Alan C. Moses
The prevalence of obesity worldwide will reach nearly 25% by 2045, further increasing the burden of diabetes and putting an even greater strain on global health systems, according to an analysis of population data presented at the European Congress on Obesity annual meeting.
“While the diabetes epidemic is driven by many factors, including age and genetics, there are modifiable factors that play a huge role, of which the major one is obesity,” Alan C. Moses, MD, FACP, senior scientific adviser for clinical, medical and regulatory affairs at Novo Nordisk, told Endocrine Today. “By aggressively addressing the obesity epidemic on a population basis, the rate of increase in diabetes can be reduced and the impact on individuals and societies can be blunted. Obesity represents approximately 44% of the attributable risk of diabetes, and without addressing it specifically at a population level, the prevalence of diabetes globally will increase from 9.1% to 11.7% by 2045 based on the model developed from country-specific data. This increase in diabetes is unsustainable medically and economically because of its impact on individuals, families, employers, and local and national governments.”
Moses and colleagues analyzed population data for all countries, stratified by age groups, from the Noncommunicable Disease Risk Factor Collaboration, a WHO database. From 2000 to 2014, the population in each age group was divided into BMI categories, with share of people in each BMI class projected for each country and age group. Researchers applied diabetes risk for each age and BMI group to estimate diabetes prevalence for each country each year, with the prevalence for each country calibrated to match the International Diabetes Federation’s regional estimates that consider country-specific way of life, nutrition and genetic disposition for the disease.
The researchers found that global diabetes prevalence will reach 11.7% by 2045 and 13.3% by 2100 if the current obesity rate increases linearly. To stabilize the global diabetes prevalence at 10% by 2045, the obesity rate would need to be decreased by 25% in the next 27 years, according to researchers.
The methodology was validated by external experts in obesity and diabetes, Moses and colleagues noted.
The study grew out of the initial findings from the Cities Changing Diabetes program, developed by Novo Nordisk in partnership with University College London and the Steno Diabetes Center in 2014. The overall program was designed to better understand the social and cultural elements that contribute to the increased risk for diabetes in urban environments and initially enrolled eight global cities, later expanding to 15 cities.
“Much has been written about the diabetes and the obesity epidemic, and now is the time for action,” Moses said. “While this should be a global initiative in which all countries can play a role, cities offer an excellent opportunity to make the kind of changes in healthy food availability, public education, mobilization of public health resources and city planning initiatives that will allow people to avoid obesity or excessive weight gain and reduce the burden of diabetes through primary prevention.”
Moses added that cities also can improve the infrastructure of the health care system to ensure that patients with diabetes have better health outcomes.
“Research from the individual cities in the Cities Changing Diabetes program will establish approaches for other cities — and countries — to follow,” Moses said. “Some of these already have been collected in a web-accessible toolbox that provides guidance.”
The researchers also noted that the projections are part of a global scenario, and individual countries display individual trends and should have their own targets. – by Regina Schaffer
For more information:
Alan C. Moses, MD, FACP, can be reached at Novo Nordisk, 800 Scudders Mill Road, Plainsboro, NJ 08536; email: firstname.lastname@example.org.
Moses AC, et al. Abstract T3P28. Presented at: European Congress on Obesity; May 23-26, 2018; Vienna.
Disclosures: Moses reports he is a full-time employee of Novo Nordisk, served as the global chief medical officer until December 2017 and holds shares in the company as part of his compensation package. Another author also reports he is an employee of Novo Nordisk.