Changes in the Prevalence of Diabetes in Bulgaria over an 18-Year Period (2006-2024)

Abstract

The international medical community is increasingly aware that diabetes is a major global health threat and poses increasing challenges to public health and health systems worldwide. <i>Aim:</i> To compare the results of three national cross-sectional studies on diabetes prevalence in Bulgaria (2006, 2012 and 2024) and to assess the dynamics. <i>Material and Methods:</i> The three studies included 2396, 2033 and 936 subjects respectively. The United Nation / The International Diabetes Federation (2006) diagnostic criteria were applied, and the data were evaluated according to type of settlement and age. <i>Results: </i>Diabetes prevalence was 7.9% in 2006 and 9.55% in 2012 (p = 0.06). This difference is due to the greater rise in men (9.2% to 11.5%, p = 0.09) compared to women (6.9% to 7.7%, NS). In the next period, 2012 - 2024, the prevalence of diabetes in general, as well as the prevalence in men and women increased significantly. (Diabetes in general - from 9.6% to 15.7%, p < 0.001; diabetic men - from 11.5% to 21.2%, p < 0.001; diabetic women – from 7.8% to 10.4%, p < 0.016). The prevalence of diabetes nearly doubled, while the population decreased and its structure, lifestyle and diet changed. Obesity significantly increased over a 18-year period - 2024 vs. 2006 (33.3% vs. 26.7%, p < 0.001). The prevalence of diabetes increased with age, with significant rise in the 30-39 age group for 2012 - 2024, from 1.7% to 4.5% (p < 0.047) and more sharply when comparing 2006 - 2024 – from 0.9% to 4.5% (p < 0.002). There was a similar increase in the next age group. For the age 60-79, the prevalence reached 29.9%, i.e. every third person. As arterial hypertension is significantly more common in diabetics, its role as a risk factor is indisputable. <i>Conclusion:</i> The health care system should be readjusted according to the new reality for early diagnose of diabetes in risk groups and adequate modern care.