IDF Diabetes Atlas estimates for the global diabetes prevalence of adults aged 18 to 99 years

Yadi Huang1, Katherine Ogurtsova1, Joao da Rocha Fernandes1, David Cavan1, Lydia E Makaroff1, Jonathan Shaw2, Nam Han Cho3
1International Diabetes Federation, Brussels, Belgium 2Baker IDI Heart and Diabetes Institute, Melbourne, Australia 3 Dependent in Preventive Medicine, Ajou Univeristy School of Medicine, Suwan , Korea

Introduction: Diabetes is one of the largest global health emergencies of the
21st century. There is a global increase in the number of people living with
diabetes resulting in significant increase in mortality and heath expenditures. In
2015, the International Diabetes Federation reported that there were 415
million adults aged 20 to 79 with diabetes, and this number is expected to
increase to 642 million in 2040 However, the number did not include diabetes in
people older than 80, and as there are some countries that report high diabetes
prevalence in people older than 80, therefore, new estimations were made for
an expanded age group from 18 to 99 years.
Results: After age expansion from 20-79 to 18-99 years, there was also a shift in the top 10
The diabetes prevalence was estimated to be 8.8% from ages 20 to 79 years in 2015 by IDF. (1) countries with the most people living with diabetes. China, India, US, Brazil, Russia,
After age expansion to 18 to 99 yeas, the diabetes prevalence was estimated to be 8.7% and the Mexico, Indonesia still keep the same rank of the most people living with diabetes
total number of people living with diabetes from age 18 to 99 years was estimated to be after age expansion. However, Japan (from 9th to 8th) and Germany (from 12th to
approximate 440 million in 2015, which was 25 million more than the number of people with 10th) ranked higher after age expansion, which is an indication that those countries
diabetes from age 20 to 79 years. have higher population older than 80 years. (Table 1)
Figure 3: Number of people with diabetes by IDF region Figure 4: Prevalence of Diabetes by age groups
180 162 12% 18-99 20-79
153

Number of people with diabetes

160 25%
10%
Methodology: The method of the country level diabetes prevalence estimation 140

Relative expansion

Diabetes Prevalence
20%
is the same as described in the methodology chapter of IDF Diabetes Atlas 7th 120 8%

(in millions)
Edition (1). Approximately, 27% of data sources reported diabetes prevalence in 100 15%
78 80 6%
ages lower than 20, and about 15% of data sources reported diabetes 66
80 60
prevalence in age solder than 80. (Figure 1).
Data sources were selected according to study quality, only data sources high in 60 44 49 4% 10%
35 37 30 31
quality were selected for analysis. A generalized linear model was used to 40 5%
estimate the country level age-dependent diabetes prevalence per data 14 16 2%
20
sources. The main methodological change introduced was the expansion of age 0%
0 0%
groups considered, from 20-79 years to 18-99 years. For countries without any

18-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95-99
data sources, extrapolation was used based on studies from similar countries in AFR EUR MENA NAC SACA SEA WP
respect to their geography, economic classification, and ethnicity. (Figure 2) IDF region
20-79 age range 18-99 age range Relative expansion Age group
Figure1: Age group distribution among all data sources
60% 55% The prevalence of diabetes in the world population increased from age 19 until 74
The total number of people with diabetes, aged 18-99 years, in the seven IDF regions were
years, with age group 70-74 years having the highest prevalence (19.4%) among all
Percentage of

39% estimated to be: 162 million in Western Pacific (WP); 80 million in South East Asia (SEA); 66
40% age groups. After the 70-74 year age-group, however, diabetes prevalence slightly
studies

27% million in Europe (EUR); 49 million in North America and Caribbean (NAC); 36 million in Middle
15% decreased. (Figure 4)
20% East and North Africa (MENA); 32 million in South and Central America (SACA); and 16 million in
Africa (AFR). (Figure 3) The number of people living with diabetes was 11% higher when the age
0% range was expanded from 20-79 to 18-99 years in Europe, which was the largest percentage Figure 5: Prevalence of Diabetes by economic classification
<20 <25 Age range >70 >80 increase among all seven IDF regions. South East Asia had the smallest percentage increase (3%) LIC MIC HIC
among all seven IDF regions. (Figure 3) 25%
Figure 2 : Work flow of diabetes estimating procedure

Diabetes Prevalence
Table 1: Top 10 countries of most people living with diabetes 20%

Country level data from: 15%

• Peer reviewed journals Rank Country Number of Country Number of
• National Health Survey (18-99) People with (20-79) People with 10%
• WHO STEPS survey Diabetes Diabetes
• Unpublished personal communication (18-99) (20-79) 5%

1 China 114.1 million China 109.6 million 0%

18-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95-99
2 India 70.2 million India 69.2 million
High quality data sources selected through analytic
hierarchy process Age group
3 US 32.8 million US 29.3 million
High quality data Low quality Figure 5 shows that Low-income countries (LIC) had the lowest diabetes prevalence
data or no data 4 Brazil 15.4 million Brazil 14.3 million
at all age groups, while Middle-income countries (MIC) had the highest diabetes
Extrapolation based prevalence at age 18-64 years, and high income countries (HIC) had the highest
Generalized linear 5 Russia 12.6 million Russia 12.1 million
on data from similar prevalence for ages over 64 years. The prevalence of diabetes peaked in the 55-59
model applied
countries* year age-group (7.1%) in LICs, at the 65-69 year age group (19.6%) in MICs, and at
6 Mexico 11.9 million Mexico 11.5 million the 75-79 year age-group in HICs (21.5%). (Figure 5)

7 Indonesia 10.2 million Indonesia 10 million

Conclusion: in the year 2015, the estimated total number of people aged 18-99
UN Population estimates 2015 applied
years living with diabetes was 440 million. Work is needed in order to implement
8 Japan* 8.2 million Egypt* 7.8 million action plans for the prevention and control of diabetes and related complications
to reduce the social and economic burden.
Country-level gender-specific diabetes prevalence 9 Egypt* 8.1 million Japan* 7.2 million
estimates by urban/rural 5 year age group References:
1. International Diabetes Federation IDF Diabetes Atlas , 7ed. Brussels, Belgium : International Diabetes Federation 2015
10 Germany* 7.8 million Bangladesh* 7.1 million
*similarities based on ethnic groups, languages spoken, country’s income Presented at the American Diabetes Association 77th in the category 16-F-Epidemioloty-other, presentation number
level, and geographic location 1671-P
*The countries which ranks are changed after age expansion
The 7th Edition of the IDF Diabetes Atlas was supported by the following sponsors: Lilly Diabetes, Merck and Co, Inc., Novo Nordisk
A/S supported through an unrestricted grant by the Novo Nordisk Changing Diabetes® initiative, Pfizer, Inc., and Sanofi Diabetes