Donald Malestein1, Lana Fani1,2, Miranda T. Schram1,2; representing the Netherlands Cohorts Consortium (NCC)
1Department of Epidemiology, Erasmus Medical Centre, Rotterdam
2CARIM, Maastricht University, Maastricht
Background: Accurate prevalence estimates of prediabetes, and (undiagnosed) type 2 diabetes (T2D), and its changes over time are essential to inform prevention strategies, clinical care, and health policy. Our objective was to describe temporal trends in the prevalence of prediabetes, and (undiagnosed) T2D based on the large population-based cohorts of the Netherlands.
Methods: Pooled prevalences for prediabetes, and (undiagnosed) T2D were estimated, mainly based on fasting glucose measurements, among ~280,000 Dutch adults (aged ≥18) from nine prospective population-based cohorts within the NCC. Results were standardized by sex and age or educational attainment (low/middle/high), and extrapolated to the Dutch.
Results: Figure 1 shows the trends in prevalence of prediabetes and (undiagnosed) T2D over three decades. The prevalence of prediabetes rose by ~50% from 2000s (n=~803,000) to the 2020s (n=~1,190,000-1,590,000), and was higher in men (10.0%) than in women (6.7%) and in those with lower educational attainment (13.8%) versus middle (12.0%) or higher education (12.2%). The prevalence of undiagnosed T2D rose by ~40% from 2000s (n=~241,000) to the 2020s (n=~338,000-473,000), and was slightly higher in men (2.7%) than in women (2.0%) and higher in individuals with lower educational attainment (4.9%) versus middle (3.5%) or higher education (2.5%). The prevalence of T2D rose by ~65% from 2000s (n=~666,000) to the 2020s (n=~1,104,000-1,486,000), and was higher in men (8.7%) than in women (6.8%), and in individuals with lower educational attainment (16.3%) versus middle (10.5%) or higher education (7.6%).
Conclusion: Type 2 diabetes and prediabetes have risen sharply over the past 30 years and are expected to rise further.