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[Display omitted] • We report higher prevalence of diabetes than previous Hungarian estimates. • 18.3% of women and 23.5% of men with diabetes were undiagnosed. • Men in their forties had a higher risk of being undiagnosed with diabetes. • Employment status and education level were not associated with being undiagnosed. • Universal health care could provide equitable access to diabetes diagnosis. To estimate prevalence of diagnosed (dDM) and undiagnosed diabetes (uDM) in Hungary and investigate determinants of uDM. Data was obtained from the nationally representative H-UNCOVER study. As laboratory measurements were available for 11/19 Hungarian counties, n = 5,974/17,787 people were eligible. After exclusions, 5,673 (representing 4,976,097 people) were included. dDM was defined by self-reporting, while uDM as negative self-reporting and elevated fasting glucose (≥7 mmol/l) and/or HbA1c (≥48 mmol/mol). Logistic regression for complex samples was used to calculate comparisons between dDM and uDM adjusted for age and BMI. Diabetes prevalence was 12.0 %/11.9 % (women/men, 95 %CI:10.7–13.4 %/10.7–13.2 %), while 2.2 %/2.8 % (1.7–2.8 %/2.2–3.6 %) of women/men were uDM. While the proportion of uDM vs. dDM was similar for women ≥ 40, men in their forties had the highest odds for uDM. Neither unemployment (women/men OR:0.58 [0.14–2.45]/0.50 [0.13–1.92]), nor education level (tertiary vs. primary; women/men OR: 1.16 [0.53–2.56]/ 0.53 [0.24–1.18]) were associated with uDM. The risk of uDM was lower in both sexes with chronic morbidities. We report higher prevalence of diabetes and undiagnosed diabetes than previous Hungarian estimates. The finding that socioeconomic factors are not associated to uDM suggests that universal health care could provide equitable access to diabetes diagnosis. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a disease associated with many complications leading to premature death. The aim of this study was to estimate prevalence of type 2 diabetes (T2D), and the proportion of the population unaware of the condition, in association with modifiable risk factors. Data from the Hellenic National Nutrition and Health Survey were used (n = 3773 adults, 40.8% men) and were obtained by trained personnel. Diabetes mellitus disease status was categorized as per the International Classification of Diseases codes (10th version). A subsample from the two main metropolitan areas was used to assess T2D and impaired fasting glucose (IFG) (n = 990; 38.2% men) from plasma analysis. The prevalence of T2D in the population was 5.2% in total, reaching 13.7% in adults aged >60 years (no sex differences). IFG was observed in 27.3% of adults in the two metropolitan areas, and 40% were unaware of having T2D in this subsample. The likelihood of having T2D significantly increased with age and body weight, whereas it decreased with higher educational level and physical activity (P for all <0.001). The high T2D prevalence in adults, especially among the older age-groups, suggests a major public health problem in Greece. • Impaired fasting glucose was observed in 27.3% of adults in the two metropolitan areas, and 40% were unaware of having T2D. • Odds of T2D significantly increased with age and body weight, and decreased with educational level and physical activity. • The population prevalence of T2D was found 5.2% in total, reaching 13.7% in adults aged >60 years (no sex differences). [ABSTRACT FROM AUTHOR]

