Turk Kardiyol Dern Ars. 2018; 46(7): 546-555 | DOI: 10.5543/tkda.2018.88225
Temporal changes in the epidemiology of diabetes mellitus in Turkey: A systematic review and meta-analysis
Mehmet Birhan Yılmaz1
, Mustafa Kılıçkap2
, Adnan Abacı3
, Cem Barçın4
, Fahri Bayram5
, Doruk Karaaslan6
, Hüseyin Göksülük2
, Meral Kayıkçıoğlu7
, Necla Özer8
, Gültekin Süleymanlar9
, Mahmut Şahin10
, Lale Tokgözoğlu8
, İlhan Satman111
Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey2
Department of Cardiology, Faculty of Medicine, Ankara University, Ankara, Turkey3
Department of Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey4
Department of Cardiology, Gülhane Training and Research Hospital, Ankara, Turkey5
Department of Endocrinology, Erciyes University Faculty of Medicine, Kayseri6
Koç University, Faculty of Medicine, Istanbul7
Department of Cardiology, Ege University Faculty of Medicine, İzmir, Turkey8
Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey9
Department of Nephrology, Akdeniz University Faculty of Medicine, Antalya, Turkey10
Department of Cardiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey11
Department of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul - TÜSEB Institute of Public Health and Chronic Diseases Turkey, Istanbul
OBJECTIVE Diabetes mellitus (DM) is a serious public health problem. It was observed that despite studies reporting prevalence of DM by various scientists, there was no meta-analysis or systematic review which assess the latest profile and temporal changes of cardiovascular risk factors, including DM. This article presents the meta-analysis of 8 studies which provide information regarding prevalence of DM along with other cardiovascular risk factors in Turkey within the last 15 years.
METHODS Studies, which were undertaken on the adult population within the last 15 years and evaluate cardiovascular risk factors in Turkey with the capacity either to be representative or to be potentially representative of the country, were searched through Ovid, Medline and Web of Science Core Collection the Turkish Academic Network and Information Center (ULAKBIM) databases. Additionally, websites of Ministry of Health and related societies were investigated for additional studies. The studies were categorized according to bias risk as high and low bias risk studies. In meta-analysis and meta-regression, random effects model of the low risk bias group was tested.
RESULTS There were 8 studies which provided information with regard to DM prevalence (n=84656). Four of these studies (n=56853) had low bias risk and four had high bias risk (n=27803). When compared with low bias risk studies, those with high bias risk had very large variation of DM prevalence (between 4% to 15%). Meta-analysis of the low bias risk group yielded a crude DM prevalence of 13.5% (95% CI: 11.6-15.5%) in the whole group, 14.2% (95% CI: 12.3-16.2%) in females, 12.6% (95% CI: 10.5-14.9%) in males. In meta-regression analysis of low bias risk group, mean age difference among the studies and the time period in which the study was undertaken were partially able to explain the inter-study heterogeneity (R2 values were 52% and 78%).
CONCLUSION Diabetes mellitus is a highly prevalent public health problem according to this meta-analysis. Contrary to studies, which compare the recent studies with previous ones and report an increasing prevalence of DM, the present meta-analysis-despite its limitations-provides findings that the temporal increase of DM prevalence is at least paused over time. This situation underlines the need for new studies.
How to cite this article
Mehmet Birhan Yılmaz, Mustafa Kılıçkap, Adnan Abacı, Cem Barçın, Fahri Bayram, Doruk Karaaslan, Hüseyin Göksülük, Meral Kayıkçıoğlu, Necla Özer, Gültekin Süleymanlar, Mahmut Şahin, Lale Tokgözoğlu, İlhan Satman. Temporal changes in the epidemiology of diabetes mellitus in Turkey: A systematic review and meta-analysis. Turk Kardiyol Dern Ars. 2018; 46(7): 546-555
Corresponding Author: Mehmet Birhan Yılmaz