Preventing type 2 diabetes mellitus in Qatar by reducing obesity, smoking, and physical inactivity: mathematical modeling analyses
Tóm tắt
The aim of this study was to estimate the impact of reducing the prevalence of obesity, smoking, and physical inactivity, and introducing physical activity as an explicit intervention, on the burden of type 2 diabetes mellitus (T2DM), using Qatar as an example. A population-level mathematical model was adapted and expanded. The model was stratified by sex, age group, risk factor status, T2DM status, and intervention status, and parameterized by nationally representative data. Modeled interventions were introduced in 2016, reached targeted level by 2031, and then maintained up to 2050. Diverse intervention scenarios were assessed and compared with a counter-factual no intervention baseline scenario. T2DM prevalence increased from 16.7% in 2016 to 24.0% in 2050 in the baseline scenario. By 2050, through halting the rise or reducing obesity prevalence by 10–50%, T2DM prevalence was reduced by 7.8–33.7%, incidence by 8.4–38.9%, and related deaths by 2.1–13.2%. For smoking, through halting the rise or reducing smoking prevalence by 10–50%, T2DM prevalence was reduced by 0.5–2.8%, incidence by 0.5–3.2%, and related deaths by 0.1–0.7%. For physical inactivity, through halting the rise or reducing physical inactivity prevalence by 10–50%, T2DM prevalence was reduced by 0.5–6.9%, incidence by 0.5–7.9%, and related deaths by 0.2–2.8%. Introduction of physical activity with varying intensity at 25% coverage reduced T2DM prevalence by 3.3–9.2%, incidence by 4.2–11.5%, and related deaths by 1.9–5.2%. Major reductions in T2DM incidence could be accomplished by reducing obesity, while modest reductions could be accomplished by reducing smoking and physical inactivity, or by introducing physical activity as an intervention.
Tài liệu tham khảo
Abdullah A, Peeters A, de Courten M, Stoelwinder J. The magnitude of association between overweight and obesity and the risk of diabetes: a meta-analysis of prospective cohort studies. Diabetes Res Clin Pract. 2010;89:309–19.
Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88.
Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA. 2007;298:2654–64.
Pan A, Wang Y, Talaei M, Hu FB, Wu T. Relation of active, passive, and quitting smoking with incident type 2 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2015;3:958–67.
Malik VS, Willett WC, Hu FB. Global obesity: trends, risk factors and policy implications. Nat Rev Endocrinol. 2013;9:13–27.
Fiona C. Bull, Timothy P. Armstrong, Tracy Dixon SH, Andrea Neiman, Pratt M: Comparative Quantification of Health Risks. Global and Regional Burden of Disease Attribution to Selected Major Risk Factors. Chapter 10: Physical Inactivity. (available at: http://www.who.int/publications/cra/chapters/volume1/0729-0882.pdf?ua=1). World Health Organization; 2004.
Alhazmi A, Stojanovski E, McEvoy M, Garg ML. Macronutrient intakes and development of type 2 diabetes: a systematic review and meta-analysis of cohort studies. J Am Coll Nutr. 2012;31:243–58.
International Diabetes Federation: IDF Diabetes Atlas. 7th edition. Brussels, Belgium (Available at:http://www.diabetesatlas.org; accessed on September 2016). 2016.
International Diabetes Federation: IDF Diabetes Atlas. Eighth edition. Brussels, Belgium (Available at:http://www.diabetesatlas.org; accessed on December 2017). 2017.
Diabetes Prevention Program Research G, Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, Brenneman AT, Brown-Friday JO, Goldberg R, Venditti E, Nathan DM. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374:1677–86.
Lindstrom J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemio K, Hamalainen H, Harkonen P, Keinanen-Kiukaanniemi S, Laakso M, et al. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet. 2006;368:1673–9.
Li G, Zhang P, Wang J, Gregg EW, Yang W, Gong Q, Li H, Li H, Jiang Y, An Y, et al. The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. Lancet. 2008;371:1783–9.
Lindstrom J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J, Uusitupa M, Tuomilehto J, Study FDP. The Finnish Diabetes Prevention Study (DPS). Diabetes Care. 2003;26:3230–6.
Lindstrom J, Peltonen M, Eriksson JG, Ilanne-Parikka P, Aunola S, Keinanen-Kiukaanniemi S, Uusitupa M, Tuomilehto J, Study FDP. Improved lifestyle and decreased diabetes risk over 13 years: long-term follow-up of the randomised Finnish Diabetes Prevention Study (DPS). Diabetologia. 2013;56:284–93.