Indigenous populations around the world have a higher health disparity and an increased risk of diabetes. Scientific literature on the prevalence of diabetes in India is not available, and the current work is a pilot study to explore the risk of diabetes in one such indigenous population in India. This is a cross-sectional survey and screening study. The study took place in a remote tribal hamlet of Machuru in South India. A door-to-door survey was conducted in the hamlet with a population of 555. The Indian Diabetes Risk Score (IDRS) questionnaire was completed by 160 individuals older than 25 years. Capillary blood glucose levels were measured to compare the glycaemic status with the predicted IDRS. Of 160 adults who completed the questionnaire, 37 were at high risk (23.13%) as per the IDRS, 52 at medium risk (32.5%) and 71 at low risk (44.38%). None of the respondents knew their family history of diabetes owing to the lack of awareness about the condition. Interestingly, the villagers had a sedentary lifestyle owing to their unique family dynamics but a healthy diet. Five participants were diagnosed with diabetes, and 18 were diagnosed with impaired fasting glucose or prediabetes. The IDRS might not be an accurate measure to understand the risk of diabetes in this particular population owing to their unique family dynamics and a lack of awareness about diabetes. The best possible way to assess the diabetes risk might be through blood examination. • Diabetes risk assessment using the IDRS was difficult in this indigenous population owing to multiple factors. • The particular population has sedentary lifestyle after the age of 30 years. • None of the respondents of the IDRS questionnaire knew their family history of diabetes. • The indigenous population had a reduced prevalence of type 2 diabetes compared with the country's average. • Their healthy diet and sleep patterns might possibly have reduced prevalence of type 2 diabetes. [ABSTRACT FROM AUTHOR]

The 2019 Diabetes Atlas delineated both accomplishments and challenges in diabetes care in Taiwan between 2005 and 2014. The series reported that Taiwan had significantly improved aspects of care quality for patients with diabetes. For example, the mortality rate decreased, the difference between the life expectancies of patients with diabetes and those of the general population decreased, and the rates of hospitalization because of heart diseases, cerebrovascular diseases, chronic kidney diseases, and unsatisfactory glycemic control decreased. However, despite these achievements, the 2019 Diabetes Atlas also reported some substantial challenges that have not been overcome. For example, the incidence of diabetes among women aged <19 years and 20-39 years increased by 27% and 33%, respectively. Furthermore, a high prevalence of macrovascular complications, a continuous increase in the dialysis prevalence rates among men with diabetes of all ages, and a low participation rate (<20%) of patients with diabetes in the pay-for-performance program were observed. The publication of the 2019 Diabetes Atlas is a milestone that demonstrates a strong will in medical societies to improve the quality of diabetes care. We expect this initiative can be reorganized every 5 years to report the results of continuous monitoring and surveillance and update the epidemiological features of diabetes in Taiwan. [ABSTRACT FROM AUTHOR]

Aims: To find diabetes prevalence of diagnosed cases, stratified by gender, age, and urban/rural municipalities in the Republic of Macedonia, based on data derived from the National eHealth System.Methods: The National eHealth System was searched for all patients with ICD-10 diagnoses E10-E14 in their electronic healthcare records. Data records from the National eHealth System contained patient's gender, date of birth, place of living, and ICD-10 code.Results: Total number of diagnosed diabetes cases was 84,568: 36,119 males (42.7%) and 48,449 females (57.3%). Diabetes prevalence of diagnosed cases in population 20-79 years was 5.0% (n = 78,233; N = 1,562,203), prevalence was higher in females than in males (4.6% vs 3.4%); in rural than in urban municipalities (5.6% vs 3.6%), and was highest in the age group 60-79 years (14.6%).Conclusion: These were the first findings on diabetes prevalence of diagnosed cases in the Republic of Macedonia derived from the National eHealth System, stratified by age, gender, and urban/rural municipalities. These data could enable more precise estimations of the total diabetes prevalence in the country, including both diagnosed and undiagnosed cases, and further analysis of the risk factors leading to higher diabetes prevalence in females and rural municipalities in the Republic of Macedonia. [ABSTRACT FROM AUTHOR]

