One in Two Mexicans Could Have Diabetes by 2050

Veronica Hackethal, MD

November 30, 2015

As many as one in two Mexicans could be diagnosed with type 2 diabetes in their lifetime if current rates continue unabated, according to a new study published in the December issue of Preventive Medicine.

The research found dramatic increases in diagnoses of diabetes, by 30% among Mexican adults, between 2000 and 2012.

"We found that there has been considerable increase in diabetes incidence since the 1960s, where incidence has roughly doubled every 10 years," commented first author Rafael Meza, PhD, of the University of Michigan School of Public Health, Ann Arbor.

Dr Meza, along with colleagues from the National Institute of Public Health, Cuernavaca, Morelos, and the National Cancer Institute in Mexico City, Mexico, used a population model to project the diabetes burden in the next 30 to 50 years if things continue as they are.

"What we found is that diabetes rates would reach a prevalence level between 14% and 22% by 2050, and 15 to 25 million individuals could have a diagnosis of diabetes by then," Dr Meza said.

That means that between one in two to one in three Mexicans will be diagnosed with diabetes in their lifetimes if rates continue as they are, he highlighted.

Diabetes already affects up to 347 million people worldwide, with the burden more heavily concentrated in middle- and low-income countries, and in the past several decades the rates have been steadily increasing.

Experts project that diabetes will become the seventh leading cause of death in the world and will exact a cost of over $490 billion by 2030.

Mexico: One of Highest Rates of Obesity in World

Mexico has one of the highest rates of overweight and obesity in the world, and diabetes rates are therefore also high, hovering around 14% in 2006. Almost half of all cases, though, remain undiagnosed. Costs amount to over $1.1 billion, according to background information in the article.

In the study, researchers used data from the Mexico National Health and Nutrition Survey for the years 2000, 2006, and 2012 and models to estimate prevalence and incidence of self-reported diagnosis of diabetes, based on age, sex, calendar year (1960–2012), and birth cohort (1920–1980).

Then they used demographic projections for the Mexican population for 2010 to 2050 to predict future rates of diabetes using a multicohort Diabetes Markov Model adopting three scenarios (optimistic scenario=future incidence similar to the incidence in 2000: middle scenario=future incidence similar to the incidence in 2005; and pessimistic scenario=future incidence the same as in 2010).

Results showed that the prevalence of diagnosed diabetes among adults in Mexico increased by about 30% from 2000 to 2012, and the most dramatic rise occurred from 2006 to 2012, when rates jumped from 7% to 8.9%, respectively.

Diabetes incidence increased "exponentially" from 1960 to 2012, roughly doubling every 10 years. Mexicans born in the 1960s had a five- to sixfold higher rate of diabetes diagnosis than those born in the 1930s.

Using the three incidence scenarios, projections showed that by 2050 diabetes could affect from 13.7% up to 22.5%, or 15 to 25 million, Mexicans.

The study highlights the need for urgent public-health efforts, such as Mexico's current obesity and diabetes prevention control plan, which includes a variety of strategies to improve the diet of the Mexican population.

A case in point is the recent soda tax — Mexico is the first country in the world to implement such a levy nationwide. This took effect in January 2014 and imposes a roughly 10% tax on sugary drinks.

Dr Meza's group was involved in studies that modeled the effect of the tax before its implementation.

Now, the first solid numbers about the effect of the tax are starting to trickle in, and so far the results are encouraging, according to Dr Meza.

"There is evidence that the tax has actually been working. There's been about a 10% reduction in consumption of sugary drinks [since implementation]," he said.

But there's still plenty of work to do.

If indeed the tax continues to have the desired effect on consumption, it remains to be seen whether that will translate into lower rates of obesity and — farther down the road — reduced rates of diabetes.

Dr Meza's group plans to look at these issues, and they would also like to evaluate the impact of the tax on diabetes complications like cardiovascular and renal disease, as well as on different socioeconomic groups in Mexico.

The results could be extended beyond Mexico, he said — for example, to Hispanic populations in the United States who also have a significant risk of diabetes.

"A lot of people in the world are interested in seeing what happens with the sugary-drink tax in Mexico," Dr Meza said, "This is a strategy that eventually could lead to methods in other countries, so we're all paying attention to what's going to happen."

The authors report no relevant financial relationships.

Prev Med. 2015;81;445–450.Abstract

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