Information Management, Regional Health, National Healthcare Group, Singapore.
Regional Health, National Healthcare Group, Singapore.
J Diabetes. 2017 Jan;9(1):65-75. doi: 10.1111/1753-0407.12384. Epub 2016 Apr 4.
The aim of the present study was to forecast the prevalence and number of adult Singapore residents with prediabetes and diabetes in 2035.
A dynamic Markov model with nine mutually exclusive states was developed based on the clinical course of diabetes using time-dependent rates and probabilities. A 1-year cycle over a 25-year time horizon from 2010 to 2035 was used in the model. With publicly available data and a chronic disease register, the model forecast annual disease burden by simulating transition of cohorts across different health states using prevalence rates, incidence rates, mortality rates, disease transition, disease detection, and complication rates. An aging index was used in the model in anticipation of population aging to minimize risks of underestimating disease burden.
From 2010 to 2035, the number of Singapore residents with prediabetes and diabetes is projected to more than double, from 434 685 to 903 596 and from 373 104 to 823 802, respectively. The prevalence of prediabetes and diabetes will rise steadily from 15.5 % to 24.9 % and from 13.3 % to 22.7 %, respectively. By 2035, a further estimate of 733 174 and 100 250 patients with prediabetes and uncomplicated diabetes, respectively, will remain undiagnosed. The prevalence of detected and undetected complications is forecast to rise from 60.0 % in 2010 to 70.2 % by 2035.
By 2035, the prevalence of prediabetes and diabetes among Singapore residents aged 21+ years is expected to be one in four and one in five, respectively. There is an impetus to adopt more aggressive interventions to contain disease progression.
本研究旨在预测 2035 年新加坡成年居民中糖尿病前期和糖尿病的患病率和人数。
根据糖尿病的临床病程，使用时变率和概率，建立了一个具有九个互斥状态的动态马尔可夫模型。模型的时间跨度为 25 年，从 2010 年到 2035 年，周期为 1 年。利用公开数据和慢性病登记，该模型通过模拟不同健康状态下队列的转移，利用患病率、发病率、死亡率、疾病转移、疾病发现和并发症率来预测每年的疾病负担。该模型使用老龄化指数来预测人口老龄化，以尽量减少低估疾病负担的风险。
从 2010 年到 2035 年，新加坡居民中糖尿病前期和糖尿病患者的人数预计将增加一倍以上，分别从 434685 人增加到 903596 人，从 373104 人增加到 823802 人。糖尿病前期和糖尿病的患病率将从 15.5%稳步上升到 24.9%和 13.3%到 22.7%。到 2035 年，预计将有另外 733174 名和 100250 名糖尿病前期和未合并并发症的糖尿病患者未被发现。发现和未发现并发症的患病率预计将从 2010 年的 60.0%上升到 2035 年的 70.2%。
到 2035 年，新加坡 21 岁及以上居民中糖尿病前期和糖尿病的患病率预计分别为四分之一和五分之一。有必要采取更积极的干预措施来控制疾病的进展。