Introduction: Since the year 2000, IDF has been measuring the prevalence of diabetes nationally, regionally and globally.Aim: To produce estimates of the global burden of diabetes and its impact for 2017 and projections for 2045.Methods: A systematic literature review was conducted to identify published studies on the prevalence of diabetes, impaired glucose tolerance and hyperglycaemia in pregnancy in the period from 1990 to 2016. The highest quality studies on diabetes prevalence were selected for each country. A logistic regression model was used to generate age-specific prevalence estimates or each country. Estimates for countries without data were extrapolated from similar countries.Results: It was estimated that in 2017 there are 451 million (age 18-99 years) people with diabetes worldwide. These figures were expected to increase to 693 million) by 2045. It was estimated that almost half of all people (49.7%) living with diabetes are undiagnosed. Moreover, there was an estimated 374 million people with impaired glucose tolerance (IGT) and it was projected that almost 21.3 million live births to women were affected by some form of hyperglycaemia in pregnancy. In 2017, approximately 5 million deaths worldwide were attributable to diabetes in the 20-99 years age range. The global healthcare expenditure on people with diabetes was estimated to be USD 850 billion in 2017.Conclusion: The new estimates of diabetes prevalence, deaths attributable to diabetes and healthcare expenditure due to diabetes present a large social, financial and health system burden across the world. [ABSTRACT FROM AUTHOR]

Aims: Epidemiological data regarding diabetes in Greece are based on regional, small-scale studies. We aimed to identify all citizens with prescribed pharmacological treatment for diabetes, to further explore type 1 diabetes prevalence and describe pharmacological treatment patterns in type 2 diabetes.Methods: The electronic prescription database of the National Organization for Health Care Services Provision was used to identify individuals who received at least two prescriptions with an ICD-10 code relevant to diabetes, dispensed between June 1st, 2014 and May 31st, 2015. Type-1 diabetes was defined in those receiving at least two fully-reimbursable insulin prescriptions with an ICD-10 code of E10 (insulin-dependent diabetes).Results: The study population consisted of 10,222,779 individuals, accounting for 95% of the Greek population. Prevalence of medication-prescribed diabetes was 7.0% (720,764 individuals), ranging from 0.08% in children and adolescents, to 8.2% in adults, and 30.3% in those ⩾75years old. Prevalence of type 1 diabetes was 0.24%, with a clear male predominance and more than half of cases developing after 14years of age. Metformin was the most frequently prescribed medication (77.4%) in type-2 diabetes followed by DPP-4 inhibitors (44.8%) and sulphonylureas (34.5%), while insulin was used by 19.4% of patients.Conclusions: This nation-wide real-world data analysis on medication-prescribed diabetes demonstrates that the current prevalence in Greece is 7.0%, with wide age variation and high figures in older adults. Identification of pharmacological patterns among patients with type 2 diabetes is a valuable guide in policy-makers' efforts to balance a cost-effective, quality-acceptable disease management. [ABSTRACT FROM AUTHOR]

Recent research supports a link between diabetes and fine particulate matter (≤ 2.5 μg in diameter; PM 2.5 ) in both laboratory and epidemiology studies. However, research investigating the potential relationship of the spatial vulnerability of diabetes to concomitant PM 2.5 levels is still sparse, and the level of diabetes geographic disparities attributed to PM 2.5 levels has yet to be evaluated. We conducted a Bayesian structured additive regression modeling approach to determine whether long-term exposure to PM 2.5 is spatially associated with diabetes prevalence after adjusting for the socioeconomic status of county residents. This study utilizes the following data sources from 2004 to 2010: the Behavioral Risk Factor Surveillance System, the American Community Survey, and the Environmental Protection Agency. We also conducted spatial comparisons with low, median-low, median-high, and high levels of PM 2.5 concentrations. When PM 2.5 concentrations increased 1 μg/m 3 , the increase in the relative risk percentage for diabetes ranged from − 5.47% (95% credible interval = − 6.14, − 4.77) to 2.34% (95% CI = 2.01, 2.70), where 1323 of 3109 counties (42.55%) displayed diabetes vulnerability with significantly positive relative risk percentages. These vulnerable counties are more likely located in the Southeast, Central, and South Regions of the U.S. A similar spatial vulnerability pattern for concentrations of low PM 2.5 levels was also present in these same three regions. A clear cluster of vulnerable counties at median-high PM 2.5 level was found in Michigan. This study identifies the spatial vulnerability of diabetes prevalence associated with PM 2.5 , and thereby provides the evidence needed to prompt and establish enhanced surveillance that can monitor diabetes vulnerability in areas with low PM 2.5 pollution. [ABSTRACT FROM AUTHOR]

