To assess the level of treatment with glucose-lowering medication among people with diabetes
Definition:
Percentage of people aged ≥ 30 years with diabetes who are currently using glucose-lowering medication. Diabetes is defined as FPG ≥7.0 mmol/L, or HbA1c ≥6.5%, or taking medication for diabetes.
Disaggregation:
Age and sex
Method of measurement
Estimated from population-based surveys as follows: Numerator: number of adults aged ≥ 30 years with diabetes who are currently taking glucose-lowering medication Denominator: total number of adults aged ≥ 30 years with diabetes, defined as fasting plasma glucose (FPG) ≥7.0 mmol/L, glycated haemoglobin (HbA1c) ≥6.5%, or taking medication for diabetes.
Whether a person is taking glucose-lowering medication for diabetes is assessed using survey-specific questions worded as variations of “are you currently taking medication for diabetes or high blood sugar?”; or the combination of “do you currently inject/use insulin for diabetes?” and “are you currently taking any medicines, tablets, or pills for diabetes?”; or using information gathered on prescribed medicines.
Method of estimation:
Population-representative studies with measurements of fasting glucose and/or glycated haemoglobin (HbA1c), and information on diabetes treatment were compiled.
Data were pooled using a Bayesian hierarchical meta-regression model to estimate diabetes treatment coverage.
Age-standardized estimates are produced by weighting the age-specific estimates by the product of the WHO Standard Population fraction and the age-specific prevalence of diabetes.
Full details of input data and methods are available at:
NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants. Lancet 2024. Available online at: https://doi.org/10.1016/S0140-6736(24)02317-1
Preferred data sources:
Nationally or sub-nationally representative population-based surveys, with blood glucose measurements (HbA1c or FPG) and a questionnaire which investigates taking medication for diabetes.
Comments:
For any comparison over time or with other populations, age standardization is recommended.
Limitations:
Data are not available for every country and year, and not all available data are nationally representative. Some studies only measured FPG or only measured HbA1c, and regressions were used to estimate how many people would have been identified with the unmeasured biomarker. A Bayesian hierarchical model is used to estimate coverage for all country-years.
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