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.
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Increases in glycaemia have resulted in a rise in prediabetes prevalence, although in some populations IGT has not risen despite increasing diabetes incidence.
“Increases in glycaemia have resulted in a rise in prediabetes prevalence, although in some populations IGT has not risen despite increasing diabetes incidence, probably because increases in obesity influence FPG more than 2-h glucose and because of improved detection of diabetes.8”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [8]
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Prediabetes: a high-risk state for diabetes development
Tabák, A. G., Herder, C., Rathmann, W., Brunner, E. J., & Kivimäki, M. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60283-9 · Cited by 2,958 · see citing works
- Authors
- Katikireddi, S. V., Morling, J. R., & Bhopal, R.
- Affiliations
- NHS Lothian (GB)
- Corresponding author
- Katikireddi, Srinivasa V
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-10-25
- Volume
- 40
- Issue
- 6
- Pages
- 1542-1553
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2107737178
- Cited by
- 28
- References
- 65
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 5 · 2016: 2 · 2015: 1 · 2014: 2 · 2013: 4 · 2012: 2
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- impaired glucose tolerance, diabetes prevalence, prediabetes, secular trends, South Asian populations, cohort effects, lifestyle modification
- MeSH terms
- Asia, Western, Cross-Sectional Studies, Diabetes Mellitus, Glucose, Glucose Tolerance Test, Humans, Prediabetic State, Prevalence
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