International trends in traditional diabetes complications (cardiovascular, renal, peripheral vascular, ophthalmic, hepatic or neurological diseases) and mortality rates are poorly characterised. An earlier review of studies published up to 2015 demonstrated that most data come from a dozen high-income countries (HICs) in North America, Europe or the Asia-Pacific region and that, in these countries at least, rates of acute glycaemic fluctuations needing medical attention and amputations, myocardial infarction and mortality were all declining over the period. Here, we provide an updated review of published literature on trends in type 2 diabetes complications and mortality in adults since 2015. We also discuss issues related to data collection, analysis and reporting that have influenced global trends in type 2 diabetes and its complications. We found that most data on trends in type 2 diabetes, its complications and mortality come from a small number of HICs with comprehensive surveillance systems, though at least some low- and middle-income countries (LMICs) from Africa and Latin America are represented in this review. The published data suggest that HICs have experienced declines in cardiovascular complication rates and all-cause mortality in people with diabetes. In parallel, cardiovascular complications and mortality rates in people with diabetes have increased over time in LMICs. However, caution is warranted in interpreting trends from LMICs due to extremely sparse data or data that are not comparable across countries. We noted that approaches to case ascertainment and definitions of complications and mortality (numerators) and type 2 diabetes (the denominator) vary widely and influence the interpretation of international data. We offer four key recommendations to more rigorously document trends in rates of type 2 diabetes complications and mortality, over time and worldwide: (1) increasing investments in data collection systems; (2) standardising case definitions and approaches to ascertainment; (3) strengthening analytical capacity; and (4) developing and implementing structured guidelines for reporting of data.

中文翻译：

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解读 2 型糖尿病并发症和死亡率的全球趋势。

传统糖尿病并发症（心血管、肾脏、外周血管、眼科、肝脏或神经系统疾病）和死亡率的国际趋势尚不清楚。对截至 2015 年发表的研究的早期回顾表明，大多数数据来自北美、欧洲或亚太地区的十几个高收入国家 (HIC)，并且至少在这些国家，急性血糖波动率需要在此期间，医疗护理和截肢、心肌梗塞和死亡率均有所下降。在这里，我们提供了自 2015 年以来已发表的关于成人 2 型糖尿病并发症和死亡率趋势的文献的更新回顾。我们还讨论了与数据收集、分析和报告相关的问题，这些问题影响了 2 型糖尿病及其并发症的全球趋势。我们发现，关于 2 型糖尿病、其并发症和死亡率趋势的大多数数据来自少数拥有综合监测系统的高收入国家，尽管非洲和拉丁美洲至少有一些低收入和中等收入国家 (LMIC)这篇评论。已发表的数据表明，HIC 在糖尿病患者中的心血管并发症发生率和全因死亡率有所下降。与此同时，在中低收入国家，糖尿病患者的心血管并发症和死亡率随着时间的推移而增加。然而，由于数据极其稀疏或无法在各国进行比较，因此在解释 LMIC 的趋势时需要谨慎。我们注意到，病例确定的方法以及并发症和死亡率（分子）和 2 型糖尿病（分母）的定义差异很大，并影响国际数据的解释。我们提出四项关键建议，以更严格地记录 2 型糖尿病并发症和死亡率随时间推移和全球范围内的趋势：（1）增加对数据收集系统的投资；(2) 规范案例定义和确定方法；(3) 加强分析能力；(4) 制定和实施结构化的数据报告指南。(1) 增加对数据收集系统的投资；(2) 规范案例定义和确定方法；(3) 加强分析能力；(4) 制定和实施结构化的数据报告指南。(1) 增加对数据收集系统的投资；(2) 规范案例定义和确定方法；(3) 加强分析能力；(4) 制定和实施结构化的数据报告指南。