Data from several countries have shown a stabilization or decrease in diabetes incidence since the mid-2000s. It is intuitively appealing to think that trends in risk factors for diabetes would parallel these changes, although such trends have not been explored. We compared age-standardized (WHO standard population) trends in obesity prevalence, from nationally representative cross-sectional surveys, with trends in diabetes incidence, from national diabetes registries or administrative data sources, in six countries where data was available for both national obesity prevalence and diabetes incidence between 1990-2015. In 5 out of 6 countries, diabetes incidence increased until the mid-2000s followed by a decreasing trend; in Korea incidence decreased across the whole time period for which data were available. An increasing trend in obesity prevalence was observed in all 6 countries with no evidence for a fall in obesity prevalence, although the rate of increase in obesity prevalence slowed in United Kingdom in the early 2000s. Among the datasets in this study, current evidence on trends in obesity prevalence do not appear to explain the recent decrease in diabetes incidence, suggesting an uncoupling of these trends. Further research on trends in other major diabetes risk factors, such as prediabetes, and the influence of diagnostic guidelines and practice may provide additional insights into trends in diabetes incidence.


T.R. Hird: None. L. Chen: None. R.M. Islam: None. M.E. Pavkov: None. E. Gregg: None. M. Tabesh: None. D. Koye: None. E.L. Barr: None. J.E. Shaw: Advisory Panel; Self; Abbott, Merck Sharp & Dohme Corp. Speaker's Bureau; Self; AstraZeneca, Mylan, Roche Diabetes Care, Sanofi-Aventis. D.J. Magliano: None.


Centers for Disease Control and Prevention

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at