The Rising Prevalence of Diabetes and Impaired Glucose Tolerance

The Rising Prevalence of Diabetes and Impaired Glucose Tolerance The Australian Diabetes, Obesity and Lifestyle Study David W. Dunstan , PHD 1 , Paul Z. Zimmet , MD 1 , Timothy A. Welborn , PHD 2 , Maximilian P. de Courten , MD 1 , Adrian J. Cameron , MPH 1 , Richard A. Sicree , MPH 1 , Terry Dwyer , PHD 3 , Stephen Colagiuri , MD 4 , Damien Jolley , MSC 5 , Matthew Knuiman , PHD 6 , Robert Atkins , MD 7 , Jonathan E. Shaw , MD 1 and On Behalf of the AusDiab Steering Committee 1 International Diabetes Institute, Melbourne, Australia 2 Department of Medicine, University of Western Australia, Perth, Australia 3 Menzies Centre for Population Health Research, University of Tasmania, Hobart, Australia 4 Department of Endocrinology, Diabetes and Metabolism, the Prince of Wales Hospital, New South Wales, Sydney, Australia 5 School of Health Sciences, Deakin University, Melbourne, Australia 6 Department of Public Health, University of Western Australia, Perth, Australia 7 Department of Nephrology, Monash University, Melbourne, Australia Abstract OBJECTIVE —To determine the population-based prevalence of diabetes and other categories of glucose intolerance (impaired glucose tolerance [IGT] and impaired fasting glucose [IFG]) in Australia and to compare the prevalence with previous Australian data. RESEARCH DESIGN AND METHODS —A national sample involving 11,247 participants aged ≥25 years living in 42 randomly selected areas from the six states and the Northern Territory were examined in a cross-sectional survey using the 75-g oral glucose tolerance test to assess fasting and 2-h plasma glucose concentrations. The World Health Organization diagnostic criteria were used to determine the prevalence of abnormal glucose tolerance. RESULTS —The prevalence of diabetes in Australia was 8.0% in men and 6.8% in women, and an additional 17.4% of men and 15.4% of women had IGT or IFG. Even in the youngest age group (25–34 years), 5.7% of subjects had abnormal glucose tolerance. The overall diabetes prevalence in Australia was 7.4%, and an additional 16.4% had IGT or IFG. Diabetes prevalence has more than doubled since 1981, and this is only partially explained by changes in age profile and obesity. CONCLUSIONS —Australia has a rapidly rising prevalence of diabetes and other categories of abnormal glucose tolerance. The prevalence of abnormal glucose tolerance in Australia is one of the highest yet reported from a developed nation with a predominantly Europid background. 2hPG,