Global Estimates for Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in Adults
Abstract
Objective— To assemble standardized estimates of abnormal glucose tolerance in adults in diverse communities worldwide and provide guidelines for the derivation of comparable estimates in future epidemiological studies. Research Design and Methods— The project was limited to population-based investigations that had used current WHO criteria for diagnosis and classification of abnormal glucose tolerance. Raw data were obtained by WHO from surveys conducted during 1976–1991 of over 150,000 persons from 75 communities in 32 countries. Data within the truncated age range of 30–64 yr were adjusted to the standard world population of Segi. Age-specific prevalences also are reported for selected populations. Results— Within the chosen age range, diabetes was absent or rare (<3%) in some traditional communities in developing countries. In European populations, age-standardized prevalence varied from 3 to 10%. Some Arab, migrant Asian Indian, Chinese, and Hispanic American populations were at higher risk with prevalences of 14–20%. The highest prevalences were found in the Nauruans (41%) and the Pima/Papago Indians (50%). Age-standardized prevalence of IGT was low (<3%) in some Chinese, traditional American Indian, and Pacific island populations. Moderate (3–10%) or high (11–20%) prevalences of IGT were observed in many populations worldwide. The highest estimates for prevalence of IGT were seen in female Muslim Asian Indians in Tanzania (32%) and in urban male Micronesians in Kiribati (28%). Prevalence of diabetes rose with age in all populations in which age-specific data were examined. This trend was most pronounced in those at moderate to high risk. The ratio of prevalence of diabetes in men versus women varied markedly between populations with little discernable trend, although IGT was generally more common in women. In most communities, at least 20% of diabetes cases were unknown before the survey, and in many communities, >50% were previously undiagnosed. In both Chinese and Indian migrant populations, relative prevalence was high when compared with indigenous communities. Conclusions— Diabetes in adults is now a global health problem, and populations of developing countries, minority groups, and disadvantaged communities in industrialized countries now face the greatest risk.
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Type 2 diabetes mellitus is strongly associated with obesity in most, but not all, ethnic groups, suggesting important ethnic differences in disease susceptibility.
“Type 2 diabetes mellitus (T2DM) is strongly associated with obesity in most, but not all, ethnic groups, suggesting important ethnic differences in disease susceptibility.”
From Increased prevalence of insulin resistance and nonalcoholic fatty liver disease in Asian-Indian men (2006) · cites this paper as [5]
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“Of the persons with diabetes, 70% were not previously aware of their diabetic status, which is more than in European populations (24).”
BackgroundResultType 2 Diabetes: An Epidemic Requiring Global Attention and Urgent Action
Herman, W. H., & Zimmet, P. (2012) · Diabetes Care · doi:10.2337/dc12-0298 · Cited by 152 · see citing works
Childhood Predictors of Young-Onset Type 2 Diabetes
Franks, P. W., Hanson, R. L., Knowler, W. C., Moffett, C. D., Enos, G., Infante, A. M., Krakoff, J. A., & Looker, H. C. (2007) · Diabetes · doi:10.2337/db06-1639 · Cited by 148 · see citing works
“Indeed, in high risk populations, such as American Indians and those exposed to diabetes in utero, the prevalence of T2DM during youth exceeds the rates during adulthood in low risk populations (28).”
BackgroundPrevalence of type 2 diabetes mellitus among inland residents in China (2000–2014): A meta‐analysis
Yang, L., Shao, J., Bian, Y., Wu, H., Shi, L., Zeng, L., Li, W., & Dong, J. (2016) · Journal of Diabetes Investigation · doi:10.1111/jdi.12514 · Cited by 150 · see citing works
Williams, J. W., Zimmet, P. Z., Shaw, J. E., De Courten, M. P., Cameron, A. J., Chitson, P., Tuomilehto, J., & Alberti, K. G. M. M. (2003) · Diabetic Medicine · doi:10.1046/j.1464-5491.2003.01059.x · Cited by 148 · see citing works
Prevalence of diabetes in Catalonia (Spain): an oral glucose tolerance test-based population study
Castell, C., Tresserras, R., Serra, J., Goday, A., Lloveras, G., & Salleras, L. (1999) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(98)00125-9 · Cited by 146 · see citing works
Amylopectin Starch Promotes the Development of Insulin Resistance in Rats
Byrnes, S. E., Brand-Miller, J. C., & Denyer, G. S. (1995) · Journal of Nutrition · doi:10.1093/jn/125.6.1430 · Cited by 145 · see citing works
The carnivore connection: dietary carbohydrate in the evolution of NIDDM
Brand-Miller, J. C., & Colagiuri, S. (1994) · Diabetologia · doi:10.1007/bf00399803 · Cited by 156 · see citing works
“Nauruans, the prevalence of NIDDM has reached epidemic proportions [1] while in other groups, such as the Australian Aborigines, the prevalence is several times higher than that of non-Aboriginal Australians.”
