Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c
Issued Date
2023-01-01
Resource Type
ISSN
10788956
eISSN
1546170X
Scopus ID
2-s2.0-85176735771
Pubmed ID
37946056
Journal Title
Nature Medicine
Rights Holder(s)
SCOPUS
Bibliographic Citation
Nature Medicine (2023)
Suggested Citation
Zhou B., Sheffer K.E., Bennett J.E., Gregg E.W., Danaei G., Singleton R.K., Shaw J.E., Mishra A., Lhoste V.P.F., Carrillo-Larco R.M., Kengne A.P., Phelps N.H., Heap R.A., Rayner A.W., Stevens G.A., Paciorek C.J., Riley L.M., Cowan M.J., Savin S., Vander Hoorn S., Lu Y., Pavkov M.E., Imperatore G., Aguilar-Salinas C.A., Ahmad N.A., Anjana R.M., Davletov K., Farzadfar F., González-Villalpando C., Khang Y.H., Kim H.C., Laatikainen T., Laxmaiah A., Mbanya J.C.N., Narayan K.M.V., Ramachandran A., Wade A.N., Zdrojewski T., Abbasi-Kangevari M., Rahim H.F.A., Abu-Rmeileh N.M., Adambekov S., Adams R.J., Aekplakorn W., Agdeppa I.A., Aghazadeh-Attari J., Agyemang C., Ahmadi A., Ahmadi N., Ahmadi N., Ahmed S.H., Ajlouni K., Al-Hinai H., Al-Lahou B., Al-Lawati J.A., Asfoor D.A., Al Qaoud N.M., Alarouj M., AlBuhairan F., AlDhukair S., Aldwairji M.A., Ali M.M., Alinezhad F., Alkandari A., Alomirah H.F., Aly E., Amarapurkar D.N., Andersen L.B., Anderssen S.A., Andrade D.S., Ansari-Moghaddam A., Aounallah-Skhiri H., Aris T., Arlappa N., Aryal K.K., Assah F.K., Assembekov B., Auvinen J., Avdičová M., Azad K., Azimi-Nezhad M., Azizi F., Bacopoulou F., Balakrishna N., Bamoshmoosh M., Banach M., Bandosz P., Banegas J.R., Barbagallo C.M., Barceló A., Baretić M., Barrera L., Basit A., Batieha A.M., Batista A.P., Baur L.A., Belavendra A., Ben Romdhane H., Benet M., Berkinbayev S. Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c. Nature Medicine (2023). doi:10.1038/s41591-023-02610-2 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/91220
Title
Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c
Author(s)
Zhou B.
Sheffer K.E.
Bennett J.E.
Gregg E.W.
Danaei G.
Singleton R.K.
Shaw J.E.
Mishra A.
Lhoste V.P.F.
Carrillo-Larco R.M.
Kengne A.P.
Phelps N.H.
Heap R.A.
Rayner A.W.
Stevens G.A.
Paciorek C.J.
Riley L.M.
Cowan M.J.
Savin S.
Vander Hoorn S.
Lu Y.
Pavkov M.E.
Imperatore G.
Aguilar-Salinas C.A.
Ahmad N.A.
Anjana R.M.
Davletov K.
Farzadfar F.
González-Villalpando C.
Khang Y.H.
Kim H.C.
Laatikainen T.
Laxmaiah A.
Mbanya J.C.N.
Narayan K.M.V.
Ramachandran A.
Wade A.N.
Zdrojewski T.
Abbasi-Kangevari M.
Rahim H.F.A.
Abu-Rmeileh N.M.
Adambekov S.
Adams R.J.
Aekplakorn W.
Agdeppa I.A.
Aghazadeh-Attari J.
Agyemang C.
Ahmadi A.
Ahmadi N.
Ahmadi N.
Ahmed S.H.
Ajlouni K.
Al-Hinai H.
Al-Lahou B.
Al-Lawati J.A.
Asfoor D.A.
Al Qaoud N.M.
Alarouj M.
AlBuhairan F.
AlDhukair S.
Aldwairji M.A.
Ali M.M.
Alinezhad F.
