Evidence map›Paper›PMID 33636102›Full record

SynthesisThe lancet. Diabetes & endocrinology2021

Trends in the incidence of diagnosed diabetes: a multicountry analysis of aggregate data from 22 million diagnoses in high-income and middle-income settings.

Dianna J Magliano, Lei Chen, Rakibul M Islam, Bendix Carstensen, Edward W Gregg, Meda E Pavkov, Linda J Andes, Ran Balicer, Marta Baviera, Elise Boersma-van Dam and 35 more

Open access · greenAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The lancet. Diabetes & endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
82citing papers in PubMed, 3 pooled it
18.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

82 citing papers in PubMed, 3 syntheses or guidelines pooled it, 172 citations in OpenAlex.

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  6. Type 2 diabetes in Norway 2009-2021: Have declining incidence rates continued?Diabetic medicine : a journal of the British Diabetic Association · 2026
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22 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

45 authors at 20 institutions in 19 countries.

Dianna J MaglianoDepartment of Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. Electronic address: dianna.magliano@baker.edu.au.
Lei ChenDepartment of Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
Rakibul M IslamSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Bendix CarstensenClinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark.
Edward W GreggDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
Meda E PavkovDivision of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Linda J AndesDivision of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Ran BalicerClalit Research Institute, Clalit Health Services, Tel Aviv, Israel.
Marta BavieraLaboratory of Cardiovascular Prevention, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy.
Elise Boersma-van DamDepartment of General Practice, Netherlands Institute for Health Services Research, Utrecht, Netherlands.
Gillian L BoothDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Juliana C N ChanDepartment of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Yi Xian ChuaEpidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore.
Sandrine Fosse-EdorhDepartment of Non-Communicable Diseases and Trauma, Santé Publique France, Saint-Maurice, France.
Sonsoles FuentesDepartment of Non-Communicable Diseases and Trauma, Santé Publique France, Saint-Maurice, France.
Hanne L GulsethDepartment for Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.
Romualdas GureviciusCenter of Health Information, Institute of Hygiene, Vilnius, Lithuania; Faculty of Public Governance and Business, Mykolas Romeris University, Vilnius, Lithuania.
Kyoung Hwa HaDepartment of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea.
Thomas R HirdDepartment of Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
György Jermendy3rd Medical Department, Bajcsy-Zsilinszky Hospital, Budapest, Hungary.
Mykola D KhalangotKomisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences, Kyiv, Ukraine; Endocrinology Department, Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine.
Dae Jung KimDepartment of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea.
Zoltán Kiss2nd Department of Medicine and Nephrological Center, Medical Faculty, University of Pécs, Pécs, Hungary.
Victor I KravchenkoKomisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences, Kyiv, Ukraine.
Maya Leventer-RobertsClalit Research Institute, Clalit Health Services, Tel Aviv, Israel; Department of Pediatrics and Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Chun-Yi LinGeneral Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan.
Andrea O Y LukDepartment of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Manel Mata-CasesCIBER of Diabetes and Associated Metabolic Diseases, Instituto de Salud Carlos III, Barcelona, Spain; DAP-Cat Group, Institut Català de la Salut, Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain.
Didac MauricioCIBER of Diabetes and Associated Metabolic Diseases, Instituto de Salud Carlos III, Barcelona, Spain; DAP-Cat Group, Institut Català de la Salut, Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain; Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain.
Gregory A NicholsScience Programs Department, Kaiser Permanente Center for Health Research, Portland, OR, USA.
Mark M NielenDepartment of General Practice, Netherlands Institute for Health Services Research, Utrecht, Netherlands.
Deanette PangEpidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore.
Sanjoy K PaulMelbourne EpiCentre, University of Melbourne, Melbourne, VIC, Australia.
Catherine PelletierCentre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada.
Santa PildavaResearch and Health Statistics Department, Centre for Disease Prevention and Control, Riga, Latvia.
Avi PorathResearch Institute, Maccabi Healthcare Services, Tel Aviv, Israel; Faculty of Health, Ben Gurion University, Beer-Sheva, Israel.
Stephanie H ReadUsher Institute, University of Edinburgh, Edinburgh, UK.
Maria Carla RoncaglioniLaboratory of Cardiovascular Prevention, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy.
Paz Lopez-Doriga RuizDepartment for Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
Marina ShestakovaDiabetes Institute, Endocrinology Research Center, Moscow, Russia.
Olga VikulovaDiabetes Institute, Endocrinology Research Center, Moscow, Russia.
Kang-Ling WangGeneral Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan.
Sarah H WildUsher Institute, University of Edinburgh, Edinburgh, UK.
Naama YekutielResearch Institute, Maccabi Healthcare Services, Tel Aviv, Israel.
Jonathan E ShawDepartment of Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Life Sciences, Latrobe University, Bundoora, VIC, Australia.
Monash University · AUAjou University · KRBaker Heart and Diabetes Institute · AUCenters for Disease Control and Prevention · USChinese University of Hong Kong · CNEndocrinology Research Center · RUInstituto de Salud Carlos III · ESMario Negri Institute for Pharmacological Research · ITMinistry of Health · SGNetherlands Institute for Health Services Research · NLNorwegian Institute of Public Health · NOSanté Publique France · FRTaipei Veterans General Hospital · TWUniversity of Edinburgh · GBBajcsy-Zsilinszky Kórház és Rendelőintézet · HUBen-Gurion University of the Negev · ILClalit Health Services · ILIcahn School of Medicine at Mount Sinai · USImperial College London · GBKaiser Permanente Center for Health Research · US

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

backgroundDiabetes prevalence is increasing in most places in the world, but prevalence is affected by both risk of developing diabetes and survival of those with diabetes. Diabetes incidence is a better metric to understand the trends in population risk of diabetes. Using a multicountry analysis, we aimed to ascertain whether the incidence of clinically diagnosed diabetes has changed over time.

methodsIn this multicountry data analysis, we assembled aggregated data describing trends in diagnosed total or type 2 diabetes incidence from 24 population-based data sources in 21 countries or jurisdictions. Data were from administrative sources, health insurance records, registries, and a health survey. We modelled incidence rates with Poisson regression, using age and calendar time (1995-2018) as variables, describing the effects with restricted cubic splines with six knots for age and calendar time.

findingsOur data included about 22 million diabetes diagnoses from 5 billion person-years of follow-up. Data were from 19 high-income and two middle-income countries or jurisdictions. 23 data sources had data from 2010 onwards, among which 19 had a downward or stable trend, with an annual estimated change in incidence ranging from -1·1% to -10·8%. Among the four data sources with an increasing trend from 2010 onwards, the annual estimated change ranged from 0·9% to 5·6%. The findings were robust to sensitivity analyses excluding data sources in which the data quality was lower and were consistent in analyses stratified by different diabetes definitions.

interpretationThe incidence of diagnosed diabetes is stabilising or declining in many high-income countries. The reasons for the declines in the incidence of diagnosed diabetes warrant further investigation with appropriate data sources.

fundingUS Centers for Disease Control and Prevention, Diabetes Australia Research Program, and Victoria State Government Operational Infrastructure Support Program.

Indexed as

Data AggregationInternationalityDiabetes Mellitus, Type 2Global HealthHumansIncidenceIncome

Identifiers

PMID33636102
PMCPMC10984526
OpenAlexW3130307224

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.