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. 2022 May 11;12(5):e053541.
doi: 10.1136/bmjopen-2021-053541.

Impact of trends and gender disparity in obesity on future type 2 diabetes in Turkey: a mathematical modelling analysis

Gül Anil Anakök  1   2 , Susanne F Awad  3 , Çiğdem Çağlayan  4 , Peijue Huangfu  5 , Laith J Abu-Raddad  6   7 , Belgin Unal  8 , Julia Alison Critchley  5
Affiliations

Impact of trends and gender disparity in obesity on future type 2 diabetes in Turkey: a mathematical modelling analysis

Gül Anil Anakök et al. BMJ Open. .

Abstract

Background: Using a previously developed and validated mathematical model, we predicted future prevalence of type 2 diabetes mellitus (T2DM) and major modifiable risk factors (obesity, physical inactivity and smoking) stratified by age and sex in Turkey up to the year 2050.

Methods: Our deterministic compartmental model fitted nationally representative demographic and risk factor data simultaneously for Turkish adults (aged 20-79) between 1997 and 2017, then estimated future trends. Our novel approach explored the impact of future obesity trends on these projections, specifically modelling (1) a gradual fall in obesity in women after the year 2020 until it equalled the age-specific levels seen in men and (2) cessation of the rise in obesity after 2020.

Results: T2DM prevalence is projected to rise from an estimated 14.0% (95% uncertainty interval (UI) 12.8% to 16.0%) in 2020 to 18.4% (95% UI 16.9% to 20.9%) by 2050; 19.7% in women and 17.2% in men by 2050; reflecting high levels of obesity (39.7% for women and 22.0% for men in 2050). Overall, T2DM prevalence could be reduced by about 4% if obesity stopped rising after 2020 or by 12% (22% in women) if obesity prevalence among women could be lowered to equal that of men. The higher age-specific obesity prevalence among women resulted in 2 076 040 additional women developing T2DM by the year 2050.

Conclusion: T2DM is common in Turkey and will remain so. Interventions and policies targeting the high burden of obesity (and low physical activity levels), particularly in women, could significantly impact future disease burdens.

Keywords: diabetes & endocrinology; epidemiology; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Prevalence of T2DM in Turkey by age, sex and calendar time (2020–2050). T2DM, type 2 diabetes mellitus.
Figure 2
Figure 2
Projections of the prevalence of key T2DM risk factors and the proportion attributed to T2DM prevalence in Turkey by sex and calendar time. T2DM, type 2 diabetes mellitus.
Figure 3
Figure 3
Scenario analysis: effects on DM prevalence and incidence of reducing women’s obesity prevalence to that of men’s between 2020 and 2030. T2DM, type 2 diabetes mellitus.
Figure 4
Figure 4
Scenario analysis: effects on DM prevalence and incidence of halting the rise in obesity prevalence after 2020 on future T2DM prevalence. T2DM, type 2 diabetes mellitus.
See this image and copyright information in PMC

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