Globally, about 1 in 11 adults have diabetes mellitus (90% have type 2 diabetes mellitus (T2DM)), and Asia is the epicentre of this global T2DM epidemic.
The major driving factors of the global T2DM epidemic include overweight and obesity, sedentary lifestyle and increased consumption of unhealthy diets containing high levels of red meat and processed meat, refined grains and sugar-sweetened beverages.
Given its global influence, it is essential to break the vicious cycle of diabetes mellitus begetting diabetes mellitus over generations by implementing effective strategies to prevent gestational diabetes mellitus.
Among patients with T2DM, cardiovascular complications are the leading cause of morbidity and mortality, and kidney complications are highly prevalent in patients in Asia with diabetes mellitus.
Major clinical trials have demonstrated that diet and lifestyle modifications are effective in preventing T2DM in high-risk individuals.
T2DM management strategies including lifestyle modifications, social support and ensuring medication adherence are key to reducing the incidence of diabetes mellitus complications.
Globally, the number of people with diabetes mellitus has quadrupled in the past three decades, and diabetes mellitus is the ninth major cause of death. About 1 in 11 adults worldwide now have diabetes mellitus, 90% of whom have type 2 diabetes mellitus (T2DM). Asia is a major area of the rapidly emerging T2DM global epidemic, with China and India the top two epicentres. Although genetic predisposition partly determines individual susceptibility to T2DM, an unhealthy diet and a sedentary lifestyle are important drivers of the current global epidemic; early developmental factors (such as intrauterine exposures) also have a role in susceptibility to T2DM later in life. Many cases of T2DM could be prevented with lifestyle changes, including maintaining a healthy body weight, consuming a healthy diet, staying physically active, not smoking and drinking alcohol in moderation. Most patients with T2DM have at least one complication, and cardiovascular complications are the leading cause of morbidity and mortality in these patients. This Review provides an updated view of the global epidemiology of T2DM, as well as dietary, lifestyle and other risk factors for T2DM and its complications.
Subscribe to Journal
Get full journal access for 1 year
only $4.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
International Diabetes Federation. IDF Diabetes Atlas — 7th Edition. DiabetesAtlas http://www.diabetesatlas.org/ (2015).
Zimmet, P. Z. Diabetes and its drivers: the largest epidemic in human history? Clin. Diabetes Endocrinol. 3, 1 (2017).
Holman, N., Young, B. & Gadsby, R. Current prevalence of type 1 and type 2 diabetes in adults and children in the UK. Diabet Med. 32, 1119–1120 (2015).
Bruno, G. et al. Incidence of type 1 and type 2 diabetes in adults aged 30–49 years: the population-based registry in the province of Turin, Italy. Diabetes Care 28, 2613–2619 (2005).
Fuchsberger, C. et al. The genetic architecture of type 2 diabetes. Nature 536, 41–47 (2016).
Chatterjee, S., Khunti, K. & Davies, M. J. Type 2 diabetes. Lancet 389, 2239–2251 (2017).
Schellenberg, E. S., Dryden, D. M., Vandermeer, B., Ha, C. & Korownyk, C. Lifestyle interventions for patients with and at risk for type 2 diabetes: a systematic review and meta-analysis. Ann. Intern. Med. 159, 543–551 (2013).
Hu, F. B. et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N. Engl. J. Med. 345, 790–797 (2001).
GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 385, 117–171 (2015).
Roglic, G. & Unwin, N. Mortality attributable to diabetes: estimates for the year 2010. Diabetes Res. Clin. Pract. 87, 15–19 (2010).
Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386, 743–800 (2015).
GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388, 1659–1724 (2016).
Beagley, J., Guariguata, L., Weil, C. & Motala, A. A. Global estimates of undiagnosed diabetes in adults. Diabetes Res. Clin. Pract. 103, 150–160 (2014).
Rubin, R. J., Altman, W. M. & Mendelson, D. N. Health care expenditures for people with diabetes mellitus, 1992. J. Clin. Endocrinol. Metab. 78, 809A–809F (1994).
NCD Risk Factor Collaboration. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet 387, 1513–1530 (2016).
