BMI and diabetes risk in low-income and middle-income countries

Abstract

Diabetes is a growing public health problem in all countries, but this increase has been much faster in low-income and middle-income countries (LMICs) 1 Seiglie JA Marcus M-E Ebert C et al. Diabetes prevalence and its relationship with education, wealth, and BMI in 29 low- and middle-income countries. Diabetes Care. 2020; 43: 767-775 Crossref PubMed Scopus (34) Google Scholar , 2 NCD Risk Factor Collaboration (NCD-RisC) – Africa Working GroupTrends in obesity and diabetes across Africa from 1980 to 2014: an analysis of pooled population-based studies. Int J Epidemiol. 2017; 46: 1421-1432 Crossref PubMed Scopus (120) Google Scholar than in high income countries (HICs) 3 Narayan KMV Boyle JP Thompson TJ Gregg EW Williamson DF Effect of BMI on lifetime risk for diabetes in the U.S. Diabetes Care. 2007; 30: 1562-1566 Crossref PubMed Scopus (303) Google Scholar over the past three decades. 4 Zhou B Lu Y Hajifathalian K et al. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants. Lancet. 2016; 387: 1513-1530 Summary Full Text Full Text PDF PubMed Scopus (2067) Google Scholar Concomitantly, the paucity of robust and representative data has prevented improved characterisation of the risk factors underlying this sharp increase in the burden in LMICs, which is needed to build more efficient diabetes screening and prevention policies than the current standard. Reliance on diabetes screening and diagnostic criteria based largely on data from HICs 5 WHOScreening for type 2 diabetes: report of a World Health Organization and International Diabetes Federation meeting. https://apps.who.int/iris/bitstream/handle/10665/68614/WHO_NMH_MNC_03.1.pdf?sequence=1&isAllowed=yDate: 2003 Date accessed: April 19, 2021 Google Scholar , 6 American Diabetes Association2. Classification and diagnosis of diabetes: standards of medical care in diabetes - 2021. Diabetes Care. 2021; 44: S15-S33 Crossref PubMed Scopus (502) Google Scholar has therefore substituted for these deficiencies, and tailoring diabetes screening strategies to cutoffs of measurable risk factors derived from data from representative cohorts in LMICs has been a long-term challenge. Body-mass index and diabetes risk in 57 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data in 685 616 adultsThe association between BMI and diabetes risk in LMICs is subject to substantial regional variability. Diabetes risk is greater at lower BMI thresholds and at younger ages than reflected in currently used BMI cutoffs for assessing diabetes risk. These findings offer an important insight to inform context-specific diabetes screening guidelines. Full-Text PDF