Increasing prevalence of type 2 diabetes in a Scottish population: Effect of increasing incidence or decreasing mortality?
ABSTRACT We examined incidence, prevalence and mortality from type 2 diabetes mellitus in a Scottish population over 12 years, and evaluated the effects on prevalence of increasing incidence and decreasing mortality.
We used a diabetes clinical information system in Tayside (population 387,908), Scotland, to identify new cases of type 2 diabetes between 1993 and 2004 and to calculate incidence rates and mid-year prevalence. We defined mortality rates as the number of deaths of diabetic people divided by mid-year prevalence. We used logistic and Poisson regression to analyse trends. We then modelled the increase in prevalence for each year for three scenarios, based on whether mortality or incidence rates remained unchanged from 1993.
There was a doubling in incidence and prevalence of type 2 diabetes in Tayside over the 12 years, with statistically significant increasing trends of 6.3 and 6.7% per year respectively. The mortality rate decreased. If incidence and mortality had remained at 1993 levels, there would have been an increase in prevalence of 855 per 100,000 in 2003, accounting for 60.1% of the actual increase of 1,423 per 100,000. If there had been no mortality decrease, prevalence in 2003 would have been very similar to the actual prevalence observed.
Decreasing mortality rates in Tayside had less effect on the increase in prevalence than did increasing incidence. Even if incidence and mortality remain unchanged, prevalence will increase by over 20% in the next decade.
Full-textDOI: · Available from: Josie Evans, Jan 29, 2014
- SourceAvailable from: Knut Borch-Johnsen
- "and in Canada  . The Scottish system covers the entire population as of 2000 and is virtually complete, collecting information from several administrative databases to form the register; however the system is recently established , so no official publications for the total of Scotland exist, only from the pioneering region Tayside . The Canadian system is based in the National Diabetes Surveillance System (NDSS) that collects data from all states of Canada and issues reports annually . "
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ABSTRACT: INTRODUCTION: During the last decade, a number of population-based diabetes registers have emerged which have enhanced the population-based epidemiology of diabetes. The aim of this paper is to review research based on Danish diabetes registers and to compare with similar research in Finland, Sweden, Scotland, and Canada. RESEARCH TOPICS: The pattern with the highest prevalences in ages around 75 years is consistent between studies based on different registers, and so is the finding that incidence rates of diabetes are higher among females than males only in ages 20-40. Diabetes registers have been and is increasingly being used to study and particularly quantify links with cardiovascular disease and with cancer. Recently, available medication profiles of diabetes patients have been used as well to further elucidate these links. CONCLUSION: Diabetes registers are valuable sources of data for description of the trends in occurrence, development, and mortality of diabetes. However, it requires careful application of modern statistical methods since effects of calendar time, age, and duration of diabetes all have to be taken into account when reporting results.Scandinavian Journal of Public Health 07/2011; 39(7 Suppl):175-9. DOI:10.1177/1403494811404279 · 3.13 Impact Factor
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- "In the Tayside region (population ≈ 400,000), Scotland is a registry operating  based on record linkage from more sources than the Danish register. They found  similar prevalence of diabetes in 1996 (1.94% compared to 1.89% in Denmark) and similar increase in prevalence (6.7%/year, compared to 6.3%/year(M) and 6.6%/year(F) in Denmark). In the Skaraborg region BxC, JKK, PO & KBJo: (population ≈ 300,000) Sweden, a registry based on clinical recordings of patients  found a prevalence of 3.2% in 1995, somewhat higher than found in Denmark. "
ABSTRACT: The aim of the study was to describe trends in the incidence rate, prevalence and mortality rate for diabetes in Denmark. Healthcare registers at the National Board of Health were used to compile a register of diabetic patients in the Danish population (5.4 million people). Age- and sex-specific prevalence, incidence rates, mortality rates and standardised mortality ratios relative to the non-diabetic part of the population were calculated. The register contains records for about 360,000 persons with diabetes; 230,000 were alive at 1 January 2007, corresponding to an overall prevalence of 4.2%. The prevalence increased by 6% per year. In 2004 the incidence rates were 1.8 per 100,000 at age 40 years and 10.0 per 100,000 at age 70 years. The incidence rate increased 5% per year before 2004 and then stabilised. The mortality rate in the diabetic population decreased 4% per year, compared with 2% per year in the non-diabetic part of the population. The mortality rate decreased 40% during the first 3 years after inclusion in the register. The standardised mortality ratio decreased with age, from 4.0 at age 50 years to 2.5 at age 70 years and just under 2 at age 85 years, identically for men and women. The standardised mortality ratio decreased 1% per calendar year. The lifetime risk of diabetes was 30%. The prevalence of diabetes in Denmark rose in 1995-2006, but the mortality rate in diabetic patients decreased faster than that of the non-diabetic population. The mortality rate decreased markedly just after inclusion in the register. Incidence rates have shown a tendency to decrease during the last few years, but this finding should be viewed with caution.Diabetologia 10/2008; 51(12):2187-96. DOI:10.1007/s00125-008-1156-z · 6.88 Impact Factor
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- "We observed a considerable increase in the prevalence of diabetes of about 1% annually. These fi ndings are in accordance with results of other epidemiologic studies in North America and the Mediterranean region, which suggests that, apart from the increase in the prevalence of diabetes, an increased incidence of diabetes also occurred during the last 30 years worldwide (Geiss et al 2006; Fox et al 2006; Evans et al 2007). For example, the prevalence of diabetes in Greece is close to the prevalence in USA (ie, 9.6%) (Geiss et al 2006), in Spain (ie, 11%) (Velverde Table 1 Five-year incidence of type 2 diabetes mellitus in men and women by age group. "
ABSTRACT: We evaluated the 5-year incidence of diabetes in an adult population from Greece. 3042 individuals (>18 years), free of cardiovascular disease, participated in the baseline examination (during 2001-2002). Of this sample, 1012 men and 1035 women were found alive at the time of follow-up, while 32 (2.1%) men and 22 (1.4%) women died during this period. The rest were lost to follow-up. Incidence of type 2 diabetes mellitus was evaluated in 1806 participants who did not have diabetes at baseline. The age-adjusted 5-year incidence of diabetes was 5.5% (men, 5.8%; women, 5.2%). A linear trend was observed between diabetes incidence and age (5.6% increases in incidence per 1-year difference in age, p<0.001). Multiple logistic regression analysis revealed that age (OR per 1 yr=1.04, 95% CI 1.02-1.06), waist (OR per 1 cm=1.02, 95% CI 1.01-1.003), physical activity (OR=0.62, 95% CI 0.35-1.02) and family history of diabetes (OR=2.65, 95% CI 1.58-4.53), as well as fasting glucose levels (OR per 1 mg/dl=1.05, 95% CI 1.03-1.07), were the most significant baseline predictors for diabetes, after adjusting for various potential confounders. Additionally, presence of metabolic syndrome at baseline evaluation 2.95-fold the risk of diabetes (95% CI 1.89-4.61), and showed better classification ability than the model that contained the components of the syndrome (ie, correct classification rate: 94.5% vs. 92.3%). Our findings show that a 5.5% incidence rate of diabetes within a 5-year period, which suggests that the prevalence of this disorder in Greece is rising. Aging, heredity, and metabolic syndrome were the most significant determinants of diabetes.Vascular Health and Risk Management 02/2008; 4(3):691-8.