Shaw, J. E., Sicree, R. A. & Zimmet, P. Z. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res. Clin. Pract. 87, 4–14 (2010).
Kong, A. P. et al. Diabetes and its comorbidities — where east meets west. Nat. Rev. Endocrinol. 9, 537–547 (2013).
Xu, Y. et al. Prevalence and control of diabetes in Chinese adults. JAMA 310, 948–959 (2013).
Anjana, R. M. et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: phase I results of the Indian Council of Medical Research-INdia DIABetes (ICMR-INDIAB) study. Diabetologia 54, 3022–3027 (2011).
Goldhaber-Fiebert, J. D. et al. Inpatient treatment of diabetic patients in Asia: evidence from India, China, Thailand and Malaysia. Diabet Med. 27, 101–108 (2010).
National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Centers for Disease Control and Prevention https://www.cdc.gov/diabetes/pubs/pdf/methods11.pdf (2011).
Al-Siyabi, H., Al-Anquodi, Z., Al-Hinai, H. & Al-Hinai, S. Nizwa Healthy Lifestyle Project Evaluation Report 2010 (Ad Dakhiliyah, Oman: Ministry of Health, 2010).
Al-Rubeaan, K. et al. Epidemiology of abnormal glucose metabolism in a country facing its epidemic: SAUDI-DM study. J. Diabetes 7, 622–632 (2015).
Lozano, R. et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380, 2095–2128 (2012).
Arredondo, A. Type 2 diabetes and health care costs in Latin America: exploring the need for greater preventive medicine. BMC Med. 12, 136 (2014).
Zimmet, P., Alberti, K. G., Magliano, D. J. & Bennett, P. H. Diabetes mellitus statistics on prevalence and mortality: facts and fallacies. Nat. Rev. Endocrinol. 12, 616–622 (2016).
Chen, L., Magliano, D. J. & Zimmet, P. Z. The worldwide epidemiology of type 2 diabetes mellitus — present and future perspectives. Nat. Rev. Endocrinol. 8, 228–236 (2011).
Nadeau, K. J. et al. Youth-onset type 2 diabetes consensus report: current status, challenges, and priorities. Diabetes Care 39, 1635–1642 (2016).
Dabelea, D. et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA 311, 1778–1786 (2014).
Mayer-Davis, E. J. et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012. N. Engl. J. Med. 376, 1419–1429 (2017).
Fazeli Farsani, S., van der Aa, M. P., van der Vorst, M. M., Knibbe, C. A. & de Boer, A. Global trends in the incidence and prevalence of type 2 diabetes in children and adolescents: a systematic review and evaluation of methodological approaches. Diabetologia 56, 1471–1488 (2013).
Fu, J. & Prasad, H. C. Changing epidemiology of metabolic syndrome and type 2 diabetes in Chinese youth. Curr. Diab Rep. 14, 447 (2014).
Praveen, P. A. et al. Registry of Youth Onset Diabetes in India (YDR): rationale, recruitment, and current status. J. Diabetes Sci. Technol. 10, 1034–1041 (2016).
Ley, S. H. et al. Metabolic syndrome and its components as predictors of incident type 2 diabetes mellitus in an Aboriginal community. CMAJ 180, 617–624 (2009).
Reinehr, T. Type 2 diabetes mellitus in children and adolescents. World J. Diabetes 4, 270–281 (2013).
Australian Institute of Health and Welfare. Type 2 diabetes in Australia's children and young people: a working paper (Australian Institute of Health and Welfare, 2014).
Stumvoll, M., Goldstein, B. J. & van Haeften, T. W. Type 2 diabetes: principles of pathogenesis and therapy. Lancet 365, 1333–1346 (2005).
Reaven, G. M. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 37, 1595–1607 (1988).
Weyer, C., Bogardus, C., Mott, D. M. & Pratley, R. E. The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J. Clin. Invest. 104, 787–794 (1999).
Centers for Disease Control and Prevention, Division of Diabetes Translation. Maps of diabetes and obesity in 1994, 2000, and 2014 (Centers for Disease Control and Prevention, 2016).