Chen L, Pei JH, Kuang J, Chen HM, Chen Z, Li ZW, Yang HZ. Effect of lifestyle intervention in patients with type 2 diabetes: a meta-analysis. Metabolism. 2015;64:338–47.
World Health Organization: Noncommunicable Diseases Global Monitoring Framework: Indicator Definitions and Specifications. vol. 2016. http://www.who.int/nmh/ncd-tools/indicators/GMF_Indicator_Definitions_FinalNOV2014.pdf?ua=1: WHO; 2013.
Saidi O, O’Flaherty M, Mansour NB, Aissi W, Lassoued O, Capewell S, Critchley JA, Malouche D. Romdhane HB, project EFfM: Forecasting Tunisian type 2 diabetes prevalence to 2027: validation of a simple model. BMC Public Health. 2015;15:104.
Abu-Rmeileh NM, Husseini A, Capewell S. O’Flaherty M, project M: Preventing type 2 diabetes among Palestinians: comparing five future policy scenarios. BMJ Open. 2013;3:e003558.
Al-Quwaidhi AJ, Pearce MS, Sobngwi E, Critchley JA, O’Flaherty M. Comparison of type 2 diabetes prevalence estimates in Saudi Arabia from a validated Markov model against the International Diabetes Federation and other modelling studies. Diabetes Res Clin Pract. 2014;103:496–503.
Awad SF, O’Flaherty M, Critchley J, Abu-Raddad LJ. Forecasting the burden of type 2 diabetes mellitus in Qatar to 2050: a novel modeling approach. Diabetes Res Clin Pract. 2018;137:100–8.
Lagarias JC, Reeds JA, Wright MH, Wright PE. Convergence properties of the Nelder-MeadSimplex method in low dimensions. SIAM Journal of Optimization. 1998;9:112–47.
The MathWorks, Inc. MATLAB: The language of technical computing. 8.5.0.197613 (R2015a). Natick, MA, USA: edition: The MathWorks, Inc.; 2015.
Supreme Council of Health, National Health Strategy: Qatar National Diabetes Strategy: Preventing Diabetes Together 2016-2022. Doha, Qatar: Supreme Council of Health; 2015.
World Population Prospects: The 2017 Revision, DVD Edition. (Available at: https://esa.un.org/unpd/wpp/Download/Standard/Population/)
Aune D, Norat T, Leitzmann M, Tonstad S, Vatten LJ. Physical activity and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis. Eur J Epidemiol. 2015;30:529–42.
Centers for Disease Control and Prevention: Strategies to Prevent Obesity and Other Chronic Diseases: the CDC Guide to Strategies to Increase Physical Activity in the Community. Atlanta: U.S. Department of Health and Human Services; 2011.
Calder N: Healthy Weight: Why Local Authority Action is Needed (Available at: www.hegroup.org.uk) Health Equalities Group: Food Active by the Health Equalities Group; 2016.
The Lancet Diabetes E. Sweet success: will sugar taxes improve health? Lancet Diabetes Endocrinol. 2017;5:235.
Borys JM, de Ruyter JC, Finch H, Harper P, Levy E, Mayer J, Richard P. Ruault du Plessis H, Seidell JC, Vinck J: Hydration and obesity prevention. Obes Facts. 2014;7(Suppl 2):37–48.
Hawkes C, Jewell J, Allen K. A food policy package for healthy diets and the prevention of obesity and diet-related non-communicable diseases: the NOURISHING framework. Obes Rev. 2013;14(Suppl 2):159–68.
NOURISHING database (Available at: https://www.wcrf.org/int/policy/nourishing-database)
The Lancet: The Lancet Commission on Obesity (Available at: https://www.worldobesity.org/what-we-do/lancetcommission/). (Lancet ed.; 2015.
Supreme Council of Health: Qatar STEPwise report 2012: Chronic disease risk factor surveillance (available at: http://www.who.int/chp/steps/qatar/en/). 2013.
Chiu M, Austin PC, Manuel DG, Shah BR, Tu JV. Deriving ethnic-specific BMI cutoff points for assessing diabetes risk. Diabetes Care. 2011;34:1741–8.
Shaw KA, Gennat HC, O’Rourke P, C DM: Exercise for overweight or obesity (Review; Available at: http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD003817.pub3/pdf/abstract). vol. Issue 4. Art. No.: CD003817. Cochrane Database of Systematic Reviews; 2006.