Abstract
The incidence of diabetes is increasing globally. We investigated the relationship between diabetes prevalence and patient socioeconomic status across multiple countries. We searched PubMed to identify population-based surveys reporting diabetes prevalence between 1990 and May 2016. Search results were filtered, and Human Development Index (HDI) values from the United Nations Development Programme were used to assess socioeconomic status for a given nation. Our analysis included 45 national surveys from 32 countries. Diabetes prevalence was positively correlated with national HDI (r = 0.421 P = 0.041) in developing countries, and negatively correlated with HDI (r = −0.442 P = 0.045) in developed countries. Diabetes prevalence trends were the same in women and men, although men were associated with increased diabetes risk in developed countries (r = 0.459 P = 0.048). Thus, diabetes prevalence rises with increasing HDI in developing countries, and this is reversed in developed countries. Ours is the first study to investigate the relationship between diabetes and socioeconomic status at global level using HDI values. These results will aid in evaluating global diabetes prevalence and risk with respect to patient socioeconomic status, and will be useful in the development of policies that help reduce disease incidence.
Highlights
Diabetes case numbers rose worldwide from 285 million adults in 2009 to 382 million in 2013, with a projected 471 million by 2030 [1, 2]
Regional studies have assessed the effects of socioeconomic factors on diabetes prevalence
A 2003 study in Turin, Italy found that age-adjusted diabetes prevalence was higher among those with lower income and/or education levels [8]
Summary
Diabetes case numbers rose worldwide from 285 million adults in 2009 to 382 million in 2013, with a projected 471 million by 2030 [1, 2]. Conflicting studies from different countries reported either no association between socioeconomic status and diabetes [6], or that higher socioeconomic status is related to increased type 2 diabetes risk [7]. These inconsistencies may result in part from changing socioeconomic statuses within these countries, and must be further explored. While researchers have investigated relationships between diabetes prevalence and socioeconomic status in specific countries or regions, this interaction has yet to be studied at a global level. We investigated possible global correlations between diabetes prevalence and socioeconomic status according to the Human Development Index (HDI)
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