Tian, Y. et al. BMI, leisure-time physical activity, and physical fitness in adults in China: results from a series of national surveys, 2000–2014. Lancet Diabetes Endocrinol. 4, 487–497 (2016).
Yang, W. et al. Prevalence of diabetes among men and women in China. N. Engl. J. Med. 362, 1090–1101 (2010).
Franco, M. et al. Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980-2010: repeated cross sectional surveys and ecological comparison of secular trends. BMJ 346, f1515 (2013).
NCD Risk Factor Collaboration. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet 387, 1377–1396 (2016).
Hu, F. B. in Obesity Epidemiology (ed. Hu, F. B.) 149–173 (Oxford Univ. Press, 2008).
Sinha, R. et al. Assessment of skeletal muscle triglyceride content by 1H nuclear magnetic resonance spectroscopy in lean and obese adolescents: relationships to insulin sensitivity, total body fat, and central adiposity. Diabetes 51, 1022–1027 (2002).
Carey, V. J. et al. Body fat distribution and risk of non-insulin-dependent diabetes mellitus in women. The Nurses' Health Study. Am. J. Epidemiol. 145, 614–619 (1997).
Zheng, Y. et al. Associations of weight gain from early to middle adulthood with major health outcomes later in life. JAMA 318, 255–269 (2017).
Lebovitz, H. E. & Banerji, M. A. Point: visceral adiposity is causally related to insulin resistance. Diabetes Care 28, 2322–2325 (2005).
Lee, J. W., Brancati, F. L. & Yeh, H. C. Trends in the prevalence of type 2 diabetes in Asians versus whites: results from the United States National Health Interview Survey, 1997–2008. Diabetes Care 34, 353–357 (2011).
Deurenberg, P., Deurenberg-Yap, M. & Guricci, S. Asians are different from Caucasians and from each other in their body mass index/body fat percent relationship. Obes. Rev. 3, 141–146 (2002).
Chan, J. C. et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA 301, 2129–2140 (2009).
Narayan, K. M. Type 2 diabetes: why we are winning the battle but losing the war? 2015 Kelly West award lecture. Diabetes Care 39, 653–663 (2016).
Carlsson, L. M. et al. Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects. N. Engl. J. Med. 367, 695–704 (2012).
Knowler, W. C. et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med. 346, 393–403 (2002).
Tuomilehto, J. et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N. Engl. J. Med. 344, 1343–1350 (2001).
Pan, X. R. et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 20, 537–544 (1997).
Tong, Y. Z. et al. Consensus on the prevention of type 2 diabetes in Chinese adults. Chin. Med. J. 130, 600–606 (2017).
Ley, S. H., Hamdy, O., Mohan, V. & Hu, F. B. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet 383, 1999–2007 (2014).
Bhupathiraju, S. N. et al. Glycemic index, glycemic load, and risk of type 2 diabetes: results from 3 large US cohorts and an updated meta-analysis. Am. J. Clin. Nutr. 100, 218–232 (2014).
Schulze, M. B. & Hu, F. B. Primary prevention of diabetes: what can be done and how much can be prevented? Annu. Rev. Public Health 26, 445–467 (2005).
Salas-Salvado, J. et al. Prevention of diabetes with Mediterranean diets: a subgroup analysis of a randomized trial. Ann. Intern. Med. 160, 1–10 (2014).
Li, Y. et al. Exposure to the Chinese famine in early life and the risk of hyperglycemia and type 2 diabetes in adulthood. Diabetes 59, 2400–2406 (2010).
Grontved, A., Rimm, E. B., Willett, W. C., Andersen, L. B. & Hu, F. B. A prospective study of weight training and risk of type 2 diabetes mellitus in men. Arch. Intern. Med. 172, 1306–1312 (2012).
Ekelund, U., Brage, S., Griffin, S. J. & Wareham, N. J. Objectively measured moderate- and vigorous-intensity physical activity but not sedentary time predicts insulin resistance in high-risk individuals. Diabetes Care 32, 1081–1086 (2009).
