Epidemiology of Diabetes and Associated Cardiovascular Risks

The global burden of diabetes has risen steeply over recent decades, driven principally by ageing populations, urbanisation and the growing prevalence of obesity. Type 2 diabetes mellitus now affects hundreds of millions worldwide, with projections indicating further increases unless preventative measures are scaled up. Epidemiological studies reveal marked geographic and socioeconomic disparities in both prevalence and incidence, reflecting the interplay of genetic predisposition, lifestyle factors and health-care access. Importantly, diabetes confers a two- to threefold greater risk of cardiovascular events, including myocardial infarction, stroke and peripheral arterial disease. Mechanistically, chronic hyperglycaemia promotes endothelial dysfunction, accelerated atherosclerosis and pro-inflammatory states. Co-existing conditions such as hypertension, dyslipidaemia and insulin resistance compound this risk, and emerging evidence highlights the prognostic value of early detection of prediabetes. Public health interventions targeting weight management, dietary quality and physical activity have demonstrated effectiveness in reducing progression to overt diabetes. Nevertheless, real-world application remains uneven, particularly in low- and middle-income regions. Enhanced surveillance, standardised diagnostic criteria and integrated care pathways are crucial to curb the tide of diabetes-related cardiovascular morbidity and mortality on a global scale.

Research from Nature Portfolio

Recent cohort analyses in European populations have refined estimates of diabetes incidence and identified high-yield risk markers. A nation-wide Spanish cohort study reported an incidence rate exceeding ten new cases per 1 000 person-years over seven years, with age, central obesity and family history emerging as dominant predictors. A complementary follow-up in the Basque Country confirmed a cumulative seven-year incidence of nearly 5 percent, revealing that over half of newly diagnosed individuals were previously undetected. Multivariate models in this setting demonstrated that combined assessment of dyslipidaemia, waist-to-hip ratio and familial risk yielded strong predictive accuracy, underscoring the value of multiplex risk stratification. These findings collectively emphasise the need for early screening programmes and tailored lifestyle interventions within primary care frameworks.

Epidemiology of Diabetes and Associated Cardiovascular Risks publication trend

The graph below shows the total number of articles in epidemiology of diabetes and associated cardiovascular risks across all publications each year (not limited to Nature Index journals).

Technical terms

Incidence: The rate at which new cases of diabetes occur in a defined population over a specified period.

Prevalence: The proportion of individuals in a population who have diabetes at a given time.

Hazard ratio: A measure of how often a particular event (e.g., death) happens in one group compared to another over time.

Prediabetes: A metabolic state characterised by blood glucose levels above normal but below diabetic thresholds, signalling elevated risk.

Dyslipidaemia: Abnormal levels of lipids in the blood, often contributing to atherosclerotic cardiovascular disease.

References

1. New onset diabetes in adulthood is associated with a substantial risk for mortality at all ages: a population based historical cohort study with a decade-long follow-up. Cardiovascular Diabetology (2017).
2. Incidence of diabetes mellitus in Spain as results of the nation-wide cohort di@bet.es study. Scientific Reports (2020).
3. Geographical variation in the progression of type 2 diabetes in Peru: The CRONICAS Cohort Study. Diabetes Research and Clinical Practice (2016).
4. Incidence of diabetes mellitus and associated risk factors in the adult population of the Basque country, Spain. Scientific Reports (2021).
5. Prevalencia mundial de la diabetes mellitus tipo 2 y su relación con el índice de desarrollo humano. BULL PAN AM HEALTH ORGAN (2017).