Prevalence of diabetes and pre-diabetes in Greece. Results of the First National Survey of Morbidity and Risk Factors (EMENO) study

Konstantinos Makrilakis; Natasa Kalpourtzi; Ioannis Ioannidis; Stella Iraklianou; Athanasios Raptis; Alexis Sotiropoulos; Magda Gavana; Apostolos Vantarakis; Maria Kantzanou; Christos Hadjichristodoulou; Grigoris Chlouverakis; Grigoris Trypsianis; Paraskevi V Voulgari; Yannis Alamanos; Giota Touloumi; Stavros Liatis; EMENO Study Group

doi:10.1016/j.diabres.2020.108646

Prevalence of diabetes and pre-diabetes in Greece. Results of the First National Survey of Morbidity and Risk Factors (EMENO) study

Diabetes Res Clin Pract. 2021 Feb:172:108646. doi: 10.1016/j.diabres.2020.108646. Epub 2020 Dec 24.

Authors

Konstantinos Makrilakis¹, Natasa Kalpourtzi², Ioannis Ioannidis³, Stella Iraklianou⁴, Athanasios Raptis⁵, Alexis Sotiropoulos⁶, Magda Gavana⁷, Apostolos Vantarakis⁸, Maria Kantzanou², Christos Hadjichristodoulou⁹, Grigoris Chlouverakis¹⁰, Grigoris Trypsianis¹¹, Paraskevi V Voulgari¹², Yannis Alamanos¹³, Giota Touloumi², Stavros Liatis¹⁴; EMENO Study Group

Affiliations

¹ Hellenic Diabetes Association, Athens, Greece; First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece. Electronic address: kmakrila@med.uoa.gr.
² Department of Hygiene, Epidemiology & Medical Statistics, National and Kapodistrian University of Athens Medical School, Athens, Greece.
³ Hellenic Diabetes Association, Athens, Greece; First Department of Internal Medicine and Diabetes Center, Konstantopoulio Hospital, Nea Ionia, Greece.
⁴ Hellenic Diabetes Association, Athens, Greece; Third Department of Internal Medicine, General Hospital Tzaneio, Piraeus, Greece.
⁵ Hellenic Diabetes Association, Athens, Greece; Second Department of Propaedeutic Internal Medicine, Research Unit and Diabetes Center, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
⁶ Hellenic Diabetes Association, Athens, Greece; 3rd Internal Medicine Department & Diabetes Center, General Hospital of Nikaia-Piraeus, Greece.
⁷ Dept of Primary Health Care, General Practice and Health Services Research, Medical School of Aristotle University, Thessaloniki, Greece.
⁸ Public Health, Medical School, University of Patras, Patra, Greece.
⁹ Dept of Hygiene and Epidemiology, Medical Faculty, University of Thessaly, Larisa, Greece.
¹⁰ Laboratory of Biostatistics, School of Medicine, University of Crete, Crete, Greece.
¹¹ Laboratory of Medical Statistics, Medical School, Democritus University of Thrace, Thrace, Greece.
¹² Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
¹³ Institute of Epidemiology, Preventive Medicine and Public Health, Corfu, Greece.
¹⁴ Hellenic Diabetes Association, Athens, Greece; First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece.

PMID: 33359752
DOI: 10.1016/j.diabres.2020.108646

Abstract

Aims: To report the results of the first national Health Examination Survey (HES) on the prevalence of diabetes, its pharmacologic treatment and level of control, as well as pre-diabetes in Greece.

Methods: Data were derived from the National Survey of Morbidity and Risk Factors (EMENO), in a randomly selected, representative sample of the adult Greek population. Sampling weights were applied to adjust for study design and post-stratification weights to match sample age/sex distribution to the population. Non-response was adjusted by inverse probability weighting. Weighted prevalence estimates are provided.

Results: A total of 4393 persons with HbA1c and/or fasting plasma glucose measurements were included. Total diabetes prevalence was 11.9% (95% CI: 10.9-12.9), known diabetes 10.4% (9.5-11.4), and unknown 1.5% (1.1-1.9), with considerable increase in older age groups and no difference between genders. Pre-diabetes prevalence was 12.4% (11.4-13.6). The majority of persons with known diabetes were receiving metformin. Of those with known diabetes (and measured HbA1c), 70.9% were well controlled (HbA1c <7.0%).

Conclusions: This first representative national HES showed high prevalence of diabetes in Greece, with low prevalence of unknown diabetes. Pre-diabetes prevalence is also substantial. These results will hopefully enable national authorities develop tailored and efficient strategies for disease prevention and management.

Keywords: Diabetes mellitus; Greece; Health examination survey; Pre-diabetes; Prevalence.

MeSH terms

Adolescent
Adult
Aged
Cross-Sectional Studies
Diabetes Mellitus / epidemiology*
Diabetes Mellitus / mortality
Female
Greece
Humans
Male
Middle Aged
Morbidity
Prediabetic State / epidemiology*
Prediabetic State / mortality
Prevalence
Risk Factors
Surveys and Questionnaires
Young Adult