Global rural diabetes prevalence: a systematic review and meta-analysis covering 1990-2012

Abstract

Aim: To investigate diabetes prevalence in rural areas globally and how it has changed over time in high-income countries (HIC) and low-middle income countries (LMIC).

Methods: We systematically searched four electronic databases (MEDLINE, EMBASE, Cochrane Library, and CINAHL) for studies reporting rural prevalence of diabetes between January 1990 and January 2012. We used random effect meta-analysis to estimate pooled prevalence and metaregression to identify factors that may be associated with our estimates.

Findings: We included 109 population-based surveys involving 1,100,746 individuals. Pooled global rural prevalence of diabetes was 6.8% (95% confidence intervals: 6.1-7.6) with no gender difference. Considering five-year increments between 1985 and 2011, when studies were conducted, global rural prevalence was 5.7% (3.5-7.9) during 1985-1989 and 8.7% (6.8-10.7) during 2005-2011. In LMICs, rural diabetes prevalence was 1.8% (1.0-2.6) during 1985-1989 and 7.5% (5.6-9.5) during 2005-2011. In HICs, rural diabetes prevalence was 8.2% (6.0-10.4) during 1985-1989 and 14.3% (8.7-20) in the most recent period.

Conclusion: Diabetes prevalence has increased in all rural areas globally but relative growth was faster in LMIC than HIC rural areas. These data suggest a need to expand diabetes surveillance to rural areas using standardized measures, as well as the need to devise and deploy appropriate prevention and control interventions.

Keywords: Diabetes; Global; Prevalence; Rural population.