Aim To examine the available evidence about the epidemiology, health, social, and economic impact of diabetes in Pacific Island Countries and Territories (PICTs). Methods We conducted a systematic review of the peer-reviewed literature published in English from January 1990 to January 2014, and relevant technical reports. Results A total of 1548 articles were identified of which 35 studies of type 2 diabetes met the inclusion criteria. Eighteen technical reports were also included. We found no articles reporting on type 1 diabetes or gestational diabetes that met the inclusion criteria. The prevalence, risk factors and complications of diabetes were substantial. Diabetes prevalence rate of around 40% was common. Physical inactivity, overweight and obesity were leading risk factors. High rates of diabetes complications were reported e.g. up to 69% retinopathy. Poor clinical outcomes were also reported with over 70% not meeting glycaemic control targets and approximately 50% not meeting blood pressure and cholesterol targets. Conclusion This review highlights the burden of diabetes in PICTs and the need for more intensive interventions to improve the quality and outcomes of diabetes care. Overall, further research is needed to monitor secular diabetes trends in PICTs using standardised criteria for diagnosing diabetes and its complications. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Few models have been developed specifically for the epidemiology of diabetes. Diabetes incidence is critical in predicting diabetes prevalence. However, reliable estimates of disease incidence rates are difficult to obtain. The aim of this study was to propose a mathematical framework for predicting diabetes prevalence using incidence rates estimated within the model using body mass index (BMI) data. Methods: A generic mechanistic model was proposed considering birth, death, migration, aging, and diabetes incidence dynamics. Diabetes incidence rates were determined within the model using their relationships with BMI represented by the Hill equation. The Hill equation parameters were estimated by fitting the model to National Health and Nutrition Examination Survey (NHANES) 1999–2010 data and used to predict diabetes prevalence pertaining to each NHANES survey year. The prevalences were also predicted using diabetes incidence rates calculated from the NHANES data themselves. The model was used to estimate death rate parameters and to quantify sensitivities of prevalence to each population dynamic. Results: The model using incidence rate estimates from the Hill equations successfully predicted diabetes prevalence of younger, middle-aged, and older adults (prediction error, 20.0%, 9.64%, and 7.58% respectively). Diabetes prevalence was positively associated with diabetes incidence in every age group, but the associations among younger adults were stronger. In contrast, diabetes prevalence was more sensitive to death rates in older adults than younger adults. Both diabetes incidence and prevalence were strongly sensitive to BMI at younger ages, but sensitivity gradually declined as age progressed. Younger and middle aged adults diagnosed with diabetes had at least a two-fold greater risk of death than their nondiabetic counterparts. Nondiabetic older adults were found to be under slightly higher death risk (0.079) than those diagnosed with diabetes (0.073). Conclusions: The proposed model predicts diagnosed diabetes incidence and prevalence reasonably well using the link between BMI and diabetes development risk. Ethnic group and gender-specific model parameter estimates could further improve predictions. Model prediction accuracy and applicability need to be comprehensively evaluated with independent data sets. [Copyright &y& Elsevier]

Abstract: Introduction: Diabetes is a major cause of morbidity and mortality and its global prevalence is growing rapidly. A simple and robust approach to estimate the prevalence of diabetes is essential for governments to set priorities on how to meet the challenges of the disease. The International Diabetes Federation has developed a methodology for generating country-level estimates of diabetes prevalence in adults (20–79 years). Methods: Using country-level data sources from peer-reviewed studies, national health statistics reports, commissioned studies on diabetes prevalence, and unpublished data obtained through personal communication, we use logistic regression to generate estimates of the prevalence of diabetes. An approach matching countries on ethnicity, geography, and income group is used to fill in gaps where original data sources are not available. The methodology also uses changes in urbanization and population to generate estimates and projections on the prevalence of diabetes in adults. Conclusion: Diabetes prevalence estimates are very sensitive to the data from which they are derived. The revised IDF methodology for estimating diabetes prevalence is a transparent, reproducible approach that will be updated annually. It takes data-driven approaches to filling in gaps where data are not available and where assumptions have to be made. It uses a qualification system to rank data sources so that only the highest quality data are used. [Copyright &y& Elsevier]

