Is there a divergence in time trends in the prevalence of impaired glucose tolerance and diabetes? A systematic review in South Asian populations

Srinivasa V. Katikireddi; Joanne R. Morling; Raj Bhopal

doi:10.1093/ije/dyr159

Is there a divergence in time trends in the prevalence of impaired glucose tolerance and diabetes? A systematic review in South Asian populations

Srinivasa V. Katikireddi^*, Joanne R. Morling, Raj Bhopal

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

19 Citations (Scopus)

Abstract

Objective: Recently, diabetes prevalence has increased in South Asians making it a global public health priority. There are suggestions that pre-diabetes, including impaired glucose tolerance (IGT), may not be increasing. We conducted a systematic review to explore the paradox. Research Design and Methods: We searched electronic databases from inception to June 2009 for cross-sectional studies providing prevalence of pre-diabetes (using WHO criteria) in South Asian adult populations. Two reviewers independently screened articles, performed data extraction, quality appraisal and study classification with any discrepancies resolved by consensus. Repeated cross-sectional studies, categorized by pre-specified criteria, were used for the primary analysis, supplemented by analysis of comparable and all studies. Results: In total, 79 cross-sectional data sets (from 69 published studies) were identified resulting in the inclusion of 179 408 people. Four sets of repeated cross-sectional studies, conducted in Chennai, rural Tamil Nadu, Mauritius and Singapore (n = 30 399), provided time trend information. Three of them showed an increase in diabetes prevalence (P < 0.001) whereas IGT fell in two (P < 0.05), and was stable in the remainder. A similar pattern was seen among three other sets of comparable studies (n = 58 820) and in scatterplots of all 79 data sets. Conclusion: This novel systematic review is the first to assess secular trends of pre-diabetes in any population. The data show diabetes prevalence is rising, whereas IGT prevalence is stable or falling. Explanations include: recent environmental or lifestyle changes favouring an increased rate of conversion from IGT to diabetes, or a cohort effect with improving maternal and infant nutrition resulting in reduced IGT with a fall in diabetes to follow. Published by Oxford University Press on behalf of the International Epidemiological Association

Original language	English
Article number	dyr159
Pages (from-to)	1542-1553
Number of pages	12
Journal	International Journal of Epidemiology
Volume	40
Issue number	6
DOIs	https://doi.org/10.1093/ije/dyr159
Publication status	Published - Dec 2011
Externally published	Yes

Bibliographical note

Funding Information:
S.V.K was funded by NHS Education for Scotland during the conduct of this research and received a small grant from the University of Edinburgh for computer equipment.

Keywords

Diabetes mellitus
Epidemiology
Prevalence
Systematic review

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/ije/dyr159

Cite this

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title = "Is there a divergence in time trends in the prevalence of impaired glucose tolerance and diabetes? A systematic review in South Asian populations",

abstract = "Objective: Recently, diabetes prevalence has increased in South Asians making it a global public health priority. There are suggestions that pre-diabetes, including impaired glucose tolerance (IGT), may not be increasing. We conducted a systematic review to explore the paradox. Research Design and Methods: We searched electronic databases from inception to June 2009 for cross-sectional studies providing prevalence of pre-diabetes (using WHO criteria) in South Asian adult populations. Two reviewers independently screened articles, performed data extraction, quality appraisal and study classification with any discrepancies resolved by consensus. Repeated cross-sectional studies, categorized by pre-specified criteria, were used for the primary analysis, supplemented by analysis of comparable and all studies. Results: In total, 79 cross-sectional data sets (from 69 published studies) were identified resulting in the inclusion of 179 408 people. Four sets of repeated cross-sectional studies, conducted in Chennai, rural Tamil Nadu, Mauritius and Singapore (n = 30 399), provided time trend information. Three of them showed an increase in diabetes prevalence (P < 0.001) whereas IGT fell in two (P < 0.05), and was stable in the remainder. A similar pattern was seen among three other sets of comparable studies (n = 58 820) and in scatterplots of all 79 data sets. Conclusion: This novel systematic review is the first to assess secular trends of pre-diabetes in any population. The data show diabetes prevalence is rising, whereas IGT prevalence is stable or falling. Explanations include: recent environmental or lifestyle changes favouring an increased rate of conversion from IGT to diabetes, or a cohort effect with improving maternal and infant nutrition resulting in reduced IGT with a fall in diabetes to follow. Published by Oxford University Press on behalf of the International Epidemiological Association",

keywords = "Diabetes mellitus, Epidemiology, Prevalence, Systematic review",

author = "Katikireddi, {Srinivasa V.} and Morling, {Joanne R.} and Raj Bhopal",

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AU - Morling, Joanne R.

