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Forecasting Tunisian type 2 diabetes prevalence to 2027: validation of a simple model.

Saidi, O; O'Flaherty, M; Mansour, NB; Aissi, W; Lassoued, O; Capewell, S; Critchley, JA; Malouche, D; Romdhane, HB; EC FP7 funded MEDCHAMPS project (2015) Forecasting Tunisian type 2 diabetes prevalence to 2027: validation of a simple model. BMC Public Health, 15. p. 104. ISSN 1471-2458
SGUL Authors: Critchley, Julia

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BACKGROUND: Most projections of type 2 diabetes (T2D) prevalence are simply based on demographic change (i.e. ageing). We developed a model to predict future trends in T2D prevalence in Tunisia, explicitly taking into account trends in major risk factors (obesity and smoking). This could improve assessment of policy options for prevention and health service planning. METHODS: The IMPACT T2D model uses a Markov approach to integrate population, obesity and smoking trends to estimate future T2D prevalence. We developed a model for the Tunisian population from 1997 to 2027, and validated the model outputs by comparing with a subsequent T2D prevalence survey conducted in 2005. RESULTS: The model estimated that the prevalence of T2D among Tunisians aged over 25 years was 12.0% in 1997 (95% confidence intervals 9.6%-14.4%), increasing to 15.1% (12.5%-17.4%) in 2005. Between 1997 and 2005, observed prevalence in men increased from 13.5% to 16.1% and in women from 12.9% to 14.1%. The model forecast for a dramatic rise in prevalence by 2027 (26.6% overall, 28.6% in men and 24.7% in women). However, if obesity prevalence declined by 20% in the 10 years from 2013, and if smoking decreased by 20% over 10 years from 2009, a 3.3% reduction in T2D prevalence could be achieved in 2027 (2.5% in men and 4.1% in women). CONCLUSIONS: This innovative model provides a reasonably close estimate of T2D prevalence for Tunisia over the 1997-2027 period. Diabetes burden is now a significant public health challenge. Our model predicts that this burden will increase significantly in the next two decades. Tackling obesity, smoking and other T2D risk factors thus needs urgent action. Tunisian decision makers have therefore defined two strategies: obesity reduction and tobacco control. Responses will be evaluated in future population surveys.

Item Type: Article
Additional Information: © 2015 Saidi et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article,unless otherwise stated.
Keywords: Adult, Aged, Diabetes Mellitus, Type 2, Female, Forecasting, Humans, Male, Markov Chains, Middle Aged, Models, Theoretical, Obesity, Prevalence, Public Health, Risk Factors, Smoking, Tunisia, Young Adult, EC FP7 funded MEDCHAMPS project, Humans, Diabetes Mellitus, Type 2, Obesity, Prevalence, Markov Chains, Risk Factors, Smoking, Public Health, Models, Theoretical, Forecasting, Adult, Aged, Middle Aged, Tunisia, Female, Male, Young Adult, 1117 Public Health and Health Services, Public Health
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: BMC Public Health
ISSN: 1471-2458
Language: eng
7 February 2015Published
14 January 2015Accepted
Publisher License: Creative Commons: Attribution 4.0
Project IDFunderFunder ID
223075Seventh Framework Programme
281640Seventh Framework Programme
UNSPECIFIEDMedical Research Council
PubMed ID: 25885910
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