Purpose: Little research has focused on the social patterning of diabetes among African Americans. We examined the relationship between socioeconomic status (SES) and the prevalence, awareness, treatment, and control of diabetes among African Americans. Methods: Education, income and occupation were examined among 4,303 participants (2,726 women and 1,577 men). Poisson regression estimated relative probabilities (RP) of diabetes outcomes by SES. Results: The prevalence of diabetes was 19.6% in women and 15.9% in men. Diabetes awareness, treatment, and control were 90.0%, 86.8%, and 39.2% in women, respectively, and 88.2%, 84.4%, and 35.9% in men, respectively. In adjusted models, low-income men and women had greater probabilities of diabetes than high-income men and women (RP, 1.94; 95% confidence interval [CI], 1.28–2.92; and RP, 1.35; 95% CI, 1.04–1.74, respectively). Lack of awareness was associated with low education and low occupation in women (RP, 2.28; 95%CI 1.01–5.18; and RP, 2.62; 95% CI, 1.08–6.33, respectively) but not in men. Lack of treatment was associated with low education in women. Diabetes control was not patterned by SES. Conclusions: Diabetes prevalence is patterned by SES, and awareness and treatment are patterned by SES in women but not men. Efforts to prevent diabetes in African Americans need to address the factors that place those of low SES at higher risk. [Copyright &y& Elsevier]

Abstract: Aims/hypothesis: To estimate the prevalence and the direct cost of pharmacologically-treated diabetes in Italy. Methods: The ARNO observatory database, containing the 20-year medical prescriptions of over 10 million Italian people, was used. Ten-year longitudinal data were available in 22 Local Health Districts (LHD). Subjects were classified as having diabetes when prescribed glucose-lowering drugs (oral agents or insulin) (311,979 individuals in 2006). The direct cost was calculated as the sum of drug use, financial compensation by LHD for the inpatient (hospital DRG) and outpatient activities (consultations, laboratory tests, radiology, etc.), all regulated by government contracts. Individuals with diabetes were compared with pharmacologically-treated subjects without diabetes, pair-matched for age, sex and general practitioner. Results: In the 10-year period, the prevalence of pharmacologically-treated diabetes increased from 3.08% to 4.45% (P for trend, <0.001). The average pro capita cost totaled €2,589 in 2006 (95% confidence interval (CI), 2,584–2,594), corresponding to a rate ratio vs. no-diabetes of 1.54 (95% CI, 1.50–1.56). The cost of drugs was € 827 (rate ratio, 1.80 vs. no-diabetes; 95% CI, 1.79–1.82), that of service use, € 488 (rate ratio, 1.07 (0.93–1.25). Only 20% of the pharmaceutical cost was due to glucose-lowering drugs, a percentage stable through the years. The cost of any hospital admission, as defined by DRGs, was independent of diabetes, but the overall cost was much higher in diabetes due to much higher admission rates. Cardiovascular complications and renal failure accounted for the large majority of excess hospital cost. Conclusion: The direct economic burden of pharmacologically-treated diabetes on the National Health System is very high, due to the growing prevalence of disease and the cost of complications. [Copyright &y& Elsevier]

