Relation Between the Prevalence of Diabetes Mellitus and Human Development Index: A Global Ecological Study

Abstract

Background: Diabetes mellitus (DM) is one of the major causes of morbidity and mortality worldwide, but little is known about the effect of Human Development Index (HDI) on the prevalence rate of DM. Objectives: This study aimed to identify the variations in DM-specific rates by HDI among world countries. Methods: This global ecological study was performed based on the data from the international diabetes federation (IDFD) and the world bank report for the year 2013. The analysis for this study was performed on ecological data available for 161 countries in 2013. Results: Globally, the prevalence of DM ranged between 4% and12% in 2013, with the highest prevalence in Middle-East and Northern African (> 12%) and the lowest in Sub-Saharan countries (< 4%). The prevalence of DM was high in older age groups in both low-to middle, and high income regions. In very-high or high HDI regions men were more likely to have diabetes, whereas in low HDI region women were more affected. The prevalence ranges of DM were 7% - 12%, 5% - 7%, 5% - 9%, and 4% - 12% among high-income, low-to-middle income, low-income, and upper-middle income countries, respectively. The rate of diabetes comparative prevalence, incidence of diabetes type-I, and impaired glucose tolerance comparative prevalence were 7.2%, 22.7 (per 100,000 people aged 0-14 years), and 8.3% in very high and 8.7%, 16.2 (per 100,000 people aged 0 - 14 years), and 8.7% in high HDI regions, respectively. Conclusions: The pandemic of diabetes is a major public health problem around the world, mostly in the countries with high and very high HDI. In addition, the prevalence of diabetes is associated with population pyramid and the income level of countries. Knowledge of national and regional rates of diabetes and associated factors can help policymakers to optimize diabetes control in countries with limited resources.