Projections of the prevalence of hyperglycaemia in pregnancy in 2019 and beyond : results from the International Diabetes Federation Diabetes Atlas, 9th edition

Aim: Hyperglycaemia in pregnancy (HIP) is one of the most common complications of pregnancy. This study aims to examine the projected HIP prevalence in 2030 and 2045 using multiple methods. Methods: The International Diabetes Federation Diabetes Atlas 2019 prevalence was projected to 2030 and 2045 by: (1) carrying forward the 2019 age-adjusted prevalence rates; (2) applying a linear regression of the past four editions of the IDF Diabetes Atlas; (3) applying a regression of the previous editions with the most consistent trend, followed by extrapolation from the 9th edition HIP estimate. Results: Respectively, for 2030 and 2045, Method 1 projected a declining HIP rate with prevalences of 14.0% and 13.3%, Method 2 projected an increasing HIP prevalence at 16.5% and 18.3%, Method 3 predicted stabilisation of the rate from 16.0% to 15.8%. Conclusion: Assuming other factors remain unchanged, our best estimation of age-adjusted HIP will show stabilisation between 2019 and 2045 of 15.8% to 16.0%. However, this estimate is confounded by the heterogeneity of studies and the influence of different gestational diabetes mellitus diagnostic criteria. To provide accurate future comparisons we recommend standardising the diagnostic criteria to the International Association of Diabetes in Pregnancy Study Groups

IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021

AIMS: To provide up-to-date estimates of undiagnosed diabetes mellitus (UDM) prevalence - both globally, and by region/country, for the year 2021. METHODS: Data sources reporting diabetes prevalence were identified through a systematic search in the peer-reviewed and grey literature. The prevalence of undiagnosed diabetes was estimated from the data from each country where data was available. For countries without in-country data, the prevalence of undiagnosed diabetes was approximated by extrapolating the average of the estimates from countries with data sources within the same International Diabetes Federation (IDF) region and World Bank income grouping. We then applied these stratified prevalence estimates of UDM from each country to the number of adults in each strata and summed the counts to generate the number of adults with UDM (aged 20-79 years) for 215 countries and territories. RESULTS: In 2021, almost one in two adults (20-79 years old) with diabetes were unaware of their diabetes status (44.7%; 239.7 million). The highest proportions of undiagnosed diabetes (53.6%) were found in the Africa, Western Pacific (52.8%) and South-East Asia regions (51.3%), respectively. The lowest proportion of undiagnosed diabetes was observed in North America and the Caribbean (24.2%). CONCLUSIONS: Diabetes surveillance needs to be strengthened to reduce the prevalence of UDM, particularly in low- and middle-income countries

IDF Diabetes Atlas: The prevalence of pre-existing diabetes in pregnancy – A systematic reviewand meta-analysis of studies published during 2010–2020

ObjectivesTo estimate the prevalence of pre-existing diabetes in pregnancy from studies published during 2010–2020. MethodsWe searched PubMed, CINAHL, Scopus and other sources for relevant data sources. The prevalence of overall pre-existing, type 1 and type 2 diabetes, by country, region and period of study was synthesised from included studies using the inverse-variance heterogeneity model and the Freeman-Tukey transformation. Heterogeneity was assessed using the I2 statistic and publication bias using funnel plots. ResultsWe identified 2479 records, of which 42 data sources with a total of 78 943 376 women, met the eligibility criteria. The included studies were from 17 countries in North America, Europe, the Middle East and North Africa, Australasia, Asia and Africa. The lowest prevalence was in Europe (0.5%, 95 %CI 0.4–0.7) and the highest in the Middle East and North Africa (2.4%, 95 %CI 1.5–3.1). The prevalence of pre-existing diabetes doubled from 0.5% (95 %CI 0.1–1.0) to 1.0% (95 %CI 0.6–1.5) during the period 1990–2020. The pooled prevalences of pre-existing type 1 and type 2 diabetes were 0.3% (95 %CI 0.2–0.4) and 0.2% (95 %CI 0.0–0.9) respectively. ConclusionWhile the prevalence of pre-existing diabetes in pregnancy is low, it has doubled from 1990 to 2020

IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group’s Criteria

AimsThe approaches used to screen and diagnose gestational diabetes mellitus (GDM) vary widely. We generated a comparable estimate of the global and regional prevalence of GDM by International Association of Diabetes in Pregnancy Study Group (IADPSG)'s criteria. MethodsWe searched PubMed and other databases and retrieved 57 studies to estimate the prevalence of GDM. Prevalence rate ratios of different diagnostic criteria, screening strategies and age groups, were used to standardize the prevalence of GDM in individual studies included in the analysis. Fixed effects meta-analysis was conducted to estimate standardized pooled prevalence of GDM by IDF regions and World Bank country income groups. ResultsThe pooled global standardized prevalence of GDM was 14.0% (95% confidence interval: 13.97–14.04%). The regional standardized prevalence of GDM were 7.1% (7.0–7.2%) in North America and Caribbean (NAC), 7.8% (7.2–8.4%) in Europe (EUR), 10.4% (10.1–10.7%) in South America and Central America (SACA), 14.2% (14.0–14.4%) in Africa (AFR), 14.7% (14.7–14.8%) in Western Pacific (WP), 20.8% (20.2–21.4%) in South-East Asia (SEA) and 27.6% (26.9–28.4%) in Middle East and North Africa (MENA). The standardized prevalence of GDM in low-, middle- and high-income countries were 12.7% (11.0–14.6%), 9.2% (9.0–9.3%) and 14.2% (14.1–14.2%), respectively. ConclusionsThe highest standardized prevalence of GDM was in MENA and SEA, followed by WP and AFR. Among the three World Bank country income groups, high income countries had the highest standardized prevalence of GDM. The standardized estimates for the prevalence of GDM provide an insight for the global picture of GDM

Toward the development of a core set of outcome domains to assess shared decision-making interventions in rheumatology: Results from an OMERACT Delphi survey and consensus meeting

Objective. The aim of this Outcome Measures in Rheumatology (OMERACT) Working Group was to determine the core set of outcome domains and subdomains for measuring the effectiveness of shared decision-making (SDM) interventions in rheumatology clinical trials.Methods. Following the OMERACT Filter 2.0, and based on a previous literature review of SDM outcome domains and a nominal group process at OMERACT 2014, (1) an online Delphi survey was conducted to gather feedback on the draft core set and refine its domains and subdomains, and (2) a workshop was held at the OMERACT 2016 meeting to gain consensus on the draft core set. Results.A total of 170 participants completed Round 1 of the Delphi survey, and 116 completed Round 2. Respondents came from 29 countries, with 49% being patients/caregivers. Results showed that 14 out of the 17 subdomains within the 7 domains exceeded the 70% criterion (endorsement ranged from 83% to 100% of respondents). At OMERACT 2016, only 8% of the 96 attendees were patients/caregivers. Despite initial votes of support in breakout groups, there was insufficient comfort about the conceptualization of these 7 domains and 17 subdomains for these to be endorsed at OMERACT 2016 (endorsement ranged from 17% to 68% of participants). Conclusion. Differences between the Delphi survey and consensus meeting may be explained by the manner in which the outcomes were presented, variations in participant characteristics, and the context of voting. Further efforts are needed to address the limited understanding of SDM and its outcomes among OMERACT participants