title: Explaining the increase of diabetes prevalence and plasma glucose in Mauritius.
abstract: OBJECTIVE
  Secular trends in the epidemiology of diabetes are best described by studying the same population over time, but few such studies exist. Using surveys from Mauritius in 1987 and 2009, we examined 1) the change in the prevalence of diabetes, 2) the extent to which changes in traditional diabetes risk factors explained the increase, and 3) the change in the distribution of plasma glucose levels over time.
  
  
  METHODS
  Independent population-based surveys were undertaken in Mauritius in 1987 and 2009 using similar methodology in adults aged 20-74 years. Physical measurements and fasting blood samples were taken, and an oral glucose tolerance test was performed at both surveys.
  
  
  RESULTS
  The age-standardized prevalence of diabetes in 2009 was 22.3% (95% CI 20.0-24.6) among men and 20.2% (18.3-22.3) among women, representing an increase since 1987 of 64 and 62% among men and women, respectively. Concurrent changes in the distribution of age, ethnicity, waist circumference, BMI, physical activity, smoking, family history of diabetes, and hypertension explained more of the increase in the prevalence of diabetes in men than in women. Increases in plasma glucose (especially fasting glucose) were seen across the population but were greater at the upper levels.
  
  
  CONCLUSIONS
  In Mauritius, there has been a marked increase in diabetes prevalence over 22 years. This mainly results from changes in traditional risk factors, leading to population-wide increases in plasma glucose levels. Interventions to control this escalation of diabetes should focus on population-wide strategies.
authors.affiliation: Baker IDI Heart and Diabetes Institute, Melbourne, Australia. dianna.magliano@bakeridi.edu.au
authors.forename: Dianna J
authors.initials: DJ
authors.lastname: Magliano
authors.forename: Stefan
authors.initials: S
authors.lastname: Söderberg
authors.forename: Paul Z
authors.initials: PZ
authors.lastname: Zimmet
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.forename: Noorjehan
authors.initials: N
authors.lastname: Joonas
authors.forename: Sudhir
authors.initials: S
authors.lastname: Kowlessur
authors.forename: Jose
authors.initials: J
authors.lastname: Larhubarbe
authors.forename: Dhanunjaye
authors.initials: D
authors.lastname: Gaoneadry
authors.forename: Vassen
authors.initials: V
authors.lastname: Pauvaday
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: K George M M
authors.initials: KG
authors.lastname: Alberti
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Shaw
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005006:Ethnicity; D005215:Fasting; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008436:Mauritius / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
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