Rockette-Wagner, B. et al. The impact of lifestyle intervention on sedentary time in individuals at high risk of diabetes. Diabetologia 58, 1198–1202 (2015).
Willi, C., Bodenmann, P., Ghali, W. A., Faris, P. D. & Cornuz, J. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 298, 2654–2664 (2007).
Hayashino, Y. et al. A prospective study of passive smoking and risk of diabetes in a cohort of workers: the High-Risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study. Diabetes Care 31, 732–734 (2008).
Reaven, G. & Tsao, P. S. Insulin resistance and compensatory hyperinsulinemia: the key player between cigarette smoking and cardiovascular disease? J. Am. Coll. Cardiol. 41, 1044–1047 (2003).
GBD 2015 Tobacco Collaborators. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015. Lancet 389, 1885–1906 (2017).
Baliunas, D. O. et al. Alcohol as a risk factor for type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 32, 2123–2132 (2009).
Mumenthaler, M. S., Taylor, J. L., O'Hara, R. & Yesavage, J. A. Gender differences in moderate drinking effects. Alcohol Res. Health 23, 55–64 (1999).
Joosten, M. M., Beulens, J. W., Kersten, S. & Hendriks, H. F. Moderate alcohol consumption increases insulin sensitivity and ADIPOQ expression in postmenopausal women: a randomised, crossover trial. Diabetologia 51, 1375–1381 (2008).
Ezzati, M. & Riboli, E. Behavioral and dietary risk factors for noncommunicable diseases. N. Engl. J. Med. 369, 954–964 (2013).
Powles, J. W., Zatonski, W., Vander Hoorn, S. & Ezzati, M. The contribution of leading diseases and risk factors to excess losses of healthy life in Eastern Europe: burden of disease study. BMC Public Health 5, 116 (2005).
Böhm, A., Weigert, C., Staiger, H. & Haring, H. U. Exercise and diabetes: relevance and causes for response variability. Endocrine 51, 390–401 (2016).
Almgren, P. et al. Heritability and familiality of type 2 diabetes and related quantitative traits in the Botnia Study. Diabetologia 54, 2811–2819 (2011).
McCarthy, M. I. Genomics, type 2 diabetes, and obesity. N. Engl. J. Med. 363, 2339–2350 (2010).
Manolio, T. A. et al. Finding the missing heritability of complex diseases. Nature 461, 747–753 (2009).
Dimas, A. S. et al. Impact of type 2 diabetes susceptibility variants on quantitative glycemic traits reveals mechanistic heterogeneity. Diabetes 63, 2158–2171 (2014).
Flannick, J. & Florez, J. C. Type 2 diabetes: genetic data sharing to advance complex disease research. Nat. Rev. Genet. 17, 535–549 (2016).
Franks, P. W., Pearson, E. & Florez, J. C. Gene-environment and gene-treatment interactions in type 2 diabetes: progress, pitfalls, and prospects. Diabetes Care 36, 1413–1421 (2013).
Hagberg, J. M., Jenkins, N. T. & Spangenburg, E. Exercise training, genetics and type 2 diabetes-related phenotypes. Acta Physiol. 205, 456–471 (2012).
Langenberg, C. et al. Gene-lifestyle interaction and type 2 diabetes: the EPIC interact case-cohort study. PLoS Med. 11, e1001647 (2014).
Hivert, M. F. et al. Updated genetic score based on 34 confirmed type 2 diabetes loci is associated with diabetes incidence and regression to normoglycemia in the diabetes prevention program. Diabetes 60, 1340–1348 (2011).
Franks, P. W. & McCarthy, M. I. Exposing the exposures responsible for type 2 diabetes and obesity. Science 354, 69–73 (2016).
Meigs, J. B. Multiple biomarker prediction of type 2 diabetes. Diabetes Care 32, 1346–1348 (2009).
Guasch-Ferre, M. et al. Metabolomics in prediabetes and diabetes: a systematic review and meta-analysis. Diabetes Care 39, 833–846 (2016).
Tripathy, D. et al. A novel insulin resistance index to monitor changes in insulin sensitivity and glucose tolerance: the ACT NOW study. J. Clin. Endocrinol. Metab. 100, 1855–1862 (2015).
