Correspondence
rates from the 1980s to the 2000s with of type 2 diabetes mentioned in
a plateau or downturn in more recent
years”. Our own study4 of coding of
diabetes by general practitioners in
the UK for 1995–2014 supported
these findings. Incidence rose steeply
until 2004 but then levelled off and
slightly decreased. Similar trends were
observed by Sharma and colleagues.5
Unsubstantiated comments on
increasing incidence of diabetes
sometimes appear in the media.
However, it is surprising to see this
statement in a Seminar in The Lancet.
Diabetes is a major health problem
worldwide and the recorded number
of people living with diagnosed
diabetes (prevalence) has certainly
increased globally. However, this
increase could be due to factors such
as better diagnosis and reporting,
together with ageing populations. It
is important to distinguish between
prevalence and incidence if we want to
develop a better understanding of the
epidemiology of this disease.
I declare no competing interests.
A Rosemary Tate
rosemary@sussex.ac.uk
University of Sussex, Brighton BN1 9RH, UK; and
CPRD@Cambridge, The Primary Care Unit,
Department of Public Health and Primary Care,
University of Cambridge, Cambridge, UK
Published Online
January 19, 2018 1 Chatterjee S, Khunti K, Davies MJ. Type 2
http://dx.doi.org/10.1016/ diabetes. Lancet 2017; 389: 2239–51.
S0140-6736(18)30105-3 2 Geiss LS, Wang J, Cheng YJ, et al. Prevalence
and incidence trends for diagnosed diabetes
among adults aged 20 to 79 years, United
States, 1980–2012. JAMA 2014; 312: 1218–26.
3 Maruthur NM. The growing prevalence of type
2 diabetes: increased incidence or improved
survival? Curr Diab Rep 2013; 13: 786–94.
4 Tate AR, Dungey S, Glew S, Beloff N,
Williams R, Williams T. Quality of recording of
diabetes in the UK: how does the GP’s method
of coding clinical data affect incidence
estimates? Cross-sectional study using the
CPRD database. BMJ Open 2017; 7: e012905
5 Sharma M, Nazareth I, Petersen I. Trends in
incidence, prevalence and prescribing in type 2
diabetes mellitus between 2000 and 2013 in
primary care: a retrospective cohort study.
BMJ Open 2016; 6: e010210.
Published Online
March 15, 2018 Authors’ reply
http://dx.doi.org/10.1016/
S0140-6736(18)30677-9
We thank A Rosemary Tate for her
insightful comments on our Seminar.1
Tate indicates that there is no evidence
to support the rise in global incidence
1262
the summary by citing a number of
references published between 2014 and
2017 in the USA and UK.
In previous work, Tate accepts that
there might be variation in different
geographical regions in terms of
incidence and prevalence of type 2
diabetes because of improved diagnosis
and quality of data reporting.2 Increased
lifespan is another factor that might
explain rising prevalence rather than
incidence of type 2 diabetes. However,
UK data for 2004–14 suggest that
there is an increased incidence of
type 2 diabetes in men and deprived
populations.3 Further, data from
the USA show that although overall
incidence of diabetes is decreasing in
the adult population, it is increasing
by 4·8% annually (p<0·001) amongst
all youth and especially in ethnic
minorities, such as Native American
and non-Hispanic adolescents aged
10–19 years.4,5 We agree that better
understanding of epidemiological
factors associated with incidence and
prevalence of type 2 diabetes globally
is essential for the delivery of optimal Department of Error
diabetes care.
Iuliano AD, Roguski KM, Chang HH, et al.
The declaration of interests remains the same as in Estimates of global seasonal influenza-
the original Seminar. associated respiratory mortality: a modelling
study. Lancet 2018; 391: 1285–300—In the
*Sudesna Chatterjee, Kamlesh Khunti,
Research in Context panel of this Article
Melanie J Davies, (published Online First on Dec 13, 2017), the
sudesna.chatterjee@uhl-tr.nhs.uk first sentence of the Evidence before this
Leicester Diabetes Centre, Leicester General Hospital, study section should read “Previous estimates
University of Leicester, Leicester LE5 4PW, UK (SC, KK, commonly attributed to WHO indicate that
MJD); and Diabetes Research Centre, College of 250 000–500 000 deaths occur annually
Medicine, Biological Sciences and Psychology, worldwide due to seasonal influenza viruses.”
University of Leicester, Leicester, UK (SC, KK, MJD) The last sentence of the second paragraph in
the Methods section should read “Of the 15
1 Chatterjee S, Khunti K, Davies MJ. Type 2 remaining countries contacted, eight did not
diabetes. Lancet 2017; 389: 2239–51. respond to collaboration requests, five were
2 Tate AR, Dungey S, Glew S, Beloff N, Williams R, unable to share data by September, 2017, and
Williams T. Quality of recording of diabetes in two had insufficient quality vital records
the UK: how does the GP’s method of coding data.” These corrections have been made to
clinical data affect incidence estimates?
the online version as of Jan 19, 2018, and the
Cross-sectional study using the CPRD database.
BMJ Open 2017; 7: e012905. printed Article is correct.
3 Zghebi SS, Steinke DT, Carr MJ, Rutter MK, Park KB, Khan U, Seung K. Open letter to
Emsley RA, Ashcroft DM. Examining trends in The Global Fund about its decision to end
type 2 diabetes incidence, prevalence and DPRK grants. Lancet 2018; 391: 1257—In this
mortality in the UK between 2004 and 2014.
Correspondence (published online first on
Diabetes Obes Metab 2017; 19: 1537–45.
March 14, 2018), the following sentence
4 Zimmet P, Shaw J. Diabetes: Rising incidence of
should have read “UK is a Director of
diabetes mellitus in youth in the USA.
Nat Rev Endocrinol 2017; 13: 379–80. Interactive Research & Development.” This
correction has been made to the online version
5 Mayer-Davis EJ, Lawrence JM, Dabelea D, et al.
Incidence trends of type 1 and type 2 diabetes as of March 15, 2018, and the printed
among youths, 2002–2012. New Engl J Med Correspondence is correct.
2017; 376: 1419–29.
www.thelancet.com Vol 391 March 31, 2018