BackgroundGillett, M., Royle, P., Snaith, A., Scotland, G., Poobalan, A. S., Imamura, M., Black, C., Boroujerdi, M. A., Jick, S. S., Wyness, L., et al. (2012) · Health Technology Assessment · doi:10.3310/hta16330 · Cited by 147 · see citing works
Diabetes and cancer risk for all and specific sites among Japanese men and women
Kuriki, K., Hirose, K., & Tajima, K. (2007) · European Journal of Cancer Prevention · doi:10.1097/01.cej.0000228404.37858.40 · Cited by 145 · see citing works
Pyranocoumarins: A new class of anti-hyperglycemic and anti-dyslipidemic agents
Kumar, A., Maurya, R. A., Sharma, S., et al. (2009) · Bioorganic & Medicinal Chemistry Letters · doi:10.1016/j.bmcl.2009.09.031 · Cited by 145 · see citing works
Prevalence of known and undetected diabetes and associated risk factors in central Kerala — ADEPS
Menon, V. U., Kumar, K., Gilchrist, A. I., Sugathan, T. N., Sundaram, K. R., Nair, V., & Kumar, H. (2006) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2006.03.025 · Cited by 145 · see citing works
Thiazolidinedione Drugs and Cardiovascular Risks
Kaul, S., Bolger, A. F., Herrington, D. M., Giugliano, R. P., & Eckel, R. H. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.02.014 · Cited by 143 · see citing works
Genetic analysis of obese diabetes in the TSOD mouse.
Hirayama, I., Yi, Z., Izumi, S., et al. (1999) · Diabetes · doi:10.2337/diabetes.48.5.1183 · Cited by 142 · see citing works
INTER-HEART: A global study of risk factors for acute myocardial infarction
Ôunpuu, S., Negassa, A., & Yusuf, S. (2001) · American Heart Journal · doi:10.1067/mhj.2001.114974 · Cited by 140 · see citing works
Type 2 diabetes and impaired glucose tolerance in aboriginal populations: A global perspective
Yu, C. H. Y., & Zinman, B. (2007) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2007.03.022 · Cited by 139 · see citing works
- Authors
- King, H., Rewers, M., & Who Ad Hoc Diabetes Reporting Group
- Affiliations
- World Health Organization (CH)
- ORCID
- Rewers, Marian
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1993-01-01
- Volume
- 16
- Issue
- 1
- Pages
- 157-177
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2163949492
- Cited by
- 886
- References
- 0
- Citations by year
- 2025: 1 · 2024: 9 · 2023: 8 · 2022: 11 · 2021: 13 · 2020: 10 · 2019: 17 · 2018: 14 · 2017: 15 · 2016: 13 · 2015: 24 · 2014: 30 · 2013: 30 · 2012: 32
- FWCI
- 19.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK030747, DK 30747)
- 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 › Health Professions › Health Information Management › Global Health and Epidemiology
- Keywords
- diabetes mellitus, impaired glucose tolerance, diabetes prevalence, global prevalence estimates, age-standardized prevalence, sex differences in diabetes, undiagnosed diabetes, migrants, ethnic groups, traditional communities, Asian Indians, Micronesian population
- MeSH terms
- Adult, Age Factors, Biometry, Diabetes Mellitus, Ethnicity, Female, Glucose Tolerance Test, Humans, Hyperglycemia, Male, Middle Aged, Prevalence, Racial Groups
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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