| Background:Diabetes mellitus is a metabolic disease characterized by elevated blood sugar.The course of diabetes is long,the complications are more,and the disease burden is heavy.The 19th National Congress of the Communist Party of China put forward the strategy of "Healthy China".China,as a country with a large population,has accelerated the aging process,and chronic diseases account for an increasing proportion of diseases.Diabetes,as one of the chronic diseases,has become a serious public health problem.There are many cross-sectional studies on the prevalence rate of diabetes and its risk factors,but the data in general reports only come from local surveys or small and medium-sized sampling surveys,and the spatial and temporal distribution and other epidemiological rules of diabetes cannot be viewed from a global bird’s eye view.Therefore,comprehensive information integration based on literature data can improve new ideas for the investigation of the epidemiology of diabetes.Objective:To comprehensively understand the epidemiological rules of diabetes mellitus through big data,which is an important basis for accurate prevention and control of diabetes mellitus and its complications.In this study,literatures on diabetes prevalence were extensively collected,and the meta-analysis method of passing rate was classified and integrated according to attribute data such as time,region,gender,age and ethnicity,so as to provide data resources for further discussion on the spatial and temporal distribution of diabetes,population characteristics and other epidemiological rules,and provide a scientific basis for diabetes prevention and control.Method:With "chronic disease","diabetes" and "prevalence" as keywords,the diabetes prevalence data meeting the inclusion and exclusion criteria were comprehensively collected through public databases such as Pubmed,Embase,Cochrane,CNKI,Wanfang and VIP,as well as books and documents such as health yearbooks and survey reports.The meta-integration of classification was conducted according to attributes such as time,region,gender,age and ethnicity,so as to form data resources for subsequent analysis.For the integrated data of diabetes prevalence from 1990 to 2020,the time series analysis method was used to comprehensively understand the distribution of diabetes prevalence from the analysis of series stability,trend,periodicity and inflection point,and the ARIMA model was established to predict the development trend of diabetes prevalence in the next 5 years.For the integrated data of diabetes prevalence in 34 provinces(municipalities and autonomous regions),the spatial correlation analysis method was used to comprehensively understand the spatial distribution of diabetes prevalence from the aspects of prevalence statistical map,global Moreland index,local Moreland index,hot spot analysis,etc.For the integrated data of diabetes prevalence rate of the population,such as gender,age and ethnicity,Chi-square test and cluster analysis were used to comprehensively understand the distribution characteristics of diabetes prevalence rate of gender,age and ethnicity.Results:From 1990 to 2022,there were 2307 literatures or reports that met the inclusion and exclusion criteria.The mean score was 15.19 points and the standard deviation was 1.64 points according to the evaluation criteria of JBI Evidence-Based Health Care Center cross-sectional study and Combie cross-sectional study.Time distribution:From 1990 to 2020,the prevalence rate of diabetes has been increasing continuously,with an average annual growth rate of 0.33%.Combined data on 30-year diabetes prevalence was 7.5%with 95%confidence interval of 0.088-0.088.It increased significantly in 1993,2003 and 2021,and had two inflection points in 1999 and 2012.The incidence projections for the next 5 years are 13.6%,14.2%,14.1%,12.5%and 15%.Spatial distribution:The prevalence rate of diabetes was 8.5%in 34 provinces(municipalities and autonomous regions),with 95%confidence interval ranging from 0.080 to 0.090.Among them,the highest incidence is Shaanxi,the lowest is Tibet.The global Moreland index was 0.0945,Z score was 1.0623,P=0.2881>0.05,indicating that there was no significant spatial aggregation in the prevalence of diabetes.The local General G index was 0.0323,the z score was 1.6879,p=0.0914<0.1,indicating that the prevalence of diabetes mellitus had a significant local aggregation.The analysis of high/low cluster analysis showed that the high-high cluster included Shanxi Province and Anhui Province,the low-low cluster included Tibet Autonomous Region,Yunnan Province and Guangxi Zhuang Autonomous Region,the low-high cluster included Hubei Province,and the high-low cluster included Xinjiang Uygur Autonomous Region and Sichuan Province.The hot spot analysis shows that the hot spots are mainly in Shanxi Province(mountain type,highest in the middle and higher around)and Hubei Province(basin type,lowest in the middle and higher around),followed by Tibet Autonomous Region and Yunnan Province.Population analysis:Gender:The incidence of diabetes was significantly different between genders(P<0.05),and the prevalence of diabetes was higher in females than in males.Age:Age is positively correlated with diabetes prevalence.The prevalence rate of diabetes increased greatly between the ages of 30～35 and 35～40,and reached the highest point between the ages of 80～85,showing an overall fluctuating rise.The incidence increases with age,reaching two inflection points at age 25 and 75.Ethnic groups:A total of 32 ethnic groups were involved in this study,of which 14 ethnic groups only had 1 document.In order to ensure the authenticity of the research results,three ethnic groups with the largest number of respondents were selected for the study,namely Kazak,Weiur and Hui.The prevalence rates of Kazak,Uygur and Hui were 0.049,0.071 and 0.102,respectively.The highest prevalence rate was 0.102 in the Hui ethnic group.The prevalence of diabetes varies significantly among ethnic groups.Conclusion:According to the literature study from 1990 to 2020,the prevalence rate of diabetes in China is regular in the three dimensions of time,space and population.The prevalence of diabetes in China has increased in twists and turns since 1990～2020,with an average annual growth rate of 0.33%.The 30-year prevalence of diabetes was combined to 8.8%,with two inflection points in 1999 and 2020,and the prevalence increased significantly.Spatially,the prevalence of diabetes in 34 provinces(municipalities and autonomous regions)was 8.5%,the global Moran index was 0.0945,the Z score was 1.0623,and the P value=0.2881>0.05,indicating that there is no aggregation as a whole,and there is obvious aggregation in local analysis,high and low aggregation is Shanxi Province and Anhui Province,and low aggregation is Tibet Autonomous Region,Yunnan Province and Guangxi Zhuang Autonomous Region.Hot spot analysis shows that the hotspot area is Shanxi Province.In population analysis,the prevalence was 8.3%in men and 7.8%in women.The prevalence is lower in women than in men;The prevalence gradually increases with age,reaching its highest point at age 85;Among the ethnic groups included in this study,the Hui had the highest incidence of co-ordination. |
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