Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific,...

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Vydané v:The Lancet (British edition) Ročník 402; číslo 10397; s. 203 - 234
Hlavní autori: Stafford, Lauryn K, Cruz, Jessica A, Aali, Amirali, Abate, Melsew Dagne, Abd ElHafeez, Samar, Adane, Tigist Demssew, Adekanmbi, Victor, Agudelo-Botero, Marcela, Ahmadi, Ali, Akinyemi, Rufus Olusola, Al Hamad, Hanadi, Alvis-Guzman, Nelson, Amusa, Ganiyu Adeniyi, Anyasodor, Anayochukwu Edward, Areda, Demelash, Armocida, Benedetta, Arumugam, Ashokan, Aryan, Zahra, Badawi, Alaa, Bagheri, Nasser, Bah, Sulaiman, Baltatu, Ovidiu Constantin, Belete, Melaku Ashagrie, Bilal, Faiq, Bintoro, Bagas Suryo, Brazo-Sayavera, Javier, Cao, Chao, Chidambaram, Saravana Babu, Chowdhury, Rajiv, Chowdhury, Enayet Karim, Contreras, Daniela, Dandona, Rakhi, Fagbamigbe, Adeniyi Francis, Farzadfar, Farshad, Feng, Xiaoqi, Flood, David, Ghadirian, Fataneh, Gyawali, Bishal, Haubold, Johannes, Hessami, Kamran, Inbaraj, Leeberk Raja, Jafarzadeh, Abdollah, Jain, Rajesh, Jeong, Wonjeong, Jonas, Jost B, Joseph, Abel, Joshua, Charity Ehimwenma, Kabir, Ali, Kaur, Navjot, Khan, Moien AB, Liu, Xuefeng, Liu, Chaojie, Lorkowski, Stefan, Makris, Konstantinos Christos, Malik, Iram, Marzo, Roy Rillera, Masoudi, Sahar, Mini, GK, Misgina, Kebede Haile, Moradi, Maryam, Nauman, Javaid, Niazi, Robina Khan, Nigatu, Yeshambel T, Nnyanzi, Lawrence Achilles, Nzoputam, Ogochukwu Janet, Oancea, Bogdan, Okwute, Patrick Godwin, Olufadewa, Isaac Iyinoluwa, Ortiz, Alberto, Palladino, Raffaele, Pasovic, Maja, Paudel, Uttam, Pereira, Marcos, Petermann-Rocha, Fanny Emily, Rahmanian, Vahid, Rahmawaty, Setyaningrum, Ratan, Zubair Ahmed, Rawaf, Salman, Rengasamy, Kannan RR, Rezazadeh, Hossein, Rias, Yohanes Andy, Rwegerera, Godfrey M, Safi, Sare, Sahoo, Harihar, Sharfaei, Sadaf, Singh, Surjit, Suleman, Muhammad, Tamuzi, Jacques JL Lukenze, Tan, Ker-Kan, Taye, Birhan Tsegaw, Temsah, Mohamad-Hani, Tesler, Riki, Tovani-Palone, Marcos Roberto, Varthya, Shoban Babu, Yesiltepe, Metin, Yohannis, Hunachew Kibret, Yonemoto, Naohiro, Zarrintan, Armin, Zeru, Naod Gebrekrstos, Zhang, Zhi-Jiang
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Amsterdam Elsevier 15.07.2023
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ISSN:1474-547X, 0140-6736, 1474-547X
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Abstract Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. Bill & Melinda Gates Foundation.
AbstractList Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050.
Background Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. Findings In 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6 center dot 1% (5 center dot 8-6 center dot 5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9 center dot 3% [8 center dot 7-9 center dot 9]) and, at the regional level, in Oceania (12 center dot 3% [11 center dot 5-13 center dot 0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76 center dot 1% (73 center dot 1-79 center dot 5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96 center dot 0% (95 center dot 1-96 center dot 8) of diabetes cases and 95 center dot 4% (94 center dot 9-95 center dot 9) of diabetes DALYs worldwide. In 2021, 52 center dot 2% (25 center dot 5-71 center dot 8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24 center dot 3% (18 center dot 5-30 center dot 4) worldwide between 1990 and 2021. By 2050, more than 1 center dot 31 billion (1 center dot 22-1 center dot 39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16 center dot 8% (16 center dot 1-17 center dot 6) in north Africa and the Middle East and 11 center dot 3% (10 center dot 8-11 center dot 9) in Latin America and Caribbean. By 2050, 89 (43 center dot 6%) of 204 countries and territories will have an age-standardised rate greater than 10%. Interpretation Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers.
Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050.BACKGROUNDDiabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050.Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively.METHODSEstimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively.In 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8-6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7-9·9]) and, at the regional level, in Oceania (12·3% [11·5-13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1-79·5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1-96·8) of diabetes cases and 95·4% (94·9-95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5-71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5-30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22-1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1-17·6) in north Africa and the Middle East and 11·3% (10·8-11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%.FINDINGSIn 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8-6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7-9·9]) and, at the regional level, in Oceania (12·3% [11·5-13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1-79·5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1-96·8) of diabetes cases and 95·4% (94·9-95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5-71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5-30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22-1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1-17·6) in north Africa and the Middle East and 11·3% (10·8-11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%.Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers.INTERPRETATIONDiabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers.Bill & Melinda Gates Foundation.FUNDINGBill & Melinda Gates Foundation.
Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. Bill & Melinda Gates Foundation.
Summary Background Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. Findings In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. Interpretation Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. Funding Bill & Melinda Gates Foundation.
Author Iso, Hiroyasu
Alemi, Sharifullah
Simpson, Colin R
Joukar, Farahnaz
Naghavi, Mohsen
Liu, Chaojie
Gudayu, Temesgen Worku
Kadashetti, Vidya
Rancic, Nemanja
Rawal, Lal
Butt, Zahid A
Kazemian, Sina
Jamalpoor, Zahra
Deng, Xinlei
Soleimani, Hamidreza
Rawaf, Salman
Shaikh, Masood Ali
Shiri, Rahman
Abdulah, Deldar Morad
Das, Saswati
Qadir, Mirza Muhammad Fahd
Boloor, Archith
Ullah, Sana
Saad, Aly M A
Ilic, Irena M
Olufadewa, Isaac Iyinoluwa
Zastrozhin, Mikhail Sergeevich
Shuval, Kerem
Momtazmanesh, Sara
Eshetu, Habitu Birhan
AL-Ahdal, Tareq Mohammed Ali
Pourali, Ghazaleh
Ghamari, Seyyed-Hadi
Solikhah, Solikhah
Saheb Sharif-Askari, Narjes
Singh, Surjit
Falahi, Shahab
Mohammadi, Mohsen
Rashedi, Vahid
Waheed, Yasir
Morovatdar, Negar
Hasan, S M Mahmudul
Krishan, Kewal
Mojiri-forushani, Hoda
Adekanmbi, Victor
Dhama, Kuldeep
Islam, Sheikh Mohammed Shariful
Lee, Munjae
Bhatti, Jasvinder Singh
Ribeiro, Daniela
Dabo, Bashir
Ahmed, Ayman
Wu, YiFan
Cousin, Ewerton
Okonji, Osaretin Christabel
Westerman, Ronny
Prates, Elton Junio Sady
Gebrehiwot, Mesfin
Valizadeh,
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  surname: Stafford
  fullname: Stafford, Lauryn K
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– sequence: 54
  givenname: Hanadi
  surname: Al Hamad
  fullname: Al Hamad, Hanadi
– sequence: 67
  givenname: Nelson
  surname: Alvis-Guzman
  fullname: Alvis-Guzman, Nelson
– sequence: 71
  givenname: Ganiyu Adeniyi
  surname: Amusa
  fullname: Amusa, Ganiyu Adeniyi
– sequence: 77
  givenname: Anayochukwu Edward
  surname: Anyasodor
  fullname: Anyasodor, Anayochukwu Edward
– sequence: 80
  givenname: Demelash
  surname: Areda
  fullname: Areda, Demelash
– sequence: 83
  givenname: Benedetta
  surname: Armocida
  fullname: Armocida, Benedetta
– sequence: 88
  givenname: Ashokan
  surname: Arumugam
  fullname: Arumugam, Ashokan
– sequence: 89
  givenname: Zahra
  surname: Aryan
  fullname: Aryan, Zahra
– sequence: 104
  givenname: Alaa
