prevalence of Diabetes. Diabetes Care 2004, 27:1047-1053.
• [2]Mather HM, Keen H: The Southall Diabetes Survey: prevalence of known diabetes in Asians and Europeans. Br Med J (Clin Res Ed) 1985, 291:1081-1084.
• [3]UK population: by ethnic group: Census update [http://www.statistics.gov.uk/statbase/ssdataset.asp?vlnk=6588&More=Y webcite]
• [4]Erens B, Primatesta P, Prior G: The Health of Minority Ethnic Groups'99 Methodology & Documentation. Vol. 2. The Stationery Office, London; 2001. The Health Survey for England
• [5]Mukhopadhyay B, Forouhi NG, Fisher BM, Kesson CM, Sattar N: A comparison of glycaemic and metabolic control over time among South Asian and European patients with Type 2 diabetes: results from follow-up in a routine diabetes clinic. Diabetic Medicine 2006, 23:94-98.
• [6]Ramachandran A, Wan Ma RC, Snehalatha C: Diabetes in Asia. The Lancet 2010, 375:408-418.
• [7]Barnett A, Dixon A, Bellary S, Hanif M, O’hare J, Raymond N, Kumar S: Type 2 diabetes and cardiovascular risk in the UK south Asian community. Diabetologia 2006, 49:2234-2246.
• [8]Mohan V, Sandeep S, Deepa R, Shah B, Varghese C: Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res 2007, 125:217-230.
• [9]Dowse GK, Zimmet PZ, King H: Relationship between prevalence of impaired glucose tolerance and NIDDM in a population. Diabetes Care 1991, 14:968-974.
• [10]International Diabetes Federation: The Diabetes Atlas. 5th edition. International Diabetes Federation, Brussels; 2011.
• [11]Sadikot SM, Nigam A, Das S, Bajaj S, Zargar AH, Prasannakumar KM, Sosale A, Munichoodappa C, Seshiah V, Singh SK, et al.: The burden of diabetes and impaired glucose tolerance in India using the WHO 1999 criteria: prevalence of diabetes in India study (PODIS). Diabetes Res Clin Pract 2004, 66:301-307.
• [12]Shera AS, Jawad F, Maqsood A: Prevalence of diabetes in Pakistan. Diabetes Res Clin Pract 2007, 76:219-222.
• [13]Katulanda P, Constantine GR, Mahesh JG, Sheriff R, Seneviratne RD, Wijeratne S, Wijesuriya M, McCarthy MI, Adler AI, Matthews DR: Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka–Sri Lanka Diabetes, Cardiovascular Study (SLDCS). Diabet Med 2008, 25:1062-1069.
• [14]Aboobakur M, Latheef A, Mohamed AJ, Moosa S, Pandey RM, Krishnan A, Prabhakaran D: Surveillance for non-communicable disease risk factors in Maldives: results from the first STEPS survey in Male. Int J Public Health 2010, 55:489-496.
• [15]Basit A, Hydrie MZ, Ahmed K, Hakeem R: Prevalence of diabetes, impaired fasting glucose and associated risk factors in a rural area of Baluchistan province according to new ADA criteria. J Pak Med Assoc 2002, 52:357-360.
• [16]Menon VU, Kumar KV, Gilchrist A, Sugathan TN, Sundaram KR, Nair V, Kumar H: Prevalence of known and undetected diabetes and associated risk factors in central Kerala–ADEPS. Diabetes Res Clin Pract 2006, 74:289-294.
• [17]Ono K, Limbu YR, Rai SK, Kurokawa M, Yanagida J, Rai G, Gurung N, Sharma M, Rai CK: The prevalence of type 2 diabetes mellitus and impaired fasting glucose in semi-urban population of Nepal. Nepal Med Coll J 2007, 9:154-156.
• [18]Sayeed MA, Mahtab H, Akter Khanam P, Abdul Latif Z, Keramat Ali SM, Banu A, Ahren B, Azad Khan AK: Diabetes and impaired fasting glycemia in a rural population of Bangladesh. Diabetes Care 2003, 26:1034-1039.
• [19]Abu Sayeed M, Mahtab H, Akter Khanam P, Abul Ahsan K, Banu A, Rashid AN, Azad Khan AK: Diabetes and impaired fasting glycemia in the tribes of Khagrachari hill tracts of Bangladesh. Diabetes Care 2004, 27:1054-1059.
