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. 2019 Jul-Aug;35(4):1173-1178.
doi: 10.12669/pjms.35.4.194.

Diabetes in Pakistan: A systematic review and meta-analysis

Sohail Akhtar  1 , Jamal Abdul Nasir  2 , Tahir Abbas  3 , Aqsa Sarwar  4
Affiliations

Diabetes in Pakistan: A systematic review and meta-analysis

Sohail Akhtar et al. Pak J Med Sci. 2019 Jul-Aug.

Abstract

Objective: The purpose of this study was assess the time trend of the prevalence of prediabetes and diabetes and risk factors associated with diabetes in Pakistan by using a systematic review and meta-analysis.

Methods: A systematic literature search of Embase, PubMed, and the Cochrane library was carried out between January 1, 1995 and August 30, 2018. Diabetes and prediabetes prevalence estimates were combined by the random-effects model. The existence of publication bias was tested by Egger regression. This systematic review was reported following the PRISMA guidelines.

Results: The search conceded a total of 635 studies, only 14 studies were considered for meta-analysis. The prevalence of diabetes in Pakistan was revealed 14.62% (10.651%-19.094%; 14 studies) based on 49,418 people using the inverse-variance random-effects model. The prevalence of prediabetes was 11.43% (8.26%-15.03%; 10 studies) based on a total sample of 26,999 people. The risk factors associated with diabetes were mean age (β = 0.48%, 95% CI: 0.21-0.78, p<0.001), the proportion of participants with a family history of diabetes (β = 0. 45%, 95% CI: 0.08-0.82, p =0.018, p<0.001), hypertension (β = 0.40%, 95% CI: 0.06-0.75, p = 0.022), weight (BMI) (β = 0.21%, 95% CI: 0.02-0.4, p=0.030).

Conclusions: There has been a continuous increase in the prevalence of prediabetes and diabetes in Pakistan. All parts of the country have been affected, with the highest in Sindh and lowest in Khyber Pakhtunkhwa. The main factors include growing age, family history, hypertension and obesity. A nationwide diabetes care survey on risk factors and prevention policy is highly recommended.

Keywords: Diabetes; Meta-analysis and Systematic review; Pakistan; Prediabetes.

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Figures

Fig. 1
Fig. 1
Flow diagram explaining the number of included and excluded articles in the meta-analysis on diabetes in Pakistan, considered from the PRISMA 2009 guideline.
Fig. 2
Fig. 2
Forest plot of prevalence of diabetes from population Jan. 1995 to Aug. 2018.
Fig. 3
Fig. 3
Forest plot of prevalence of prediabetes from population Jan. 1995 to Aug. 2018.
Fig. 4
Fig. 4
Funnel plot of the prevalence of diabetes in Pakistan from Jan. 1995 to Aug. 2018.
See this image and copyright information in PMC

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