title: Burden of type 2 diabetes in Mexico: past, current and future prevalence and incidence rates.
abstract: BACKGROUND
  Mexico diabetes prevalence has increased dramatically in recent years. However, no national incidence estimates exist, hampering the assessment of diabetes trends and precluding the development of burden of disease analyses to inform public health policy decision-making. Here we provide evidence regarding current magnitude of diabetes in Mexico and its future trends.
  
  
  METHODS
  We used data from the Mexico National Health and Nutrition Survey, and age-period-cohort models to estimate prevalence and incidence of self-reported diagnosed diabetes by age, sex, calendar-year (1960-2012), and birth-cohort (1920-1980). We project future rates under three alternative incidence scenarios using demographic projections of the Mexican population from 2010-2050 and a Multi-cohort Diabetes Markov Model.
  
  
  RESULTS
  Adult (ages 20+) diagnosed diabetes prevalence in Mexico increased from 7% to 8.9% from 2006 to 2012. Diabetes prevalence increases with age, peaking around ages 65-68 to then decrease. Age-specific incidence follows similar patterns, but peaks around ages 57-59. We estimate that diagnosed diabetes incidence increased exponentially during 1960-2012, roughly doubling every 10 years. Projected rates under three age-specific incidence scenarios suggest diabetes prevalence among adults (ages 20+) may reach 13.7-22.5% by 2050, affecting 15-25 million individuals, with a lifetime risk of 1 in 3 to 1 in 2.
  
  
  CONCLUSIONS
  Diabetes prevalence in Mexico will continue to increase even if current incidence rates remain unchanged. Continued implementation of policies to reduce obesity rates, increase physical activity, and improve population diet, in tandem with diabetes surveillance and other risk control measures is paramount to substantially reduce the burden of diabetes in Mexico.
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor, MI USA. Electronic address: rmeza@umich.edu.
authors.forename: Rafael
authors.initials: R
authors.lastname: Meza
authors.affiliation: Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos Mexico.
authors.forename: Tonatiuh
authors.initials: T
authors.lastname: Barrientos-Gutierrez
authors.affiliation: Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos Mexico.
authors.forename: Rosalba
authors.initials: R
authors.lastname: Rojas-Martinez
authors.affiliation: Division of Research, National Cancer Institute, Mexico City, Mexico.
authors.forename: Nancy
authors.initials: N
authors.lastname: Reynoso-Noverón
authors.affiliation: National Institute of Public Health, Cuernavaca, Morelos Mexico.
authors.forename: Lina Sofia
authors.initials: LS
authors.lastname: Palacio-Mejia
authors.affiliation: Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos Mexico.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.affiliation: National Institute of Public Health, Cuernavaca, Morelos Mexico.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Hernández-Ávila
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000453:epidemiology*; D005260:Female; D005544:Forecasting; D006801:Humans; D015994:Incidence; D008297:Male; D008390:Markov Chains; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D008962:Models, Theoretical; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology; D011158:Population Growth; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
keywords: Age-period-cohort models; Age-specific diabetes incidence; Diabetes incidence and prevalence; Diabetes projections; Markov simulation models