Plate Nº 87 · recorded September 30, 2026
Health & Medicine ResearchReported finding
Maurius Becomes First Country to Reverse Its Type 2 Diabetes Epidemic
Using WHO gold-standard glucose testing across seven surveys since 1987, Mauritius has become the first country to document a sustained fall in type 2 diabetes prevalence.
By Marcus Bennett4 min read765 words
In brief
- Diabetes prevalence in Mauritius fell from 23.3% in 2009 to 19.9% in 2021, dropping 11% in men and 16% in women over that period.
- Mauritius is the only country to have monitored diabetes and prediabetes over time using the WHO-recommended two-hour oral glucose tolerance test.
- The findings, presented at the EASD meeting in Milan and published in The Lancet Diabetes & Endocrinology, credit multisectoral prevention policies and free public health care.
The island nation of Mauritius has become the first country to demonstrate that it is reversing its type 2 diabetes epidemic, according to new research presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Milan, Italy, held September 28 to October 2, and published in The Lancet Diabetes & Endocrinology.
The finding rests on an unusually solid foundation: more than three decades of surveys that used the World Health Organization's gold-standard diagnostic method, the two-hour oral glucose tolerance test (2-hour OGTT). No other country has systematically used this test to monitor diabetes over such a long period.
Why the testing method matters
Type 2 diabetes prevalence has been rising globally for decades, yet the numbers behind that trend are shakier than many people realize. Estimates typically come from population surveys in some countries and routine administrative data, while most countries have no survey data at all. Only a handful of nations have repeated diabetes surveys over many years.
Survey methods also vary between countries, and most studies skip the WHO-recommended OGTT. That matters because today's common first-line tests — fasting plasma glucose or glycated hemoglobin (HbA1c), a measure of average blood sugar over recent months — miss many asymptomatic cases that an OGTT can catch. Studies that skipped the OGTT have therefore likely underestimated both diabetes and prediabetes, the intermediate state of elevated blood sugar also called intermediate hyperglycemia.
The OGTT itself is demanding. The person fasts, consuming nothing but water, for eight to ten hours. A health professional then draws blood to measure fasting blood sugar. The person drinks a sweet liquid containing 75 grams of glucose for adults, and further blood samples follow, typically one hour and two hours after the drink. Until the final sample, the person must stay sedentary and avoid eating, drinking anything else, smoking, and exercise.
Thirty-four years of data
Mauritius, an Indian Ocean island east of Madagascar with 1.2 million people, has undergone a profound socioeconomic transition. Changing lifestyles shifted its disease burden from infectious illnesses to chronic noncommunicable diseases, a pattern shared with many other island nations, including Pacific states, where obesity and type 2 diabetes have surged since the 1980s.
Unlike those nations, Mauritius tracked the shift. Seven cross-sectional surveys since 1987 measured diabetes and prediabetes with the OGTT. Paul Zimmet, now a professor of diabetes at Monash University in Melbourne, Australia, initiated the surveys, which the Ministry of Health and Wellness carried out. Teams led by Zimmet, Jaakko Tuomilehto of the University of Helsinki's Department of Public Health, and Sir George Alberti of the U.K. supported the work, joined more recently by Stefan Söderberg of Umeå, Sweden.
The trajectory is clear. Prevalence climbed from 14.7% overall in 1987 to 17.3% in 1992, 20.2% in 1998 and 23.3% in 2009. It then dipped slightly to 23.1% in 2015 and fell to 19.9% in 2021. Between 1987 and 2009, prevalence rose 61% in men and 56% in women. Between 2009 and 2021, it dropped 11% in men and 16% in women.
What may explain the turnaround
The authors, who include Tuomilehto, point to Mauritius's multisectoral response. The country adopted an action plan for prevention, policy measures including advocacy and legislation, NCD risk-factor screening through mobile clinics, and community engagement, backed by national plans on nutrition, physical activity and tobacco control. A national integrated NCD action plan provided a road map for health across the life course, and a national service framework set standards of care. Public-sector health services, including essential medicines, are free of charge.
"Mauritius is the first country to show a sustained decrease in the prevalence of type 2 diabetes and prediabetes, based on long-term data using the WHO-recommended gold-standard oral glucose tolerance test–based diagnostic criteria," the authors write.
They add that the results carry a wider message: "It is encouraging to learn that the continuous increase in type 2 diabetes occurring in almost all countries around the world could be halted and even reversed. Previous experiences with other major public health problems, such as cardiovascular diseases and lung cancer, have shown that it is possible to tackle chronic NCD epidemics."
The authors caution, in effect, that the achievement involved a combination of measures rather than a single intervention, and the observational data cannot isolate which component drove the decline. Still, for countries shouldering the human and economic costs of type 2 diabetes, Mauritius offers something rare: documented evidence that the epidemic can be turned around.
via Medical Xpress (Source)
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