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      Type 2 Diabetes Mellitus in Nepal from 2000 to 2020: A systematic review and meta-analysis

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          Abstract

          Aims: To evaluate the prevalence and risk factors of type 2 diabetes mellitus (T2DM) from 2000-2020 in various parts of Nepal.  Methods: PubMed, Embase, Scopus, and Google Scholar were searched using the appropriate keywords. All Nepalese studies mentioning the prevalence of T2DM and/or details  such as risk factors were included. Studies were screened using Covidence. Two reviewers independently selected studies based on the inclusion criteria. Meta-analysis was conducted using Comprehensive Meta-Analysis Software v.3.  Results: Total 15 studies met the inclusion criteria. The prevalence of T2DM, pre-diabetes, and impaired glucose tolerance in Nepal in the last two decades was 10% (CI, 7.1%- 13.9%), 19.4% (CI, 11.2%- 31.3%), and 11.0% (CI, 4.3%- 25.4%) respectively. The prevalence of T2DM in the year 2010-15 was 7.75% (CI, 3.67-15.61), and it increased to 11.24% between 2015-2020 (CI, 7.89-15.77). There were 2.19 times higher odds of having T2DM if the body mass index was ≥24.9 kg/m 2. Analysis showed normal waist circumference, normal blood pressure, and no history of T2DM in a family has 64.1%, 62.1%, and 67.3% lower odds of having T2DM, respectively.  Conclusion: The prevalence of T2DM, pre-diabetes, and impaired glucose tolerance in Nepal was estimated to be 10%, 19.4%, and 11% respectively.

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          WITHDRAWN: Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition

          Pouya Saeedi, Inga Petersohn, Paraskevi Salpea … (2019)
          To provide global estimates of diabetes prevalence for 2019 and projections for 2030 and 2045.
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            Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group.

            D F Stroup, J A Berlin, S C Morton … (2000)
            Because of the pressure for timely, informed decisions in public health and clinical practice and the explosion of information in the scientific literature, research results must be synthesized. Meta-analyses are increasingly used to address this problem, and they often evaluate observational studies. A workshop was held in Atlanta, Ga, in April 1997, to examine the reporting of meta-analyses of observational studies and to make recommendations to aid authors, reviewers, editors, and readers. Twenty-seven participants were selected by a steering committee, based on expertise in clinical practice, trials, statistics, epidemiology, social sciences, and biomedical editing. Deliberations of the workshop were open to other interested scientists. Funding for this activity was provided by the Centers for Disease Control and Prevention. We conducted a systematic review of the published literature on the conduct and reporting of meta-analyses in observational studies using MEDLINE, Educational Research Information Center (ERIC), PsycLIT, and the Current Index to Statistics. We also examined reference lists of the 32 studies retrieved and contacted experts in the field. Participants were assigned to small-group discussions on the subjects of bias, searching and abstracting, heterogeneity, study categorization, and statistical methods. From the material presented at the workshop, the authors developed a checklist summarizing recommendations for reporting meta-analyses of observational studies. The checklist and supporting evidence were circulated to all conference attendees and additional experts. All suggestions for revisions were addressed. The proposed checklist contains specifications for reporting of meta-analyses of observational studies in epidemiology, including background, search strategy, methods, results, discussion, and conclusion. Use of the checklist should improve the usefulness of meta-analyses for authors, reviewers, editors, readers, and decision makers. An evaluation plan is suggested and research areas are explored.
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              Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants

              Emily Sonestedt, Kim Overvad (2016)
              Summary Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world’s men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world’s poorest regions, especially in south Asia. Funding Wellcome Trust, Grand Challenges Canada.
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                Author and article information

