澳大利亚墨尔本贝克心脏与糖尿病研究所Dianna J Magliano研究组，9月11日于《英国医学杂志》在线发表综述文章，评估报告糖尿病发病率上升、稳定或下降趋势的研究比例。

在过去几十年中，发达国家和发展中国家的糖尿病患病率大幅上升，使糖尿病成为全球优先关注的健康事项。糖尿病总负担趋势检查是监测这一健康优先领域的一个重要组成部分，但迄今为止，它主要研究糖尿病的患病率。

研究组从各大数据库中筛选了22833份摘要，包括47项研究，提供了121个不同性别或种族人群的数据，其中42项（89%）研究报告确诊糖尿病。1960-1989年，36%（8/22）的研究人群糖尿病发病率呈上升趋势，55%（12/22）呈稳定趋势，9%（2/22）呈下降趋势。1990-2005年，66%（33/50）的人群中糖尿病发病率呈上升趋势，32%（16/50）呈稳定趋势，2%（1/50）呈下降趋势。2006-2014年，只有33%（11/33）的人群糖尿病发病率呈上升趋势，30%（10/33）呈稳定趋势，36%（12/33）呈下降趋势。

自2006年以来，临床诊断糖尿病的发病率仅在少数人群中持续上升，超过三分之一的人群在这段时间内发病率下降，该结果一部分可归功于近几年的预防策略。此外，低中收入国家的数据有限，这些国家的糖尿病发病率趋势可能不同。

附：英文原文

Title:Trends in incidence of total or type 2 diabetes: systematic review

Author: Dianna J Magliano, laboratory head of diabetes and population health1 2,  Rakibul M Islam, postdoctoral research fellow1 2,  Elizabeth L M Barr, postdoctoral research fellow1,  Edward W Gregg, chair in diabetes and cardiovascular disease epidemiology3 4,  Meda E Pavkov, physician scientist3,  Jessica L Harding, research fellow3,  Maryam Tabesh, research study coordinator1 2,  Digsu N Koye, postdoctoral research fellow1 2,  Jonathan E Shaw, deputy director of Baker Heart and Diabetes Institute1 2

Issue&Volume: 2019-09-11

Abstract:

Objective To assess what proportions of studies reported increasing, stable, or declining trends in the incidence of diagnosed diabetes.

Design Systematic review of studies reporting trends of diabetes incidence in adults from 1980 to 2017 according to PRISMA guidelines.

Data sources Medline, Embase, CINAHL, and reference lists of relevant publications.

Eligibility criteria Studies of open population based cohorts, diabetes registries, and administrative and health insurance databases on secular trends in the incidence of total diabetes or type 2 diabetes in adults were included. Poisson regression was used to model data by age group and year.

Results Among the 22 833 screened abstracts, 47 studies were included, providing data on 121 separate sex specific or ethnicity specific populations; 42 (89%) of the included studies reported on diagnosed diabetes. In 1960-89, 36% (8/22) of the populations studied had increasing trends in incidence of diabetes, 55% (12/22) had stable trends, and 9% (2/22) had decreasing trends. In 1990-2005, diabetes incidence increased in 66% (33/50) of populations, was stable in 32% (16/50), and decreased in 2% (1/50). In 2006-14, increasing trends were reported in only 33% (11/33) of populations, whereas 30% (10/33) and 36% (12/33) had stable or declining incidence, respectively.

Conclusions The incidence of clinically diagnosed diabetes has continued to rise in only a minority of populations studied since 2006, with over a third of populations having a fall in incidence in this time period. Preventive strategies could have contributed to the fall in diabetes incidence in recent years. Data are limited in low and middle income countries, where trends in diabetes incidence could be different.

DOI:https://doi.org/10.1136/bmj.l5003

Source:https://www.bmj.com/content/366/bmj.l5003