Study: Prevalence of Diabetes Might Be Vastly Underestimated

The estimated number of individuals with diabetes around the world may be underestimated by as much as 25%, according to Monash University-led research, which suggests there could be as many as 100 million more people with diabetes than previously had been believed.

In a new paper, investigators cite International Diabetes Federation (IDF) figures from 2015, when the organization estimated that the number of people with diabetes was 415 million. The authors say that total could be as high as 520 million, however, and contend the organizations that public health policymakers depend on, such as the World Health Organization (WHO) and the IDF, have used various and questionable methods to determine diabetes prevalence.
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The Australian 2012-2013 National Health Survey, for instance, relied on fasting blood sugar as the diagnostic test for these conditions, note the researchers, who say this almost certainly means the true burden of diabetes in that country has been underestimated, and that the resources identified in the Australian 2015 National Diabetes Strategy are therefore insufficient.

In the new paper, the authors recommend an alternative blood glucose test for both fasting and at 2 hours after taking a glucose drink to provide more accurate data regarding diabetes.

The investigators suggest the second test, a glucose challenge, be done as a way to confirm the likelihood that a patient has or will eventually develop diabetes, and note that WHO and the American Diabetes Association currently recommend an alternative test, Hb_A1c, to bypass the 2-hour test.

"While there is still academic debate amongst diabetologists regarding the best test for detecting diabetes, primary care physicians should continue to use blood glucose or Hb_A1c to diagnose diabetes, based on WHO recommendations," added Dianna Magliano, MPH, PhD, an associate professor and senior epidemiologist at Monash University in Melbourne, Australia, and one of the paper's coauthors.

—Mark McGraw

Reference

Zimmet P, Alberti KG, Magliano DJ, Bennett PH. Diabetes mellitus statistics on prevalence and mortality: facts and fallacies [published online July 8, 2016]. Nat Rev Endocrinol. doi:10.1038/nrendo.2016.105.