Diabetes increasing among rural populations in developing countries

This systematic review reports that the prevalence of diabetes among rural populations in developing countries increased from 1.8% (1.0-2.6) of the population in 1985-1989 to 8.6% (6.4-10.7) of the population in 2005-2010.

Clinical question

In rural populations in low and middle income countries, is the prevalence of diabetes increasing over time?

The evidence

The reviewers searched Medline and EMBASE for published reports of diabetes prevalence.  They pooled the data from these reports and performed statistical analysis to derive overall estimates.

The overal prevalence of diabetes in rural populations was was estimated at 5.6% (95% CI=4.6-6.6).  When the reviewers looked at the data from different time periods, they found a significant trend towards increased prevalence over time.

As these populations can be hard to reach with health care and education services, these findings have important implications for patients and health systems alike.

Appraisal hints

  • Did the reviewers do enough to identify all of the relevant evidence?  They only searched two databases and did not look for grey literature.
  • Were the studies sufficiently similar in their methods and samples to merit being combined in this way?  This is often a problem when combining studies from different time periods.
  • Did the reviewers adjust the results according to other known factors, such as improved diagnosis?


Hwang CK, Han PV, Zabetian A, Ali MK, Venkat Narayan KM. Rural diabetes prevalence quintuples over twenty-five years in low- and middle-income countries: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2012 Jan 17.

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I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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