No increase in the prevalence of known diabetes between 1986 and 1999 in subjects 25–64 years of age in northern Sweden

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Abstract
Aims A global increase in diabetes is predicted due to higher body weight and less physical activity. Over the period 1986–1999, the body mass index (BMI) of the adult population of northern Sweden increased from 25.3 to 26.2 and the prevalence of obesity (BMI ≥ 30) from 11% to 15%, although this was more distal than central adiposity. Our hypothesis was that this would lead to a higher prevalence of diabetes. Methods Four population surveys with new and independent cohorts of 2000 invited subjects, 25–64 years old, in 1986, 1990, 1994 and 1999. In the first three surveys an oral glucose tolerance test was carried out in 47%. Results Over the time period 1986–1999 there was no increase in the prevalence of known diabetes. No trends were noted in the finding of previously undiagnosed diabetes or impaired glucose tolerance over the period 1986–1994, although the confidence intervals are wide. Fasting, but not post‐load, glucose levels increased with 0.040 mmol/year (95% CI 0.026; 0.055) in men and 0.033 mmol/year (0.023; 0.044) in women. Conclusion In spite of a marked increase in BMI, we found no increased prevalence of known diabetes over a 13‐year observation period, although our data cannot exclude minor increases in undiagnosed diabetes. The development of more distal than abdominal obesity, a diet with less saturated fat and lower glycaemic index and fewer regular smokers in the population may contribute to this. The effects of obesity may thus be attenuated by other secular trends in society and highlight potential ways of curbing the worldwide increase in diabetes.