Prevalence of type 2 diabetes among global Indigenous adult populations: a systematic review
Bibliographic record
Abstract
AIMS/HYPOTHESIS: Despite evidence documenting high prevalence of type 2 diabetes among several Indigenous populations, a comprehensive systematic review of type 2 diabetes among global Indigenous Peoples has not been recently conducted. Our aim was to report region-, time-, age- and sex-specific type 2 diabetes prevalence among Indigenous adult populations globally. METHODS: MEDLINE, Embase and CINAHL were searched for English-language studies published between 1 January 1980 and 3 March 2023. Studies reporting type 2 diabetes prevalence and/or cases of diabetes among global Indigenous adult populations aged 18 years and older were included. Type 2 diabetes prevalence data were extracted for the overall Indigenous population, sex, age group and year. Summaries of extracted data were tabulated, and are presented using comprehensive tables and figures. A modified Newcastle-Ottawa quality assessment scale reflective of Indigenous-specific criteria was applied to assess paper quality. RESULTS: The search identified 2332 studies, of which 202 met the inclusion criteria. The included studies represented at least 187 Indigenous populations from 37 countries, although the exact number of populations is approximate, as some studies did not name specific Nations/Tribes/Groups for populations from different geographic regions. Diabetes prevalence ranged from 0 to 40%, with a mean of 73% of Indigenous populations reporting type 2 diabetes prevalence above the estimated global prevalences for every decade between 1980 and 2020. Prevalence increased over time and with age for many populations, with the highest reported prevalence (50.5%) in the 45-54 year age group. Type 2 diabetes prevalence was notably high among Indigenous women, with 73% of studies reporting higher prevalence for Indigenous women than for Indigenous men. Potential limitations include publication bias, which may have led to fewer studies being included in this review. CONCLUSIONS/INTERPRETATION: Type 2 diabetes prevalence among Indigenous adult populations was markedly higher than the global averages in every decade from 1980 to 2020, with a mean of 73% of populations reporting higher prevalence. These findings underscore the persistent and disproportionate burden of diabetes experienced by many Indigenous communities over several decades. Future work should aim to generate representative data on type 2 diabetes prevalence across global Indigenous populations, investigate factors that contribute to alarmingly high and notably low diabetes prevalence, and support Indigenous-led, culturally safe, Indigenous population-specific health practices to prevent and manage type 2 diabetes and achieve equitable outcomes. FUNDING: There was no funding source for this study. TRIAL REGISTRATION: PROSPERO registration no. CRD42021258623.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.044 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.006 |
| Bibliometrics | 0.010 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".