Alkandari A.
Alomirah H.F.
Aly E.
Amarapurkar D.N.
Andersen L.B.
Anderssen S.A.
Andrade D.S.
Ansari-Moghaddam A.
Aounallah-Skhiri H.
Aris T.
Arlappa N.
Aryal K.K.
Assah F.K.
Assembekov B.
Auvinen J.
Avdičová M.
Azad K.
Azimi-Nezhad M.
Azizi F.
Bacopoulou F.
Balakrishna N.
Bamoshmoosh M.
Banach M.
Bandosz P.
Banegas J.R.
Barbagallo C.M.
Barceló A.
Baretić M.
Barrera L.
Basit A.
Batieha A.M.
Batista A.P.
Baur L.A.
Belavendra A.
Ben Romdhane H.
Benet M.
Berkinbayev S.
Sheffer K.E.
Bennett J.E.
Gregg E.W.
Danaei G.
Singleton R.K.
Shaw J.E.
Mishra A.
Lhoste V.P.F.
Carrillo-Larco R.M.
Kengne A.P.
Phelps N.H.
Heap R.A.
Rayner A.W.
Stevens G.A.
Paciorek C.J.
Riley L.M.
Cowan M.J.
Savin S.
Vander Hoorn S.
Lu Y.
Pavkov M.E.
Imperatore G.
Aguilar-Salinas C.A.
Ahmad N.A.
Anjana R.M.
Davletov K.
Farzadfar F.
González-Villalpando C.
Khang Y.H.
Kim H.C.
Laatikainen T.
Laxmaiah A.
Mbanya J.C.N.
Narayan K.M.V.
Ramachandran A.
Wade A.N.
Zdrojewski T.
Abbasi-Kangevari M.
Rahim H.F.A.
Abu-Rmeileh N.M.
Adambekov S.
Adams R.J.
Aekplakorn W.
Agdeppa I.A.
Aghazadeh-Attari J.
Agyemang C.
Ahmadi A.
Ahmadi N.
Ahmadi N.
Ahmed S.H.
Ajlouni K.
Al-Hinai H.
Al-Lahou B.
Al-Lawati J.A.
Asfoor D.A.
Al Qaoud N.M.
Alarouj M.
AlBuhairan F.
AlDhukair S.
Aldwairji M.A.
Ali M.M.
Alinezhad F.
Alkandari A.
Alomirah H.F.
Aly E.
Amarapurkar D.N.
Andersen L.B.
Anderssen S.A.
Andrade D.S.
Ansari-Moghaddam A.
Aounallah-Skhiri H.
Aris T.
Arlappa N.
Aryal K.K.
Assah F.K.
Assembekov B.
Auvinen J.
Avdičová M.
Azad K.
Azimi-Nezhad M.
Azizi F.
Bacopoulou F.
Balakrishna N.
Bamoshmoosh M.
Banach M.
Bandosz P.
Banegas J.R.
Barbagallo C.M.
Barceló A.
Baretić M.
Barrera L.
Basit A.
Batieha A.M.
Batista A.P.
Baur L.A.
Belavendra A.
Ben Romdhane H.
Benet M.
Berkinbayev S.