                Contributors
                Dhan Bahadur Shrestha: Role: ConceptualizationRole: Data CurationRole: Formal AnalysisRole: MethodologyRole: Writing – Original Draft Preparation
                ORCID: https://orcid.org/0000-0002-8121-083X
                Pravash Budhathoki: Role: Data CurationRole: Formal AnalysisRole: MethodologyRole: SupervisionRole: ValidationRole: Writing – Original Draft Preparation
                Yub Raj Sedhai: Role: Data CurationRole: MethodologyRole: SupervisionRole: ValidationRole: Writing – Review & Editing
                Achyut Marahatta: Role: Data CurationRole: Formal AnalysisRole: Project AdministrationRole: SoftwareRole: Writing – Original Draft Preparation
                ORCID: https://orcid.org/0000-0003-2984-4242
                Samit Lamichhane: Role: Data CurationRole: Formal AnalysisRole: InvestigationRole: MethodologyRole: Project AdministrationRole: Writing – Original Draft Preparation
                ORCID: https://orcid.org/0000-0001-5003-0126
                Sarbin Nepal: Role: Data CurationRole: Formal AnalysisRole: MethodologyRole: SoftwareRole: Writing – Original Draft Preparation
                ORCID: https://orcid.org/0000-0002-1458-4495
                Anurag Adhikari: Role: Data CurationRole: Formal AnalysisRole: InvestigationRole: MethodologyRole: SoftwareRole: Writing – Review & Editing
                ORCID: https://orcid.org/0000-0003-0939-3587
                Ayusha Poudel: Role: Data CurationRole: Formal AnalysisRole: InvestigationRole: MethodologyRole: SoftwareRole: Writing – Review & Editing
                ORCID: https://orcid.org/0000-0002-1640-4558
                Samata Nepal: Role: Formal AnalysisRole: InvestigationRole: MethodologyRole: SoftwareRole: SupervisionRole: Writing – Review & Editing
                ORCID: https://orcid.org/0000-0001-9189-4510
                Alok Atreya: Role: SupervisionRole: ValidationRole: Writing – Review & Editing
                ORCID: https://orcid.org/0000-0001-6657-7871
                Journal
                Journal ID (nlm-ta): F1000Res
                Journal ID (iso-abbrev): F1000Res
                Title: F1000Research
                Publisher: F1000 Research Limited (London, UK )
                ISSN (Electronic): 2046-1402
                Publication date (Electronic): 7 July 2021
                Publication date Collection: 2021
                Volume: 10
                Electronic Location Identifier: 543
                Affiliations
                [1 ]Department of Emergency Medicine, Mangalbare Hospital, Morang, 56600, Nepal
                [2 ]Department of Emergency Medicine, Dr. Iwamura Memorial Hospital, Bhaktapur, 44800, Nepal
                [3 ]Department of Internal Medicine, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, 23298, USA
                [4 ]Chitwan Medical College Teaching Hospital, Chitwan, 44200, Nepal
                [5 ]Department of Emergency Medicine, Nepal National Hospital, Kathmandu, Bagmati, 44600, Nepal
                [6 ]Department of Emergency Medicine, Alka Hospital, Lalitpur, Bagmati, 44600, Nepal
                [7 ]Department of Community Medicine, Lumbini Medical College, Palpa, Lumbini, 32500, Nepal
                [8 ]Department of Forensic Medicine, Lumbini Medical College, Palpa, Lumbini, 32500, Nepal
                [1 ]School of Health and Wellbeing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
                [1 ]Department of Natural Resources and Environment, Faculty of Agriculture, Natural Resources, and Environment, Naresuan University, Phitsanulok, Thailand
                Lumbini Medical College, Nepal
                [1 ]Department of Internal Medicine, Reading Hospital and Medical Centre, West Reading, PA, USA
                Lumbini Medical College, Nepal
                Author notes

                No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Author information
                https://orcid.org/0000-0002-8121-083X
                https://orcid.org/0000-0003-2984-4242
                https://orcid.org/0000-0001-5003-0126
                https://orcid.org/0000-0002-1458-4495
                https://orcid.org/0000-0003-0939-3587
                https://orcid.org/0000-0002-1640-4558
                https://orcid.org/0000-0001-9189-4510
                https://orcid.org/0000-0001-6657-7871
                Article
                DOI: 10.12688/f1000research.53970.1
                PMC ID: 8459622
                PubMed ID: 34621512
                SO-VID: 859c405d-3ba8-425b-a888-9f0d9456876e
                Copyright © Copyright: © 2021 Shrestha DB et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date accepted : 30 June 2021
                Funding
                The author(s) declared that no grants were involved in supporting this work.
                Categories
                Subject: Systematic Review
                Subject: Articles

                Keywords: blood pressure,body mass index,diabetes mellitus type 2,nepal
                Data availability:
                Keywords: blood pressure, body mass index, diabetes mellitus type 2, nepal

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