Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Sep 1:13:04088.
doi: 10.7189/jogh.13.04088.

Incidence and temporal trends in type 2 diabetes by weight status: A systematic review and meta-analysis of prospective cohort studies

Hong-Jie Yu  1 , Mandy Ho  1 , Xiangxiang Liu  2 , Jundi Yang  1 , Pui Hing Chau  1 , Daniel Yee Tak Fong  1
Affiliations
Meta-Analysis

Incidence and temporal trends in type 2 diabetes by weight status: A systematic review and meta-analysis of prospective cohort studies

Hong-Jie Yu et al. J Glob Health. .

Abstract

Background: Diabetes is more prevalent among overweight/obese individuals, but has become a significant public health challenge among normal weight populations. In this meta-analysis, we aimed to estimate diabetes/prediabetes incidence and its temporal trends by weight status.

Methods: PubMed, Embase, Web of Science, and Cochrane Library were searched until 8 December 2021. Prospective cohort studies reporting diabetes incidence by baseline body mass index (BMI) categories in adults were included. The median year of data collection was used to assess the temporal trends. Subgroup analyses and meta-regression were also performed.

Results: We included 94 studies involving 3.4 million adults from 22 countries. The pooled diabetes incidence in underweight, normal-weight, and overweight/obese adults was 4.5 (95% confidence interval (CI) = 2.8-7.3), 2.7 (95% CI = 2.2-3.3), and 10.5 (95% CI = 9.3-11.8) per 1000 person-years, respectively. The diabetes incidence in low- and middle-income countries (LMICs) was higher than in high-income countries among normal-weight (5.8 vs 2.0 per 1000 person-years) or overweight/obese (15.9 vs 8.9 per 1000 person-years) adults. European and American regions had a higher diabetes incidence than the non-Western areas, regardless of weight status. Underweight diabetes incidence decreased significantly from 1995-2000 to 2005-2010. Diabetes incidence in normal-weight populations has increased continuously since 1985 by an estimated 36% every five years. In overweight/obese adults, diabetes incidence increased between 1985-1990 and 1995-2000, stabilised between 2000 and 2010, and spiked suddenly after 2010.

Conclusions: Diabetes incidence and its temporal trends differed by weight status. The continuous upward trend of diabetes incidence among overweight/obese individuals requires urgent attention, particularly in LMICs. Furthermore, diabetes among normal-weight individuals is becoming a significant public health problem.

Registration: PROSPERO (CRD42020215957).

PubMed Disclaimer

Conflict of interest statement

Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests.

Figures

Figure 1
Figure 1
The pooled incidence of diabetes by baseline weight status. Panel A. Underweight. Panel B. Normal weight. Panel C. Overweight/obesity. BMI – body mass index (kg/m2), F – female, M – male.
Figure 2
Figure 2
The temporal trends of diabetes incidence by baseline weight status. Blue line: Underweight. Red line: Normal weight. Green line: Overweight/obesity. The diabetes incidence was pooled by five years interval; median year of data collection was calculated by the mean value of baseline and follow-up year.
See this image and copyright information in PMC

References

    1. Lingvay I, Sumithran P, Cohen RV, le Roux CW.Obesity management as a primary treatment goal for type 2 diabetes: time to reframe the conversation. Lancet. 2022;399:394-405. 10.1016/S0140-6736(21)01919-X - DOI - PubMed
    1. Gujral UP, Narayan KMV.Diabetes in Normal-Weight Individuals: High Susceptibility in Nonwhite Populations. Diabetes Care. 2019;42:2164-6. 10.2337/dci19-0046 - DOI - PMC - PubMed
    1. Olaogun I, Farag M, Hamid P.The pathophysiology of type 2 diabetes mellitus in non-obese individuals: an overview of the current understanding. Cureus. 2020;12:e7614. 10.7759/cureus.7614 - DOI - PMC - PubMed
    1. Gujral UP, Weber MB, Staimez LR, Narayan KMV.Diabetes among non-overweight individuals: an emerging public health challenge. Curr Diab Rep. 2018;18:60. 10.1007/s11892-018-1017-1 - DOI - PubMed
    1. Vaag A, Lund SS.Non-obese patients with type 2 diabetes and prediabetic subjects: distinct phenotypes requiring special diabetes treatment and (or) prevention? Appl Physiol Nutr Metab. 2007;32:912-20. 10.1139/H07-100 - DOI - PubMed