Time trends in diabetes mellitus in Jordan between 1994 and 2017

Abstract

Aim The prevalence of diabetes has been increasing over the past few decades. The objective of this study is to assess the time trends in diabetes between 1994 and 2017 in Jordan. Methods Surveys were conducted in 1994, 2004, 2009 and 2017 by the same investigators using generally similar methods. Fasting blood glucose was measured in all surveys. Variables were obtained using structured questionnaires designed specifically for the surveys. Crude and age‐specific diabetes prevalence rates were derived for each sex, together with overall, crude and age‐standardized prevalence rates. Results The prevalence of diabetes in men aged ≥ 25 years increased from 14.2% in 1994 to 18.3% in 2004, 26.8% in 2009 and 32.4% in 2017. The corresponding prevalence rates in women were 12.3%, 16.9%, 18.8%, and 18.1%, respectively. The overall age‐standardized prevalence rate increased from 13.0% in 1994 to 17.1% in 2004, 22.2% in 2009 and 23.7% in 2017. Known diabetes in the 2017 survey accounted for 82.6% of people with diabetes. A HbA1c of < 59 mmol/mol (7.5%) was observed in 41.4% of participants with known diabetes. Conclusion The results showed a high prevalence of diabetes in Jordan among people aged ≥ 25 years. Prevalence increased from 1994 to 2009, but slowed thereafter. The increase was greater in men than in women. Previously diagnosed diabetes accounted for a high percentage of people with diabetes in all surveys and was highest in 2017 survey, suggesting that the national strategy against diabetes has brought some benefits. Efforts should be made to improve glycaemic control in people with diabetes.

Trends in incidence of diabetes in Jordan between 1994 and 2017

“…Ajlouni et al . provided valuable results on time trends in diabetes prevalence in Jordan. Their study covered the years 1994 to 2017 with consistent methods used for measuring prevalence throughout the study period.…”

“…, we use data from Ajlouni et al . and mathematical relations between prevalence, incidence and mortality, to quantify temporal trends in the incidence rate . The differential mortality of people with vs. people without diabetes can be incorporated using the age‐ and sex‐specific general mortality of the Jordan population and the hazard ratio (HR).…”

“…For all HR scenarios, we solved Equation (2.9) in Brinks and Landwehr for the age‐specific incidence rate and plotted the results for each survey year reported in Ajlouni et al . .…”

“…Ajlouni et al . found that the increase in prevalence slowed after 2009 and argued that this may be due to a flattening of increases in the incidence rate. However, our results indicate a stable upward trend in the incidence rate over the whole observation period.…”

“…Owing to unknown HR trends in Jordan, we considered annual decreases between 0% and 2% per calendar year, a range that covers observed trends in other countries [5]. For all HR scenarios, we solved Equation (2.9) in Brinks and Landwehr [3] for the agespecific incidence rate and plotted the results for each survey year reported in Ajlouni et al [1]. Figure 1 shows a considerable increase in the age-specific incidence rate for diabetes between 1994 and 2017.…”