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Variations in Diabetes Prevalence in Low-, Middle-, and High-Income Countries: Results From the Prospective Urban and Rural Epidemiological Study Publisher Pubmed



Dagenais GR1 ; Gerstein HC2 ; Zhang X2 ; Mcqueen M2 ; Lear S3 ; Lopezjaramillo P4 ; Mohan V5 ; Mony P6 ; Gupta R7 ; Kutty VR8 ; Kumar R9 ; Rahman O10 ; Yusoff K11, 12 ; Zatonska K13 Show All Authors
Authors
  1. Dagenais GR1
  2. Gerstein HC2
  3. Zhang X2
  4. Mcqueen M2
  5. Lear S3
  6. Lopezjaramillo P4
  7. Mohan V5
  8. Mony P6
  9. Gupta R7
  10. Kutty VR8
  11. Kumar R9
  12. Rahman O10
  13. Yusoff K11, 12
  14. Zatonska K13
  15. Oguz A14
  16. Rosengren A15
  17. Kelishadi R16
  18. Yusufali A17
  19. Diaz R18
  20. Avezum A19
  21. Lanas F20
  22. Kruger A21
  23. Peer N22, 23
  24. Chifamba J24
  25. Iqbal R25
  26. Ismail N26
  27. Xiulin B27
  28. Jiankang L28
  29. Wenqing D29
  30. Gejie Y30
  31. Rangarajan S2
  32. Teo K2
  33. Yusuf S2

Source: Diabetes Care Published:2016


Abstract

OBJECTIVE: The goal of this study was to assess whether diabetes prevalence varies by countries at different economic levels and whether this can be explained by known risk factors. RESEARCH DESIGN AND METHODS: The prevalence of diabetes, defined as self-reported or fasting glycemia ≥7 mmol/L, was documented in 119,666 adults from three high-income (HIC), seven uppermiddle-income (UMIC), four lower-middle-income (LMIC), and four low-income (LIC) countries. Relationships between diabetes and its risk factors within these country groupings were assessed using multivariable analyses. RESULTS: Age- and sex-adjusted diabetes prevalences were highest in the poorer countries and lowest in the wealthiest countries (LIC 12.3%, UMIC 11.1%, LMIC 8.7%, and HIC 6.6%; P < 0.0001). In the overall population, diabetes risk was higher with a 5-year increase in age (odds ratio 1.29 [95% CI 1.28-1.31]), male sex (1.19 [1.13-1.25]), urban residency (1.24 [1.11-1.38]), low versus high education level (1.10 [1.02-1.19]), low versus high physical activity (1.28 [1.20-1.38]), family history of diabetes (3.15 [3.00-3.31]), higher waist-to-hip ratio (highest vs. lowest quartile; 3.63 [3.33-3.96]), and BMI (≥35 vs. <25 kg/m2; 2.76 [2.52-3.03]). The relationship between diabetes prevalence and both BMI and family history ofdiabetes differed in higher-versus lower-income country groups (P for interaction < 0.0001). After adjustment for all risk factors and ethnicity, diabetes prevalences continued to show a gradient (LIC 14.0%, LMIC 10.1%, UMIC 10.9%, and HIC 5.6%). CONCLUSIONS: Conventional risk factors do not fully account for the higher prevalence of diabetes in LIC countries. These findings suggest that other factors are responsible for the higher prevalence of diabetes in LIC countries. © 2016 by the American Diabetes Association.
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