• [20]Rahim MA, Hussain A, Azad Khan AK, Sayeed MA, Keramat Ali SM, Vaaler S: Rising prevalence of type 2 diabetes in rural Bangladesh: a population based study. Diabetes Res Clin Pract 2007, 77:300-305.
• [21]Sayeed MA, Mahtab H, Khanam PA, Latif ZA, Banu A, Khan AK: Prevalence of diabetes and impaired fasting glucose in urban population of Bangladesh. Bangladesh Med Res Counc Bull 2007, 33:1-12.
• [22]Rahman MM, Rahim MA, Nahar Q: Prevalence and risk factors of type 2 diabetes in an urbanizing rural community of Bangladesh. Bangladesh Med Res Counc Bull 2007, 33:48-54.
• [23]Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK, Rao PV, Yajnik CS, Prasanna Kumar KM, Nair JD: High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia 2001, 44:1094-1101.
• [24]Ramachandran A, Snehalatha C, Satyavani K, Vijay V: Impaired fasting glucose and impaired glucose tolerance in urban population in India. Diabet Med 2003, 20:220-224.
• [25]Ajay VS, Prabhakaran D, Jeemon P, Thankappan KR, Mohan V, Ramakrishnan L, Joshi P, Ahmed FU, Mohan BV, Chaturvedi V, et al.: Prevalence and determinants of diabetes mellitus in the Indian industrial population. Diabet Med 2008, 25:1187-1194.
• [26]Chow CK, Raju PK, Raju R, Reddy KS, Cardona M, Celermajer DS, Neal BC: The prevalence and management of diabetes in rural India. Diabetes Care 2006, 29:1717-1718.
• [27]Vijayakumar G, Arun R, Kutty VR: High prevalence of type 2 diabetes mellitus and other metabolic disorders in rural Central Kerala. J Assoc Physicians India 2009, 57:563-567.
• [28]Ravikumar P, Bhansali A, Ravikiran M, Bhansali S, Walia R, Shanmugasundar G, Thakur JS, Kumar Bhadada S, Dutta P: Prevalence and risk factors of diabetes in a community-based study in North India: the Chandigarh Urban Diabetes Study (CUDS). Diabetes Metab 2011, 37:216-221.
• [29]Zaman FA, Pal R, Zaman GS, Swati IA, Kayyum A: Glucose indices, frank and undetected diabetes in relation to hypertension and anthropometry in a South Indian rural population. Indian J Public Health 2011, 55:34-37.
• [30]Vaz NC, Ferreira AM, Kulkarni MS, Vaz FS: Prevalence of diabetes mellitus in a rural population of Goa, India. Natl Med J India 2011, 24:16-18.
• [31]Singh DL, Bhattarai MD: High prevalence of diabetes and impaired fasting glycaemia in urban Nepal. Diabet Med 2003, 20:170-171.
• [32]Shrestha UK, Singh DL, Bhattarai MD: The prevalence of hypertension and diabetes defined by fasting and 2-h plasma glucose criteria in urban Nepal. Diabet Med 2006, 23:1130-1135.
• [33]Malavige G, de Alwis N, Weerasooriya N, Fernando D, Siribaddana S: Increasing diabetes and vascular risk factors in a sub-urban Sri Lankan population. Diabetes research and clinical practice 2002, 57:143-145.
• [34]Wijewardene K, Mohideen MR, Mendis S, Fernando DS, Kulathilaka T, Weerasekara D, Uluwitta P: Prevalence of hypertension, diabetes and obesity: baseline findings of a population based survey in four provinces in Sri Lanka. The Ceylon medical journal 2005, 50:62-70.
• [35]Hussain A, Rahim MA, Azad Khan AK, Ali SMK, Vaaler S: Type 2 diabetes in rural and urban population: diverse prevalence and associated risk factors in Bangladesh. Diabetic Medicine 2005, 22:931-936.
• [36]Singh RB, Bajaj S, Niaz MA, Rastogi SS, Moshiri M: Prevalence of type 2 diabetes mellitus and risk of hypertension and coronary artery disease in rural and urban population with low rates of obesity. Int J Cardiol 1998, 66:65-72.
