Population aging, macroeconomic changes, and global diabetes prevalence, 1990-2008

Area of Science:

• Epidemiology
• Public Health
• Gerontology

Background:

• Diabetes mellitus is a significant global health concern, contributing substantially to morbidity and mortality.
• The specific impacts of population aging and macroeconomic shifts on the increasing prevalence of diabetes over two decades remain incompletely understood.

Purpose of the Study:

• To quantify the influence of population aging on the rise in global diabetes prevalence from 1990 to 2008.
• To assess the role of age composition in diabetes prevalence disparities between high-income countries (HICs) and low-to-middle-income countries (LMICs).
• To investigate the association between macroeconomic changes and the increasing prevalence of diabetes.

Main Methods:

• Utilized cross-sectional data on diabetes prevalence, population estimates, and macroeconomic variables for 1990, 2000, and 2008.
• Employed decomposition analysis to determine the contribution of population aging to changes in global diabetes prevalence.
• Applied age-standardization to compare diabetes prevalence between HICs and LMICs and used regression analyses to examine macroeconomic influences.

Main Results:

• Global diabetes prevalence increased from 7.4% in 1990 to 9.4% in 2008.
• Population aging accounted for 19% of this growth; 81% was due to increased age-specific prevalences, particularly in the 45-65 age group.
• Age-standardized differences in prevalence between LMICs and HICs persisted, and no association was found between macroeconomic changes and diabetes prevalence growth.

Conclusions:

• Population aging is a minor factor in the recent increase in global diabetes prevalence.
• The primary driver of rising diabetes rates globally between 1990 and 2008 was increased prevalence in the 45-65 age demographic.
• Economic growth, development, globalization, and urbanization indicators showed no correlation with the observed rise in diabetes levels.