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Trends in type 2 diabetes

BMJ 2019; 366 doi: (Published 11 September 2019) Cite this as: BMJ 2019;366:l5407

Linked research

Trends in incidence of total or type 2 diabetes

  1. Mike Lean, professor of human nutrition,
  2. Louise McCombie, research associate,
  3. Joe McSorely, patient representative
  1. School of Medicine, GRI Campus College of Medical, Veterinary and Life Sciences University of Glasgow, Glasgow G31 2ER, UK
  1. Correspondence to: L McCombie louise.mccombie{at}

Falling or stalling rates can be deceptive

The increasing prevalence of type 2 diabetes frequently makes headline news, apparently pointing towards a failure of prevention strategies. Although incidence and prevalence are still confused in the media—and even in more scientific reporting, Magliano and colleagues’ new systematic review (doi:10.1136/bmj.l5003) of trends in diabetes emphasises that prevalence and incidence data tell very different things about a disease or epidemic.1

Prevalence is important to guide allocation of resources for management, but prevention strategies must be directed against incidence. Effective prevention always reduces incidence (new cases) but won’t necessarily reduce prevalence, which can continue to rise through better treatment and an increase in the number of survivors.

Magliano and colleagues reviewed published data on the incidence of type 2 diabetes over three periods, across more than 100 populations in mostly high income countries.1 They report that although incidence increased consistently until 2005, about one third of more recent studies suggest decreasing incidence and another third suggest stable incidence. The …

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