title: Societal correlates of diabetes prevalence: An analysis across 94 countries.
abstract: OBJECTIVE
  To quantify relationships between societal-level factors and diabetes prevalence and identify potential policy responses.
  
  
  METHODS
  Using data from International Diabetes Federation, World Health Organization, World Bank, and Food and Agricultural Organization, we extracted recent estimates for country-level variables: total caloric availability; sugar, animal fat, fruit and vegetable availability; physical inactivity markers (vehicles per capita and value-added from service sector); gross domestic product per capita (GDP); imports; and age-adjusted mortality rate. We used generalized linear models to investigate relationships between these factors and diabetes prevalence.
  
  
  RESULTS
  Median global diabetes prevalence was 6.4% in 2010. Every additional percentage point of calories from sugar/sweeteners and from animal fats were associated with 5% (OR: 1.05, 95% CI 1.02-1.07) and 3% (OR: 1.03, 95% CI 0.99-1.06) higher diabetes prevalence, respectively, while each additional unit in fruit and vegetable availability was associated with 3% lower diabetes prevalence (OR: 0.97, 95% CI 0.93-0.99). One percent higher GDP from the service industry was associated with a 1% higher diabetes prevalence (OR: 1.01, 95% CI 0.99-1.02).
  
  
  CONCLUSIONS
  Macro-level societal factors are associated with diabetes prevalence. Investigating how these factors affect individual-level diabetes risk may offer further insight into policy-level interventions.
authors.affiliation: Graduate Division of Biological and Biomedical Sciences, Laney Graduate School, Emory University, 1462 Clifton Road, Atlanta, GA 30322, USA. Karen.siegel@emory.edu
authors.forename: Karen R
authors.initials: KR
authors.lastname: Siegel
authors.forename: Justin B
authors.initials: JB
authors.lastname: Echouffo-Tcheugui
authors.forename: Mohammed K
authors.initials: MK
authors.lastname: Ali
authors.forename: Neil K
authors.initials: NK
authors.lastname: Mehta
authors.forename: K M
authors.initials: KM
authors.lastname: Narayan
authors.forename: Veerappa
authors.initials: V
authors.lastname: Chetty
mesh_terms: D003920:Diabetes Mellitus / Q000453:epidemiology*; D002149:Energy Intake; D005638:Fruit; D014943:Global Health; D006801:Humans; D012307:Risk Factors; D014675:Vegetables