TY - JOUR
T1 - Low- and middle-income countries demonstrate rapid growth of type 2 diabetes
T2 - an analysis based on Global Burden of Disease 1990–2019 data
AU - Liu, Jinli
AU - Bai, Ruhai
AU - Chai, Zhonglin
AU - Cooper, Mark E.
AU - Zimmet, Paul Z.
AU - Zhang, Lei
N1 - Funding Information:
Open Access funding enabled and organized by CAUL and its Member Institutions. This study was supported by the National Natural Science Foundation of China (Grant number: 8191101420), Outstanding Young Scholars Funding (Grant number: 3111500001), Xi’an Jiaotong University Basic Research and Profession Grant (Grant number: xtr022019003, xzy032020032) and Xi’an Jiaotong University Young Talent Support Grant (Grant number: YX6J004). The funders had no role in study design, data collection, data analysis, interpretation or writing of the manuscript.
Funding Information:
This manuscript uses publicly available results from the Global Burden of Disease (GBD) Results Tool. The Institute for Health Metrics and Evaluation (IHME), the University of Washington (UW) and the GBD Collaborator Network were not involved in the preparation of this manuscript; the contents and views in this manuscript are those of the authors and should not be construed to represent the views or interpretation of results of IHME, UW or the GBD Collaborator Network. The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. LZ and JL substantially contributed by developing the conceptual framework and design of the study. JL wrote the first draft of the manuscript and performed the statistical analysis. All authors contributed to the interpretation of the results and writing. LZ and PZ critically revised the manuscript for important intellectual content. All authors have approved the final version to be published. LZ is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/8
Y1 - 2022/8
N2 - Aims/hypothesis: The study aims to quantify the global trend of the disease burden of type 2 diabetes caused by various risks factors by country income tiers. Methods: Data on type 2 diabetes, including mortality and disability-adjusted life years (DALYs) during 1990–2019, were obtained from the Global Burden of Disease Study 2019. We analysed mortality and DALY rates and the population attributable fraction (PAF) in various risk factors of type 2 diabetes by country income tiers. Results: Globally, the age-standardised death rate (ASDR) attributable to type 2 diabetes increased from 16.7 (15.7, 17.5)/100,000 person-years in 1990 to 18.5 (17.2, 19.7)/100,000 person-years in 2019. Similarly, age-standardised DALY rates increased from 628.3 (537.2, 730.9)/100,000 person-years to 801.5 (670.6, 954.4)/100,000 person-years during 1990–2019. Lower-middle-income countries reported the largest increase in the average annual growth of ASDR (1.3%) and an age-standardised DALY rate (1.6%) of type 2 diabetes. The key PAF attributing to type 2 diabetes deaths/DALYs was high BMI in countries of all income tiers. With the exception of BMI, while in low- and lower-middle-income countries, risk factors attributable to type 2 diabetes-related deaths and DALYs are mostly environment-related, the risk factors in high-income countries are mostly lifestyle-related. Conclusions/interpretation: Type 2 diabetes disease burden increased globally, but low- and middle-income countries showed the highest growth rate. A high BMI level remained the key contributing factor in all income tiers, but environmental and lifestyle-related factors contributed differently across income tiers. Data availability: To download the data used in these analyses, please visit the Global Health Data Exchange at http://ghdx.healthdata.org/gbd-2019. Graphical abstract: [Figure not available: see fulltext.].
AB - Aims/hypothesis: The study aims to quantify the global trend of the disease burden of type 2 diabetes caused by various risks factors by country income tiers. Methods: Data on type 2 diabetes, including mortality and disability-adjusted life years (DALYs) during 1990–2019, were obtained from the Global Burden of Disease Study 2019. We analysed mortality and DALY rates and the population attributable fraction (PAF) in various risk factors of type 2 diabetes by country income tiers. Results: Globally, the age-standardised death rate (ASDR) attributable to type 2 diabetes increased from 16.7 (15.7, 17.5)/100,000 person-years in 1990 to 18.5 (17.2, 19.7)/100,000 person-years in 2019. Similarly, age-standardised DALY rates increased from 628.3 (537.2, 730.9)/100,000 person-years to 801.5 (670.6, 954.4)/100,000 person-years during 1990–2019. Lower-middle-income countries reported the largest increase in the average annual growth of ASDR (1.3%) and an age-standardised DALY rate (1.6%) of type 2 diabetes. The key PAF attributing to type 2 diabetes deaths/DALYs was high BMI in countries of all income tiers. With the exception of BMI, while in low- and lower-middle-income countries, risk factors attributable to type 2 diabetes-related deaths and DALYs are mostly environment-related, the risk factors in high-income countries are mostly lifestyle-related. Conclusions/interpretation: Type 2 diabetes disease burden increased globally, but low- and middle-income countries showed the highest growth rate. A high BMI level remained the key contributing factor in all income tiers, but environmental and lifestyle-related factors contributed differently across income tiers. Data availability: To download the data used in these analyses, please visit the Global Health Data Exchange at http://ghdx.healthdata.org/gbd-2019. Graphical abstract: [Figure not available: see fulltext.].
KW - DALYs
KW - Death
KW - Population attributable fraction
KW - Type 2 diabetes mellitus
UR - https://www.scopus.com/pages/publications/85130469237
U2 - 10.1007/s00125-022-05713-6
DO - 10.1007/s00125-022-05713-6
M3 - Article
C2 - 35587275
AN - SCOPUS:85130469237
SN - 0012-186X
VL - 65
SP - 1339
EP - 1352
JO - Diabetologia
JF - Diabetologia
IS - 8
ER -
SDG 3 Good Health and Well-being