| Titre : | Is there a divergence in time trends in the prevalence of impaired glucose tolerance and diabetes ? A systematic review in South Asian populations. (2011) |
| Auteurs : | KATIKIREDDI (Srinivasa-V) : GBR. Department of Public Health and Health Policy. Nhs Lothian. Edinburgh. ; Raj BHOPAL ; Joanne-R MORLING ; Centre for Population Health Sciences. Public Health Sciences Section. University of Edinburgh. Medical School. Edinburgh. GBR |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 40, n° 6, 2011) |
| Pagination : | 1542-1553 |
| Langues: | Anglais |
| Mots-clés : | Tendance séculaire ; Diabète ; Prévalence ; Population ; Epidémiologie ; Asie ; Glande endocrine [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST-CNRS oR0xFoqI. Diffusion soumise à autorisation]. Objective Recently, diabetes prevalence has increased in South Asians making it a global public health priority. There are suggestions that prediabetes, including impaired glucose tolerance (IGT), may not be increasing. We conducted a systematic review to explore the paradox. Research We searched electronic databases from inception to June 2009 for Design cross-sectional studies providing prevalence of pre-diabetes (using and WHO criteria) in South Asian adult populations. Two reviewers Methods independently screened articles, performed data extraction, quality appraisal and study classification with any discrepancies resolved by consensus. Repeated cross-sectional studies, categorized by prespecified criteria, were used for the primary analysis, supplemented by analysis of comparable and all studies. Results In total, 79 cross-sectional data sets (from 69 published studies) were identified resulting in the inclusion of 179408 people. Four sets of repeated cross-sectional studies, conducted in Chennai, rural Tamil Nadu, Mauritius and Singapore (n =30 399), provided time trend information. Three of them showed an increase in diabetes prevalence (P <0.001) whereas IGT fell in two (P <0.05), and was stable in the remainder. A similar pattern was seen among three other sets of comparable studies (n =58 820) and in scatterplots of all 79 data sets. Conclusion This novel systematic review is the first to assess secular trends of pre-diabetes in any population. The data show diabetes prevalence is rising, whereas IGT prevalence is stable or falling. Explanations include : recent environmental or lifestyle changes favouring an increased rate of conversion from IGT to diabetes, or a cohort effect with improving maternal and infant nutrition resulting in reduced IGT with a fall in diabetes to follow. |
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