Neel, J. V. Diabetes mellitus: a “thrifty” genotype rendered detrimental by “progress”? Am. J. Hum. Genet. 14, 353–362 (1962).
Cunningham, M. The state of the World's indigenous peoples. Chapter V, health. United Nations http://www.un.org/esa/socdev/unpfii/documents/SOWIP/en/SOWIP_chapter5.pdf (2009).
Hales, C. N. & Barker, D. J. The thrifty phenotype hypothesis. Br. Med. Bull. 60, 5–20 (2001).
Whincup, P. H. et al. Birth weight and risk of type 2 diabetes: a systematic review. JAMA 300, 2886–2897 (2008).
Ravelli, A. C. et al. Glucose tolerance in adults after prenatal exposure to famine. Lancet 351, 173–177 (1998).
Ong, T. P. & Ozanne, S. E. Developmental programming of type 2 diabetes: early nutrition and epigenetic mechanisms. Curr. Opin. Clin. Nutr. Metab. Care 18, 354–360 (2015).
Coustan, D. R. Gestational diabetes mellitus. Clin. Chem. 59, 1310–1321 (2013).
Chen, L., Mayo, R., Chatry, A. & Hu, G. Gestational diabetes mellitus: its epidemiology and implication beyond pregnancy. Curr. Epidemiol. Rep. 3, 1–11 (2016).
Bellamy, L., Casas, J. P., Hingorani, A. D. & Williams, D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet 373, 1773–1779 (2009).
Dabelea, D. et al. Increasing prevalence of type II diabetes in American Indian children. Diabetologia 41, 904–910 (1998).
Ussar, S. et al. Interactions between gut microbiota, host genetics and diet modulate the predisposition to obesity and metabolic syndrome. Cell Metab. 22, 516–530 (2015).
Qin, J. et al. A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature 490, 55–60 (2012).
Rao, X., Montresor-Lopez, J., Puett, R., Rajagopalan, S. & Brook, R. D. Ambient air pollution: an emerging risk factor for diabetes mellitus. Curr. Diab Rep. 15, 603 (2015).
Gall, E. T., Carter, E. M., Earnest, C. M. & Stephens, B. Indoor air pollution in developing countries: research and implementation needs for improvements in global public health. Am. J. Public Health 103, e67–72 (2013).
World Health Organization. Ambient air pollution: a global assessment of exposure and burden of disease. WHO http://apps.who.int/iris/bitstream/10665/250141/1/9789241511353-eng.pdf (2016).
Anyanwagu, U., Idris, I. & Donnelly, R. Drug-induced diabetes mellitus: evidence for statins and other drugs affecting glucose metabolism. Clin. Pharmacol. Ther. 99, 390–400 (2016).
Litwak, L. et al. Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study. Diabetol Metab. Syndr. 5, 57 (2013).
Gregg, E. W., Sattar, N. & Ali, M. K. The changing face of diabetes complications. Lancet Diabetes Endocrinol. 4, 537–547 (2016).
Zimmet, P. Z., Magliano, D. J., Herman, W. H. & Shaw, J. E. Diabetes: a 21st century challenge. Lancet Diabetes Endocrinol. 2, 56–64 (2014).
Zhuo, X., Zhang, P. & Hoerger, T. J. Lifetime direct medical costs of treating type 2 diabetes and diabetic complications. Am. J. Prev. Med. 45, 253–261 (2013).
Reusch, J. E. & Manson, J. E. Management of type 2 diabetes in 2017: getting to goal. JAMA 317, 1015–1016 (2017).
Booth, G. L., Kapral, M. K., Fung, K. & Tu, J. V. Relation between age and cardiovascular disease in men and women with diabetes compared with non-diabetic people: a population-based retrospective cohort study. Lancet 368, 29–36 (2006).
Beckman, J. A., Paneni, F., Cosentino, F. & Creager, M. A. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part II. Eur. Heart J. 34, 2444–2452 (2013).
Sarwar, N. et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 375, 2215–2222 (2010).
