title: Global rural diabetes prevalence: a systematic review and meta-analysis covering 1990-2012.
abstract: OBJECTIVE
  To investigate diabetes prevalence in rural areas globally and how it has changed over time in high-income countries (HIC) and low-middle income countries (LMIC).
  
  
  METHODS
  We systematically searched four electronic databases (MEDLINE, EMBASE, Cochrane Library, and CINAHL) for studies reporting rural prevalence of diabetes between January 1990 and January 2012. We used random effect meta-analysis to estimate pooled prevalence and metaregression to identify factors that may be associated with our estimates.
  
  
  RESULTS
  We included 109 population-based surveys involving 1,100,746 individuals. Pooled global rural prevalence of diabetes was 6.8% (95% confidence intervals: 6.1-7.6) with no gender difference. Considering five-year increments between 1985 and 2011, when studies were conducted, global rural prevalence was 5.7% (3.5-7.9) during 1985-1989 and 8.7% (6.8-10.7) during 2005-2011. In LMICs, rural diabetes prevalence was 1.8% (1.0-2.6) during 1985-1989 and 7.5% (5.6-9.5) during 2005-2011. In HICs, rural diabetes prevalence was 8.2% (6.0-10.4) during 1985-1989 and 14.3% (8.7-20) in the most recent period.
  
  
  CONCLUSIONS
  Diabetes prevalence has increased in all rural areas globally but relative growth was faster in LMIC than HIC rural areas. These data suggest a need to expand diabetes surveillance to rural areas using standardized measures, as well as the need to devise and deploy appropriate prevention and control interventions.
authors: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: azizabetian@yahoo.com.
authors: Azadeh
authors: A
authors: Zabetian
authors: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors: Isabelle M
authors: IM
authors: Sanchez
authors: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; School of Medicine, Emory University, Atlanta, GA, USA.
authors: K M Venkat
authors: KM
authors: Narayan
authors: School of Medicine, Emory University, Atlanta, GA, USA.
authors: Christopher K
authors: CK
authors: Hwang
authors: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors: Mohammed K
authors: MK
authors: Ali
mesh_terms: D003906:Developing Countries; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005544:Forecasting; D006801:Humans; D011203:Poverty; D015995:Prevalence; D012424:Rural Population
keywords: Diabetes; Global; Prevalence; Rural population