Abstract
BackgroundData on the future diabetes burden in Scandinavia is limited. Our aim was to project the future burden of diabetes in Sweden by modelling data on incidence, prevalence, mortality, and demographic factors.MethodTo project the future burden of diabetes we used information on the prevalence of diabetes from the national drug prescription registry (adults ≥20 years), previously published data on relative mortality in people with diabetes, and population demographics and projections from Statistics Sweden. Alternative scenarios were created based on different assumptions regarding the future incidence of diabetes.ResultsBetween 2007 and 2013 the prevalence of diabetes rose from 5.8 to 6.8% in Sweden but incidence remained constant at 4.4 per 1000 (2013). With constant incidence and continued improvement in relative survival, prevalence will increase to 10.4% by year 2050 and the number of afflicted individuals will increase to 940 000. Of this rise, 30% is accounted for by changes in the age structure of the population and 14% by improved relative survival in people with diabetes. A hypothesized 1% annual rise in incidence will result in a prevalence of 12.6% and 1 136 000 cases. Even with decreasing incidence at 1% per year, prevalence of diabetes will continue to increase.ConclusionWe can expect diabetes prevalence to rise substantially in Sweden over the next 35 years as a result of demographic changes and improved survival among people with diabetes. A dramatic reduction in incidence is required to prevent this development.
Highlights
Diabetes is increasing world wide and this development is expected to continue: In Europe, diabetes prevalence has been projected to rise from 8.5% (2013) to 10.3% (2035) in adults 20–79 years, as a consequence of the aging population [1]
The drugs are classified according to the Anatomical Therapeutic Chemical (ATC) classification system [13] and those belonging to ATC group 10 where used in this study
To account for non-pharmacologically treated diabetes, which accounted for 22.6% of all diabetes in adults in Sweden in 2013, according to recently published data from the national diabetes registry (NDR) [14], we amplified the prescription registry-based diabetes count by a factor of 1.292
Summary
Diabetes is increasing world wide and this development is expected to continue: In Europe, diabetes prevalence has been projected to rise from 8.5% (2013) to 10.3% (2035) in adults 20–79 years, as a consequence of the aging population [1]. Changes in survival in patients with diabetes will affect the future burden of diabetes and according to data from the US [2], UK [3], Denmark [4] and Sweden [5,6] mortality is decreasing faster in people with diabetes than in the general population. As far as we know, only one previous study [8] accounted for trends in incidence and survival while forecasting the future burden of diabetes in Europe. Our aim was to project the future burden of diabetes in Sweden by modelling data on incidence, prevalence, mortality, and demographic factors. Editor: Andrea Icks, Heinrich-Heine University, Faculty of Medicine, GERMANY
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