Seshasai, S. R. et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N. Engl. J. Med. 364, 829–841 (2011).
Regensteiner, J. G. et al. Sex differences in the cardiovascular consequences of diabetes mellitus: a scientific statement from the american heart association. Circulation 132, 2424–2447 (2015).
Clarke, P. M. et al. Event rates, hospital utilization, and costs associated with major complications of diabetes: a multicountry comparative analysis. PLoS Med. 7, e1000236 (2010).
Chi, Z. S., Lee, E. T., Lu, M., Keen, H. & Bennett, P. H. Vascular disease prevalence in diabetic patients in China: standardised comparison with the 14 centres in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia 44, S82–S86 (2001).
Forouhi, N. G., Sattar, N., Tillin, T., McKeigue, P. M. & Chaturvedi, N. Do known risk factors explain the higher coronary heart disease mortality in South Asian compared with European men? Prospective follow-up of the Southall and Brent studies, UK. Diabetologia 49, 2580–2588 (2006).
van Dieren, S., Beulens, J. W., van der Schouw, Y. T., Grobbee, D. E. & Neal, B. The global burden of diabetes and its complications: an emerging pandemic. Eur. J. Cardiovasc. Prev. Rehabil. 17, S3–S8 (2010).
Afkarian, M. et al. Clinical manifestations of kidney disease among US adults with diabetes, 1988–2014. JAMA 316, 602–610 (2016).
Zhang, L. et al. Trends in chronic kidney disease in China. N. Engl. J. Med. 375, 905–906 (2016).
McNeely, M. J. & Fujimoto, W. Y. in The Epidemiology of Diabetes Mellitus (eds Ekoé, J.-M., Rewers, M., Williams, R. & Zimmet, P.) 323–337 (John Wiley & Sons, 2008).
Wilkinson, E. et al. Lack of awareness of kidney complications despite familiarity with diabetes: a multi-ethnic qualitative study. J. Ren Care 37, 2–11 (2011).
Zhang, X. et al. Prevalence of diabetic retinopathy in the United States, 2005–2008. JAMA 304, 649–656 (2010).
Wong, T. Y. et al. Prevalence and risk factors for diabetic retinopathy: the Singapore Malay Eye Study. Ophthalmology 115, 1869–1875 (2008).
Jee, D., Lee, W. K. & Kang, S. Prevalence and risk factors for diabetic retinopathy: the Korea National Health and Nutrition Examination Survey 2008–2011. Invest. Ophthalmol. Vis. Sci. 54, 6827–6833 (2013).
Schofield, C. J. et al. Mortality and hospitalization in patients after amputation: a comparison between patients with and without diabetes. Diabetes Care 29, 2252–2256 (2006).
Lim, T. S. et al. Outcomes of a contemporary amputation series. ANZ J. Surg. 76, 300–305 (2006).
Giovannucci, E. et al. Diabetes and cancer: a consensus report. Diabetes Care 33, 1674–1685 (2010).
Cali, A. M. et al. Glucose dysregulation and hepatic steatosis in obese adolescents: is there a link? Hepatology 49, 1896–1903 (2009).
Jordan, A. S., McSharry, D. G. & Malhotra, A. Adult obstructive sleep apnoea. Lancet 383, 736–747 (2014).
Tabak, A. G., Akbaraly, T. N., Batty, G. D. & Kivimaki, M. Depression and type 2 diabetes: a causal association? Lancet Diabetes Endocrinol. 2, 236–245 (2014).
Wadden, T. A. et al. The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it. Obesity 14, 737–752 (2006).
Wing, R. R. et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N. Engl. J. Med. 369, 145–154 (2013).
Church, T. S. et al. Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial. JAMA 304, 2253–2262 (2010).
Sigal, R. J. & Kenny, G. P. Combined aerobic and resistance exercise for patients with type 2 diabetes. JAMA 304, 2298–2299 (2010).
Estruch, R. et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N. Engl. J. Med. 368, 1279–1290 (2013).
Diaz-Lopez, A. et al. Mediterranean diet, retinopathy, nephropathy, and microvascular diabetes complications: a post hoc analysis of a randomized trial. Diabetes Care 38, 2134–2141 (2015).