Abstract: We examined time trends in the prevalence of diabetes using nationally representative samples, with a focus on gender differences. Data were from the Nutrition and Health Survey in Taiwan (NAHSIT), 1993–1996 (n =2700), and NAHSIT 2004–2008 (n =2258). Participants aged 19 years or older with adequate fasting glucose data were included. When needed, rates were standardized to the year 2000 WHO 5-year interval population for comparisons. The prevalence increased significantly in men, whose standardized rate increased from 4.6% to 9.3%. In women, the age standardized prevalence decreased slightly from 7.9% to 6.4%. High triglycerides (≥150mg/dL) was associated with diabetes with odds ratios (OR) of 2.14, and 2.69 (all with p <0.05) in the two surveys. High waist circumference (men≥90cm; women≥80cm) was also associated with diabetes with ORs of 2.52, and 1.93 (all with p <0.05). We recommend the development of innovative health promotion programs targeting not only the general population, but also high risk groups such as men, to further reduce diabetes. [ABSTRACT FROM AUTHOR]

Abstract: Background: Although studies of immigrant Asian Indians in other countries show high rates of diabetes (DM), metabolic syndrome (MetS), and cardiovascular disease (CVD), no randomized, population-based studies of this rapidly growing ethnic group exist in the US. Methods: The sample comprised 1038 randomly selected Asian Indian immigrants, aged 18 years and older at seven US sites. Prevalence of diabetes and MetS (age-adjusted and sex-adjusted means) was estimated and ANOVA was used to calculate gender and group differences (normoglycemia/impaired fasting glucose/diabetes) for CVD risk factors. Results: The mean age was 48.2 years. The majority of respondents were male, married, educated, and with some form of health insurance. Prevalence of diabetes was 17.4%, and 33% of the respondents had prediabetes. Cardiovascular risk factors, especially high levels of triglycerides, total cholesterol, LDL cholesterol, homocysteine, and C-reactive protein, and low levels of HDL cholesterol, were also prevalent; elevated lipoprotein(a) was not observed. The age-adjusted prevalence of MetS was 26.9% by the original NCEP/ATP III criteria, 32.7% by the modified NCEP/ATP III criteria, and 38.2% by the IDF criteria. The MetS rates for women, but not for men, increased with age using all three criteria. There was a progressive worsening of all metabolic parameters as individuals progressed from normal to IFG to diabetes. Conclusion: The prevalence rates of diabetes and MetS among US Asian Indians are higher than reported in earlier, nonrandomized, smaller surveys. These data provide a firm basis for future mechanistic and interventional studies. [Copyright &y& Elsevier]

Abstract: Using data from the Salud Bienestar y Envejecimiento (SABE) project and the U.S. National Health and Nutrition Examination Survey (NHANES 1999–2004), we examined the prevalence of obesity and diagnosed diabetes among older adults in the Americas; we also examined the association of age, sex, level of education, weight status, waist circumference, smoking, and race/ethnicity with diabetes among older adults. The prevalence of diagnosed diabetes was highest in the US Blacks and Mexican Americans, followed by Bridgetown and Mexico City (22% for each) and lowest in Santiago, Montevideo, Havana, and US Whites (13–15%). Diagnosed diabetes was significantly associated with BMI among participants from Bridgetown, Sao Paulo, and the three US ethnic groups, while it was associated with waist circumference in all sites except Mexico City. Our findings suggest major geographical and ethnic variation in the prevalence of diagnosed diabetes among older adults. Waist circumference was more consistently associated with the prevalence of diagnosed diabetes than BMI. Higher prevalences of diabetes are found among the elderly of African or Mexican descent in the United States and in other countries of the Americas when compared to the prevalence among whites in the United States and in other Latin American countries with populations of predominant Western European descent. [Copyright &y& Elsevier]