Author's Affiliation
Dasman Diabetes Institute
Non-Communicable Diseases Research Center
University of Science and Technology
Western Norway University of Applied Sciences
Kazakh National Medical University
Neyshabur University of Medical Sciences
Terveyden ja Hyvinvoinnin Laitos
India Diabetes Research Foundation
King Saud bin Abdulaziz University for Health Sciences
Qatar University
Birzeit University
University of Cuenca
Al Farabi Kazakh National University
Ministry of Health Oman
Food and Nutrition Research Institute
Université de Yaoundé I
Ministry of Health Kuwait
Universidad del Valle, Cali
Baqai Medical University
Jordan University of Science and Technology
Université de Tunis El Manar
Kuwait Institute for Scientific Research
National Center for Diabetes, Endocrinology and Genetics Jordan
Baker Heart and Diabetes Institute
Harvard T.H. Chan School of Public Health
KBC Zagreb
Tabriz University of Medical Sciences
Zahedan University of Medical Sciences
Universitetet i Bergen
University of Miami
South African Medical Research Council
National and Kapodistrian University of Athens
Tehran University of Medical Sciences
Organisation Mondiale de la Santé
Universidad Autónoma de Madrid
The University of Sydney
University of California, Berkeley
Universidade Federal de Ouro Preto
Shahid Beheshti University of Medical Sciences, Research Institute for Endocrine Science
Instituto Nacional de Salud Pública. México
Diabetic Association of Bangladesh
Bill & Melinda Gates Foundation
Centers for Disease Control and Prevention
Urmia University of Medical Sciences
Flinders University
Università degli Studi di Palermo
National Institute of Nutrition India
Yonsei University College of Medicine
Oulu University Hospital
University of the Witwatersrand, Johannesburg
Imperial College London
Oulun Yliopisto
Kementerian Kesihatan Malaysia
Mahidol University
Gdanski Uniwersytet Medyczny
Bombay Hospital and Medical Research Centre
Universitetet i Oslo
Instituto Nacional de la Nutrición Salvador Zubiran
Shahid Sadoughi University of Medical Sciences
Medical University of Lodz
The University of Auckland
Yale University
Norges Idrettshøgskole
Universiteit van Amsterdam
Emory University
Seoul National University College of Medicine
Christian Medical College, Vellore
Madras Diabetes Research Foundation
Royal College of Surgeons in Ireland
Modeling in Health Research Center
Aldara Hospital and Medical Center
Cafam University Foundation
National Institute of Public Health
Regional Authority of Public Health
Non-Communicable Diseases Research Center
University of Science and Technology
Western Norway University of Applied Sciences
Kazakh National Medical University
Neyshabur University of Medical Sciences
Terveyden ja Hyvinvoinnin Laitos
India Diabetes Research Foundation
King Saud bin Abdulaziz University for Health Sciences
Qatar University
Birzeit University
University of Cuenca
Al Farabi Kazakh National University
Ministry of Health Oman
Food and Nutrition Research Institute
Université de Yaoundé I
Ministry of Health Kuwait
Universidad del Valle, Cali
Baqai Medical University
Jordan University of Science and Technology
Université de Tunis El Manar
Kuwait Institute for Scientific Research
National Center for Diabetes, Endocrinology and Genetics Jordan
Baker Heart and Diabetes Institute
Harvard T.H. Chan School of Public Health
KBC Zagreb
Tabriz University of Medical Sciences
Zahedan University of Medical Sciences
Universitetet i Bergen
University of Miami
South African Medical Research Council
National and Kapodistrian University of Athens
Tehran University of Medical Sciences
Organisation Mondiale de la Santé
Universidad Autónoma de Madrid
The University of Sydney
University of California, Berkeley
Universidade Federal de Ouro Preto
Shahid Beheshti University of Medical Sciences, Research Institute for Endocrine Science
Instituto Nacional de Salud Pública. México
Diabetic Association of Bangladesh
Bill & Melinda Gates Foundation
Centers for Disease Control and Prevention
Urmia University of Medical Sciences
Flinders University
Università degli Studi di Palermo
National Institute of Nutrition India
Yonsei University College of Medicine
Oulu University Hospital
University of the Witwatersrand, Johannesburg
Imperial College London
Oulun Yliopisto
Kementerian Kesihatan Malaysia
Mahidol University
Gdanski Uniwersytet Medyczny
Bombay Hospital and Medical Research Centre
Universitetet i Oslo
Instituto Nacional de la Nutrición Salvador Zubiran
Shahid Sadoughi University of Medical Sciences
Medical University of Lodz
The University of Auckland
Yale University
Norges Idrettshøgskole
Universiteit van Amsterdam
Emory University
Seoul National University College of Medicine
Christian Medical College, Vellore
Madras Diabetes Research Foundation
Royal College of Surgeons in Ireland
Modeling in Health Research Center
Aldara Hospital and Medical Center
Cafam University Foundation
National Institute of Public Health
Regional Authority of Public Health
Other Contributor(s)
Abstract
Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance.