Global estimates of the prevalence of impaired glucose tolerance for 2013

and projections for 2035 1 InternationalDiabetes Federation, Brussels, Belgium

Leonor Guariguata 1, David R. Whiting 2, Ute 1
Linnenkamp , Jessica 1
Beagley , Jonathan Shaw 3 2 Directorate of Public Health, Medway Council, Chatham, United Kingdom

3 Baker IDI Heart and Diabetes Institute, Melbourne, Australia

Background Results Discussion

A total of 116 data sources were considered and 78 included, representing 63 countries. This The new estimates of IGT in adults quantifies the large burden of people at high risk of diabetes,
Diabetes is a serious and increasing global health burden. Impaired glucose especially in low and middle income countries. The prevalence of IGT is generally similar to that of
tolerance (IGT) is an asymptomatic condition defined by elevated (though study estimated that 316 million adults worldwide, 6.9% of adults, had IGT in 2013. This is in
addition to the 382 million people, 8.3% of adults, worldwide estimated to have diabetes. In 2035 diabetes, but somewhat higher than the diabetes prevalence in the European Region and lower
not diabetic) levels of blood glucose two hours after a 75g oral glucose than diabetes prevalence in the African and South-East Asia Regions.
challenge. IGT puts people at high risk of developing diabetes and is linked this study predicts that 471 million, 7.3% of adults, will have IGT, in addition to the 592 million,
10.1% of adults, who are predicted to have diabetes. Most people with IGT live in low- and A recent study (9) found that the age-standardised prevalence of IGT in Mauritius to be 15.3%
with the development of cardiovascular diseases.1-3 (13.5-17.1%). As this survey was not incorporated into the current IDF Atlas study, is was not
middle-income countries and these will experience the greatest increase in cases of diabetes
Aims and Objectives included in Table 1 . However, this survey will be considered for inclusion in future updates, and it is
over the next 22 years. The majority of adults with IGT (153 million) are less than 50 years of
The International Diabetes Federation (IDF) has produced estimates of the age, with almost one third belonging to the age-group 20-39 years. likely that Mauritius will be found in the top ten countries for prevalence of IGT in the next update of
prevalence of IGT since the year 2003.2-6 Previous estimates of the the IDF Diabetes Atlas.
prevalence of IGT have demonstrated a large and increasing burden, with As no other variables except from changes in the age and urban/rural distribution of the population
significant regional variability. The current estimates provide the latest figures Table 1 :Top 10 countries/ territories for prevalence *(%) of IGT (20-79 years ) 2013 and 2035
have been considered in producing the estimates for 2035, and that it is likely that the age-specific
based on the most recent and highest quality data on IGT prevalence for 219 Country/ 2013 Country/ 2035
countries and territories. prevalence will rise due to changes in lifestyle, the figures reported here may be underestimating
Territory (%) Territory (%) the futureFigure
burden
4: of IGT. of people with
Number Figure 5: Prevalence (%) of IGT (20-79
Kuwait 17.9 Poland 19.3 IGT by age (20-79 years), 2013 years) by age and sex, 2013
Methods
Qatar 17.1 Kuwait 18.1 and 2035 18%
We conducted a literature search of studies reporting the age-specific 200,000
prevalence for IGT and used the Analytic Hierarchy Process (AHP) to United Arab Emirates 16.6 Qatar 17.4
systematically select studies to generate estimates for 219 countries and Poland 16.5 United Arab Emirates 17.0 180,000 16%
territories. Data sources included country-level data sources from peer- Bahrain 16.3 Bahrain 16.7
reviewed studies, national health statistics reports, commissioned studies on 160,000 14%
Malaysia 15.2 Malaysia 15.3
diabetes prevalence, and unpublished data obtained through personal
Hong Kong SAR 13.3 Hong Kong SAR 13.2 140,000
communication. Estimates for countries without available source data were 12%
modelled from countries with similar ethnicity, geography, and income group. Nicaragua 12.9 Anguilla 13.0
Logistic regression was applied to generate smoothed age-specific Japan 12.6 Guadeloupe 13.0 120,000
10%
prevalence estimates for adults 20-79 years which were then applied to Singapore 12.4 Macau SAR 12.9 100,000
population estimates for 2013 and 2035. Logistic regression was used to * Age-adjusted prevalence
8%
generate estimates of the prevalence of IGT. The national* prevalence and
80,000
the age-adjusted** prevalence was generated for each country and territory. Figure 2 :Prevalence* (%) of IGT (20-79 years) per country, 2013 6%
Figure 1: Study design and data flow 60,000
4%
40,000
2%
20,000

- 0%
20 25 30 35 40 45 50 55 60 65 70 75
20-39 40-59 60-79
2013 2035 Male Female Total

Figure 6: Prevalence (%) of IGT (20-79 years) by age and income group, 2013
25%

20%

15%

10%
Figure 3 : Prevalence (%) of IGT (20-79 years) by IDF Region, 2013

Africa

*National or regional prevalence is the 5%

percentage of each country’s or region’s South and Central America

adult population that has IGT. It is ideal for

assessing the burden of IGT for each South-East Asia 0%
country or region. However, because the
20 25 30 35 40 45 50 55 60 65 70 75
prevalence of IGT increases with age, it Europe
cannot be used for comparing risk of IGT High income countries Upper middle income countries
between countries or regions which have
Western Pacific Lower middle income countries Low income countries
different age structures.

**Adjusted prevalence has been Middle East and North Africa Conclusion
calculated by assuming that every country In 2013, 316 million adults worldwide (6.9% of adults aged 20-79) had IGT. This is in addition to
and region has the same age profile. This North America and Carribean the 382 million people, 8.3% of adults, worldwide estimated to have diabetes. In 2035, 471
removes the differences of age between million (7.3% of adults aged 20-79) are predicted to have IGT, in addition to the 592 million
countries and regions, and makes this World (10.1% of adults aged 20-79) who are predicted to have diabetes.
figure ideal for making comparisons.
0% 2% 4% 6% 8% 10% 12%
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