Abstract: Background: Widening of social inequality in health is often discussed. Data regarding trends of the association between diabetes prevalence and social status are lacking. Methods: Using two German health surveys (age 25–69 years), we estimated diabetes prevalences in 1998 compared to 1990–1992. Interaction of secular time with educational level, adjusted for age and BMI, were estimated in men and women using multiple regression models, considering the sample design. Results: Diabetes prevalences in 1990–1992 and 1998 were 5.1% (95% CI 4.1–6.0) and 4.3% (3.5–5.1) in men, and 4.7% (4.0–5.4) and 3.8% (3.0–4.6) in women. It was significantly higher in older subjects and in obese subjects, and tended to be higher in lower educated subjects. Overall, prevalence tended to be lower in 1998 compared to 1990–1992, however, not statistically significant after adjustment for education and BMI (odds ratio, 95% CI: men 0.73; 0.39–1.37; women 0.41; 0.17–1.03). On a descriptive level, in the lowest education group, the diabetes prevalence was higher in 1998 compared to 1990–1992, whereas, it has decreased in higher educated subjects. However, confidence intervals were large, and we found no statistically significant interaction between calendar year and the educational level. Conclusions: Diabetes prevalence tended to decrease in Germany during the 1990s. A widening of social disparity in diabetes risk might be present, but a significant increase could not be confirmed. [Copyright &y& Elsevier]

Abstract: Objective: To estimate the net growth in the risk of type 2 diabetes mellitus (DM) in the population of patients with schizophrenia that may be attributable to the increased use of the class of atypical antipsychotics (A-APDs), adjusting for community trends in DM risk. Methods: Using data from the National Hospital Discharge Survey, we perform trend analyses for prevalence of DM and general illness unrelated to insulin resistance in patients with schizophrenia, as well as in individuals without known mental illness, during three time periods: 1) prior to any A-APDs introduction (1979–1989); 2) short-term after their introduction (1990–1995), and long-term following their introduction (1996–2001). Results: Trends in DM and general illness risks were comparable among inpatients with schizophrenia and those without mental illness during the pre-A-APD era and the short-term post-A-APDs era. During 1996–2001, the net difference in DM prevalence grew at an increasing rate (0.7% per year, p <0.001). By 2001, over a base DM prevalence of 10% in patients with schizophrenia, 3.1 percentage points (p =0.016) could be attributed to the use of A-APDs. There was no significant net growth in the prevalence of general illness during this period for these patients. This growth was most pronounced among African-American females and middle aged (35–49 years old) patients. This increased risk of DM translates into additional direct medical costs of $800 million per year. Conclusions: The introduction of A-APDs, after a lag period, is associated with increased risk of DM. This needs to be considered in light of the advantages of these drugs in efficacy and tolerability. Long-term studies are necessary to identify the effect of individual A-APDs on DM risk. [Copyright &y& Elsevier]

The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) addresses the urgent need for data on diabetes prevalence, risk factors and associated conditions in Australia. Here we describe the methods used and the response rates obtained. AusDiab was a population-based cross-sectional survey of national diabetes mellitus prevalence and associated risk factors in people aged ⩾25 years, conducted between May 1999 and December 2000 in the six states and the Northern Territory of Australia. The study involved an initial household interview, followed by a biomedical examination that included an oral glucose tolerance test (OGTT), standard anthropometric tests, blood pressure measurements and the administration of questionnaires. Of the 20 347 eligible people (aged ⩾25 years and resident at the address for ⩾6 months) who completed a household interview, 11 247 (55.3%) attended for the biomedical examination. Of those who completed the biomedical examination 55.1% were female. Comparisons with the 1998 Australian population estimates showed that younger age responders were under-represented at the biomedical examination, while the middle-aged and older age groups were over-represented. Weighting of the AusDiab data for age and gender have corrected for this bias. AusDiab, which is the largest national diabetes prevalence study undertaken in a developed nation to have used an OGTT, provides a valuable national resource for the study of the prevalence and possible causes of diabetes, as well as identifying possible risk factors that may lead to diabetes. Furthermore, it generates the baseline data for a prospective 5-year cohort study. The data will be important for national and regional public health and lifestyle education and health promotion programs. [Copyright &y& Elsevier]