Osborn, C. Y., Rivet Amico, K., Fisher, W. A., Egede, L. E. & Fisher, J. D. An information-motivation-behavioral skills analysis of diet and exercise behavior in Puerto Ricans with diabetes. J. Health Psychol. 15, 1201–1213 (2010).
Mayberry, L. S. & Osborn, C. Y. Family support, medication adherence, and glycemic control among adults with type 2 diabetes. Diabetes Care 35, 1239–1245 (2012).
Barry, C. L., Gollust, S. E. & Niederdeppe, J. Are Americans ready to solve the weight of the nation? N. Engl. J. Med. 367, 389–391 (2012).
Mozaffarian, D. et al. Executive summary: heart disease and stroke statistics — 2016 update: a report from the American Heart Association. Circulation 133, 447–454 (2016).
Zhao, Z. et al. Body iron stores and heme-iron intake in relation to risk of type 2 diabetes: a systematic review and meta-analysis. PLoS ONE 7, e41641 (2012).
Wu, J. H. et al. Omega-3 fatty acids and incident type 2 diabetes: a systematic review and meta-analysis. Br. J. Nutr. 107, S214–S227 (2012).
Schulze, M. B. et al. Fiber and magnesium intake and incidence of type 2 diabetes: a prospective study and meta-analysis. Arch. Intern. Med. 167, 956–965 (2007).
Dong, J. Y., Xun, P. & Qin, L. Q. Magnesium intake and risk of type 2 diabetes: meta-analysis of prospective cohort studies. Diabetes Care 34, 2116–2122 (2011).
Song, Y. et al. Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care 36, 1422–1428 (2013).
Pan, A. et al. Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. Am. J. Clin. Nutr. 94, 1088–1096 (2011).
Hu, E. A., Pan, A., Malik, V. & Sun, Q. White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ 344, e1454 (2012).
Carter, P., Gray, L. J., Troughton, J., Khunti, K. & Davies, M. J. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ 341, c4229 (2010).
Cooper, A. J. et al. Fruit and vegetable intake and type 2 diabetes: EPIC-InterAct prospective study and meta-analysis. Eur. J. Clin. Nutr. 66, 1082–1092 (2012).
Tong, X., Dong, J. Y., Wu, Z. W., Li, W. & Qin, L. Q. Dairy consumption and risk of type 2 diabetes mellitus: a meta-analysis of cohort studies. Eur. J. Clin. Nutr. 65, 1027–1031 (2011).
Aune, D., Norat, T., Romundstad, P. & Vatten, L. J. Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. Eur. J. Epidemiol. 28, 845–858 (2013).
Malik, V. S. et al. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care 33, 2477–2483 (2010).
Romaguera, D. et al. Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct. Diabetologia 56, 1520–1530 (2013).
Ding, M., Bhupathiraju, S. N., Chen, M., van Dam, R. M. & Hu, F. B. Caffeinated and decaffeinated coffee consumption and risk of type 2 diabetes: a systematic review and a dose-response meta-analysis. Diabetes Care 37, 569–586 (2014).
de Koning, L. et al. Diet-quality scores and the risk of type 2 diabetes in men. Diabetes Care 34, 1150–1156 (2011).
Y.Z. was supported by fellowship 7-12-MN-34 from the American Diabetes Association.
The authors declare no competing financial interests.
About this article
Cite this article
Zheng, Y., Ley, S. & Hu, F. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol 14, 88–98 (2018). https://doi.org/10.1038/nrendo.2017.151
Cell Reports (2021)
Whole Alga, Algal Extracts, and Compounds as Ingredients of Functional Foods: Composition and Action Mechanism Relationships in the Prevention and Treatment of Type-2 Diabetes Mellitus
International Journal of Molecular Sciences (2021)
Adherence to guideline-recommended HbA1c testing frequency and better outcomes in patients with type 2 diabetes: a 5-year retrospective cohort study in Australian general practice
BMJ Quality & Safety (2021)
Primary Care Diabetes (2021)