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. 2015 Mar;38(3):482-7.
doi: 10.2337/dc14-1432. Epub 2014 Dec 31.

Trends in diabetes incidence: the Framingham Heart Study

Tobin M Abraham  1 , Karol M Pencina  2 , Michael J Pencina  3 , Caroline S Fox  4
Affiliations

Trends in diabetes incidence: the Framingham Heart Study

Tobin M Abraham et al. Diabetes Care. 2015 Mar.

Abstract

Objective: Obesity and type 2 diabetes continue to increase in prevalence in the U.S. Whether diabetes incidence continues to increase in recent times is less well documented. We examined trends in diabetes incidence over the previous four decades.

Research design and methods: Framingham Heart Study participants ages 40-55 years and free of diabetes at baseline (n = 4,795; mean age 45.3 years; 51.6% women) were followed for the development of diabetes in the 1970s, 1980s, 1990s, and 2000s. Diabetes was defined as either fasting glucose ≥126 mg/dL or use of antidiabetes medication. Poisson regression was used to calculate sex-specific diabetes incidence rates for a 47-year-old individual in each decade. Rates were also calculated among obese, overweight, and normal weight individuals.

Results: The annualized rates of diabetes per 1,000 individuals were 2.6, 3.8, 4.7, and 3.0 (women) and 3.4, 4.5, 7.4, and 7.3 (men) in the 1970s, 1980s, 1990s, and 2000s, respectively. Compared with the 1970s, the age- and sex-adjusted relative risks of diabetes were 1.37 (95% CI 0.87-2.16; P = 0.17), 1.99 (95% CI 1.30-3.03; P = 0.001), and 1.81 (95% CI 1.16-2.82; P = 0.01) in the 1980s, 1990s, and 2000s, respectively. Compared with the 1990s, the relative risk of diabetes in the 2000s was 0.85 (95% CI 0.61-1.20; P = 0.36).

Conclusions: In our community-based sample, the risk of new-onset diabetes continued to be higher in the 2000s compared with the 1970s. In the past decade, diabetes incidence remained steady despite the ongoing trend of rising adiposity.

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Figures

Figure 1
Figure 1
Annualized rates of diabetes per 1,000 individuals. Age-adjusted annualized rates of diabetes for a 47-year-old per 1,000 individuals, stratified by normal, overweight, or obese BMI. Error bars represent 95% CIs. Number of participants at risk in the normal, overweight, and obese categories, respectively, in the 1970s were 585, 542, and 181; in the 1980s: 721, 604, and 226; in the 1990s: 671, 654, and 338; in the 2000s: 651, 637, and 404.
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