• [37]Zargar AH, Khan AK, Masoodi SR, Laway BA, Wani AI, Bashir MI, Dar FA: Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in the Kashmir Valley of the Indian subcontinent. Diabetes Res Clin Pract 2000, 47:135-146.
• [38]Mohan V, Mathur P, Deepa R, Deepa M, Shukla DK, Menon GR, Anand K, Desai NG, Joshi PP, Mahanta J, et al.: Urban rural differences in prevalence of self-reported diabetes in India–the WHO-ICMR Indian NCD risk factor surveillance. Diabetes Res Clin Pract 2008, 80:159-168.
• [39]Ebrahim S, Kinra S, Bowen L, Andersen E, Ben-Shlomo Y, Lyngdoh T, Ramakrishnan L, Ahuja RC, Joshi P, Das SM, et al.: The effect of rural-to-urban migration on obesity and diabetes in India: a cross-sectional study. PLoS Med 2010, 7:e1000268.
• [40]Mehta KD, Karki P, Lamsal M, Paudel IS, Majhi S, Das BK, Sharma S, Jha N, Baral N: Hyperglycemia, glucose intolerance, hypertension and socioeconomic position in eastern Nepal. Southeast Asian J Trop Med Public Health 2011, 42:197-207.
• [41]Mohan V, Deepa M, Deepa R, Shanthirani CS, Farooq S, Ganesan A, Datta M: Secular trends in the prevalence of diabetes and impaired glucose tolerance in urban South India–the Chennai Urban Rural Epidemiology Study (CURES-17). Diabetologia 2006, 49:1175-1178.
• [42]Ramachandran A, Snehalatha C, Vijay V: Temporal changes in prevalence of type 2 diabetes and impaired glucose tolerance in urban southern India. Diabetes Res Clin Pract 2002, 58:55-60.
• [43]Ramachandran A, Snehalatha C, Latha E, Vijay V, Viswanathan M: Rising prevalence of NIDDM in an urban population in India. Diabetologia 1997, 40:232-237.
• [44]Ramachandran A, Snehalatha C, Baskar AD, Mary S, Kumar CK, Selvam S, Catherine S, Vijay V: Temporal changes in prevalence of diabetes and impaired glucose tolerance associated with lifestyle transition occurring in the rural population in India. Diabetologia 2004, 47:860-865.
• [45]Ramachandran A, Mary S, Yamuna A, Murugesan N, Snehalatha C: High prevalence of diabetes and cardiovascular risk factors associated with urbanization in India. Diabetes Care 2008, 31:893-898.
• [46]Illangasekera U, Rambodagalla S, Tennakoon S: Temporal trends in the prevalence of diabetes mellitus in a rural community in Sri Lanka. J R Soc Promot Health 2004, 124:92-94.
• [47]Fernando DJ, Siribaddana S, de Silva D: Impaired glucose tolerance and diabetes mellitus in a suburban Sri Lankan community. Postgrad Med J 1994, 70:347-349.
• [48]Islam A, Tahir MZ: Health sector reform in South Asia: new challenges and constraints. Health Policy 2002, 60:151-169.
• [49]Mohan V: Why are Indians more prone to diabetes? J Assoc Physicians India 2004, 52:468-474.
• [50]Misra A, Khurana L: Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab 2008, 93:S9-30.
• [51]Misra A, Khurana L, Isharwal S, Bhardwaj S: South Asian diets and insulin resistance. Br J Nutr 2009, 101:465-473.
• [52]Mohan V, Shanthirani CS, Deepa R: Glucose intolerance (diabetes and IGT) in a selected South Indian population with special reference to family history, obesity and lifestyle factors–the Chennai Urban Population Study (CUPS 14). J Assoc Physicians India 2003, 51:771-777.
• [53]Yajnik CS: Early life origins of insulin resistance and type 2 diabetes in India and other Asian countries. J Nutr 2004, 134:205-210.
• [54]Mohan V, Shanthirani S, Deepa R, Premalatha G, Sastry NG, Saroja R: Intra-urban differences in the prevalence of the metabolic syndrome in southern India -- the Chennai Urban Population Study (CUPS No. 4). Diabetic Medicine. J Brit Diabetic Assoc 2001, 18:280-287.
• [55]Gupta A, Gupta R, Sarna M, Rastogi S, Gupta VP, Kothari K: Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population. Diabetes Res Clin Pract 2003, 61:69-76.