Rates of diabetes vary widely across developing countries worldwide, according to a new analysis led by Dr. Longjian Liu of Drexel University’s School of Public Health.

Worldwide, four in five people with diabetes now live in developing countries. Liu’s study found that access to healthcare support for diabetes varied widely in developing countries, and that one in 10 diagnosed cases remain untreated. The study is available online and will appear in a future issue of the journal Diabetic Medicine.

“Diabetes is now one of the most common non-communicable diseases globally,” Liu said. “It is the fourth or fifth leading cause of death in most high-income countries and there is substantial evidence that it is epidemic in many low- and middle-income countries.” The number of people with diabetes is expected to increase substantially in coming decades.

Many past studies have measured rates of diabetes in developing countries in isolation using different methods, leaving researchers unable to make direct comparisons between countries. Liu’s team analyzed data from the World Health Organization’s World Health Survey, one of the first and largest global surveys using a standard method to measure the rates of chronic conditions in multiple countries worldwide. Liu’s team included a total of more than 215,000 participants from 49 countries in their analysis. The countries represent a variety of regions, including Africa, the Americas, Europe, South-East Asia and the Western Pacific.

The prevalence of diabetes varied widely, from a low of 0.27 percent in Mali, to 15.54 percent in Mauritius. Researchers noted that age is a common factor in diabetes; the low rate observed in Mali may reflect that country’s low life expectancy due to infectious diseases.

The study results showed that so-called “adverse body weight” - being underweight, overweight or obese - was associated with increased risk of diabetes. People with diabetes who were underweight were the most likely to go untreated.

Liu and colleagues noted that it is important to identify and address the lack of treatment because diabetes is an independent risk factor for additional health problems and complications, including heart and kidney diseases. Such complications “are resulting in increasing disability, reduced life expectancy and enormous health costs for virtually every society,” Liu said.

Liu’s continuing research focuses on the epidemiology and prevention of diabetes and cardiovascular disease. Important next steps include examining risk factors for diabetes and finding effective ways to control these risk factors, including personal health behaviors, social and environmental factors.

Full citation: Liu, L., Yin, X., & Morrissey, S. Global variability in diabetes mellitus and its association with body weight and primary healthcare support in 49 low- and middle-income developing countries. Diabetic Medicine. DOI: 10.1111/j.1464-5491.2011.03549.x

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