聂鹏教授作为NCD-RisC成员有关全球糖尿病流行率和治疗的合作研究发表于The Lancet
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发布时间：2024-11-15
发布时间：2024-11-15
文章标题：聂鹏教授作为NCD-RisC成员有关全球糖尿病流行率和治疗的合作研究发表于The Lancet
内容：
聂鹏教授作为NCD Risk Factor Collaboration (NCD-RisC)成员之一，其参与的合作研究于在2024年11月14日在The Lancet发表题为“Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1101 population-representative studies with 82 million participants”。
Summary
Background: Diabetes can be detected at the primary health-care level, and low-cost effective treatments can lower the risk of mortality and complications. We estimated trends from 1990 to 2022 in diabetes prevalence and treatment coverage for 200 countries and territories.
Methods: We used data from 1,101 population-representative studies with 82 million participants aged 18 years and older with measurement of fasting glucose and/or HbA1c, and information on diabetes treatment. Consistent with clinical guidelines, we defined diabetes as having a fasting plasma glucose (FPG) of 7.0 mmol/L or higher, having a glycated haemoglobin (HbA1c) of 6.5% or higher, or taking medications for diabetes. We defined diabetes treatment as the proportion of people with diabetes who used oral hypoglycaemic drugs or insulin. We pooled and analysed the data in a Bayesian hierarchical meta-regression model to estimate diabetes prevalence and treatment. We estimated the number of people with diabetes and the number of people with treated versus untreated diabetes by multiplying age-specific prevalence by the corresponding age-specific population.
Results: In 2022, an estimated 823 million (95% credible interval (CrI) 754-901) adults had diabetes, an increase of 626 million (552-708) from 1990. From 1990 to 2022, age-standardised prevalence of diabetes increased with a posterior probability (PP) >0.80 by 2-22 percentage points in 130 countries for women and by 2-18 percentage points in 155 countries for men. The largest increases were in low- and middle-income countries in southeast Asia (e.g., Malaysia), south Asia (e.g., Pakistan), the Middle East and north Africa (e.g., Egypt), and Latin America and the Caribbean (e.g., Jamaica, Trinidad and Tobago, Costa Rica). Age-standardised prevalence decreased by 1-2 percentage points with a PP >0.80 in women in Japan, Spain and France; it neither increased nor decreased with a PP >0.80 in some Pacific island nations where prevalence was already high in 1990, as well as some countries in western and central Europe, sub-Saharan Africa and east Asia and the Pacific. The lowest prevalences in the world in 2022 were in western Europe and central and east Africa for both sexes, and in Japan and Canada for women. At the other extreme, age-standardised diabetes prevalence among women in 21 countries and men in 13 countries surpassed 25% in 2022. These included many countries in Polynesia and Micronesia (Nauru, Micronesia, Cook Islands, Marshall Islands, American Samoa, Tokelau), some in the Caribbean (e.g., Jamaica, Trinidad and Tobago) and the Middle East and north Africa (e.g., Egypt), as well as Pakistan and Malaysia.
In 2022, 445 million (95% CrI 401-495) adults aged 30+ years with diabetes did not receive treatment, 3.5 times of the number in 1990. Of those with untreated diabetes, 133 million (108-159) lived in India, 78 million (53-110) in China, followed by Pakistan, Indonesia, the USA and Bangladesh. From 1990 to 2022, diabetes treatment coverage increased with a PP >0.80 in 114 countries for women and 98 for men by 6-37 percentage points. The largest improvement in treatment coverage was in some countries from central and western Europe (e.g., Netherlands, Finland), Latin America (Mexico, Colombia, Chile, Costa Rica), Canada, South Korea, Russian Federation, Seychelles and Jordan. There was no increase in treatment coverage in most countries in sub-Saharan Africa, the Caribbean, Pacific island nations, and south, southeast and central Asia. In 2022, age-standardised treatment was lowest in countries in sub-Saharan Africa and south Asia, below 10% in some African countries. Treatment was ≥55% in South Korea, many high-income western countries, and some countries in central and eastern Europe (e.g., Poland, Czechia, Russian Federation), Latin America (e.g., Costa Rica, Chile, Mexico), and the Middle East and north Africa (Jordan, Qatar, Kuwait).
Interpretation: In the majority of countries, especially in low- and middle-income countries, diabetes treatment has not increased at all or has expanded insufficiently in comparison with the rise in prevalence. Together with population increase and ageing, this has substantially increased the number of people with diabetes who lack treatment and are at risk of complications, with the burden of diabetes and untreated diabetes increasingly borne by low- and middle-income countries.
Weblink: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02317-1/fulltext
Citation:
相关国际主流新闻媒体报道：
Financial Times, https://www.ft.com/content/40d098ed-129a-4116-83a1-7941c58bd9cf;
The Guardian, https://www.theguardian.com/society/2024/nov/13/diabetes-rates-increase-world-study;
The Telegraph, https://www.telegraph.co.uk/global-health/science-and-disease/millions-of-diabetics-worldwide-without-medication/;
The Indian Express, https://indianexpress.com/article/health-wellness/lancet-study-quarter-diabetics-globally-indians-9668262/;
The Times of India, https://timesofindia.indiatimes.com/city/mumbai/alarm-as-diabetes-cases-surpass-100-million-in-india/articleshow/115265182.cms