AU - Bhopal, Raj

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N2 - Objective: Recently, diabetes prevalence has increased in South Asians making it a global public health priority. There are suggestions that pre-diabetes, including impaired glucose tolerance (IGT), may not be increasing. We conducted a systematic review to explore the paradox. Research Design and Methods: We searched electronic databases from inception to June 2009 for cross-sectional studies providing prevalence of pre-diabetes (using WHO criteria) in South Asian adult populations. Two reviewers independently screened articles, performed data extraction, quality appraisal and study classification with any discrepancies resolved by consensus. Repeated cross-sectional studies, categorized by pre-specified criteria, were used for the primary analysis, supplemented by analysis of comparable and all studies. Results: In total, 79 cross-sectional data sets (from 69 published studies) were identified resulting in the inclusion of 179 408 people. Four sets of repeated cross-sectional studies, conducted in Chennai, rural Tamil Nadu, Mauritius and Singapore (n = 30 399), provided time trend information. Three of them showed an increase in diabetes prevalence (P < 0.001) whereas IGT fell in two (P < 0.05), and was stable in the remainder. A similar pattern was seen among three other sets of comparable studies (n = 58 820) and in scatterplots of all 79 data sets. Conclusion: This novel systematic review is the first to assess secular trends of pre-diabetes in any population. The data show diabetes prevalence is rising, whereas IGT prevalence is stable or falling. Explanations include: recent environmental or lifestyle changes favouring an increased rate of conversion from IGT to diabetes, or a cohort effect with improving maternal and infant nutrition resulting in reduced IGT with a fall in diabetes to follow. Published by Oxford University Press on behalf of the International Epidemiological Association

AB - Objective: Recently, diabetes prevalence has increased in South Asians making it a global public health priority. There are suggestions that pre-diabetes, including impaired glucose tolerance (IGT), may not be increasing. We conducted a systematic review to explore the paradox. Research Design and Methods: We searched electronic databases from inception to June 2009 for cross-sectional studies providing prevalence of pre-diabetes (using WHO criteria) in South Asian adult populations. Two reviewers independently screened articles, performed data extraction, quality appraisal and study classification with any discrepancies resolved by consensus. Repeated cross-sectional studies, categorized by pre-specified criteria, were used for the primary analysis, supplemented by analysis of comparable and all studies. Results: In total, 79 cross-sectional data sets (from 69 published studies) were identified resulting in the inclusion of 179 408 people. Four sets of repeated cross-sectional studies, conducted in Chennai, rural Tamil Nadu, Mauritius and Singapore (n = 30 399), provided time trend information. Three of them showed an increase in diabetes prevalence (P < 0.001) whereas IGT fell in two (P < 0.05), and was stable in the remainder. A similar pattern was seen among three other sets of comparable studies (n = 58 820) and in scatterplots of all 79 data sets. Conclusion: This novel systematic review is the first to assess secular trends of pre-diabetes in any population. The data show diabetes prevalence is rising, whereas IGT prevalence is stable or falling. Explanations include: recent environmental or lifestyle changes favouring an increased rate of conversion from IGT to diabetes, or a cohort effect with improving maternal and infant nutrition resulting in reduced IGT with a fall in diabetes to follow. Published by Oxford University Press on behalf of the International Epidemiological Association

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M1 - dyr159

ER -

Is there a divergence in time trends in the prevalence of impaired glucose tolerance and diabetes? A systematic review in South Asian populations

Abstract

Bibliographical note

Keywords

UN SDGs

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