Ethnic disparities in the prevalence of prediabetes and diabetes in Australia: a systematic review and meta-analysis

Background: Ethnicity plays a significant role in the prevalence of prediabetes and diabetes, yet no systematic review has explored this in Australia. Objective: This study aims to systematically review and meta-analyse ethnic differences in the prevalence of diabetes and prediabetes in Australia. Method: In July–August 2024, a comprehensive search of cross-sectional and observational studies published between 2010 and 2024 in MEDLINE, EMBASE, Scopus, CINAHL, and Web of Science was conducted. Studies that reported the prevalence of diabetes and prediabetes in adults from various ethnic groups in Australia were included, while those focused on pregnant women and individuals under 18 were excluded. In STATA,’metaprop' and'metapreg' were used to estimate each indicator's prevalence and assess across different subgroups. Results: Of 2,838 studies, 27 studies involving 1,137,925 participants were included. In 46.2% of studies, diabetes diagnoses were based on self-reported data. The pooled weighted prevalence was 21.8% (95% CI: 20.60–23.01) for diabetes and 13.7% (CI: 10.42–17.02) for prediabetes. Pacific people (36.5%, CI: 15.20–57.86) and Indigenous Australians (30.7%, CI: 23.90–37.49) had the highest pooled weighted prevalence of diabetes, while White/People of European descent (14.5%, CI: 13.03–16.01) and non-Indigenous Australians (18.6%, CI: 20.83–23.24) had the lowest prevalence of diabetes. There were significant heterogeneity (I² = 99.9%, p < 0.05) among the reviewed studies. Conclusion: Diabetes and prediabetes are highly prevalent in Australia, with marked disparities across ethnic groups. Pacific people and Indigenous Australians had the the highest burden of both conditions, highlighting the need for targeted, culturally appropriate interventions. Future research exploring the underlying causes of these disparities and the effectiveness of tailored prevention strategies are warranted.