  surname: Badawi
  fullname: Badawi, Alaa
– sequence: 107
  givenname: Nasser
  surname: Bagheri
  fullname: Bagheri, Nasser
– sequence: 109
  givenname: Sulaiman
  surname: Bah
  fullname: Bah, Sulaiman
– sequence: 113
  givenname: Ovidiu Constantin
  surname: Baltatu
  fullname: Baltatu, Ovidiu Constantin
– sequence: 132
  givenname: Melaku Ashagrie
  surname: Belete
  fullname: Belete, Melaku Ashagrie
– sequence: 143
  givenname: Faiq
  surname: Bilal
  fullname: Bilal, Faiq
– sequence: 144
  givenname: Bagas Suryo
  surname: Bintoro
  fullname: Bintoro, Bagas Suryo
– sequence: 151
  givenname: Javier
  surname: Brazo-Sayavera
  fullname: Brazo-Sayavera, Javier
– sequence: 158
  givenname: Chao
  surname: Cao
  fullname: Cao, Chao
– sequence: 175
  givenname: Saravana Babu
  surname: Chidambaram
  fullname: Chidambaram, Saravana Babu
– sequence: 178
  givenname: Rajiv
  surname: Chowdhury
  fullname: Chowdhury, Rajiv
– sequence: 179
  givenname: Enayet Karim
  surname: Chowdhury
  fullname: Chowdhury, Enayet Karim
– sequence: 185
  givenname: Daniela
  surname: Contreras
  fullname: Contreras, Daniela
– sequence: 194
  givenname: Rakhi
  surname: Dandona
  fullname: Dandona, Rakhi
– sequence: 242
  givenname: Adeniyi Francis
  surname: Fagbamigbe
  fullname: Fagbamigbe, Adeniyi Francis
– sequence: 247
  givenname: Farshad
  surname: Farzadfar
  fullname: Farzadfar, Farshad
– sequence: 250
  givenname: Xiaoqi
  surname: Feng
  fullname: Feng, Xiaoqi
– sequence: 253
  givenname: David
  surname: Flood
  fullname: Flood, David
– sequence: 268
  givenname: Fataneh
  surname: Ghadirian
  fullname: Ghadirian, Fataneh
– sequence: 285
  givenname: Bishal
  surname: Gyawali
  fullname: Gyawali, Bishal
– sequence: 303
  givenname: Johannes
  surname: Haubold
  fullname: Haubold, Johannes
– sequence: 307
  givenname: Kamran
  surname: Hessami
  fullname: Hessami, Kamran
– sequence: 324
  givenname: Leeberk Raja
  surname: Inbaraj
  fullname: Inbaraj, Leeberk Raja
– sequence: 337
  givenname: Abdollah
  surname: Jafarzadeh
  fullname: Jafarzadeh, Abdollah
– sequence: 339
  givenname: Rajesh
  surname: Jain
  fullname: Jain, Rajesh
– sequence: 349
  givenname: Wonjeong
  surname: Jeong
  fullname: Jeong, Wonjeong
– sequence: 352
  givenname: Jost B
  surname: Jonas
  fullname: Jonas, Jost B
– sequence: 354
  givenname: Abel
  surname: Joseph
  fullname: Joseph, Abel
– sequence: 355
  givenname: Charity Ehimwenma
  surname: Joshua
  fullname: Joshua, Charity Ehimwenma
– sequence: 359
  givenname: Ali
  surname: Kabir
  fullname: Kabir, Ali
– sequence: 369
  givenname: Navjot
  surname: Kaur
  fullname: Kaur, Navjot
– sequence: 375
  givenname: Moien AB
  surname: Khan
  fullname: Khan, Moien AB
– sequence: 427
  givenname: Xuefeng
  surname: Liu
  fullname: Liu, Xuefeng
– sequence: 428
  givenname: Chaojie
  surname: Liu
  fullname: Liu, Chaojie
– sequence: 431
  givenname: Stefan
  surname: Lorkowski
  fullname: Lorkowski, Stefan
– sequence: 443
  givenname: Konstantinos Christos
  surname: Makris
  fullname: Makris, Konstantinos Christos
– sequence: 446
  givenname: Iram
  surname: Malik
  fullname: Malik, Iram
– sequence: 455
  givenname: Roy Rillera
  surname: Marzo
  fullname: Marzo, Roy Rillera
– sequence: 457
  givenname: Sahar
  surname: Masoudi
  fullname: Masoudi, Sahar
– sequence: 468
  givenname: GK
  surname: Mini
  fullname: Mini, GK
– sequence: 474
  givenname: Kebede Haile
  surname: Misgina
  fullname: Misgina, Kebede Haile
– sequence: 492
  givenname: Maryam
  surname: Moradi
  fullname: Moradi, Maryam
– sequence: 515
  givenname: Javaid
  surname: Nauman
  fullname: Nauman, Javaid
– sequence: 525
  givenname: Robina Khan
  surname: Niazi
  fullname: Niazi, Robina Khan
– sequence: 526
  givenname: Yeshambel T
  surname: Nigatu
  fullname: Nigatu, Yeshambel T
– sequence: 529
  givenname: Lawrence Achilles
  surname: Nnyanzi
  fullname: Nnyanzi, Lawrence Achilles
– sequence: 532
  givenname: Ogochukwu Janet
  surname: Nzoputam
  fullname: Nzoputam, Ogochukwu Janet
– sequence: 534
  givenname: Bogdan
  surname: Oancea
  fullname: Oancea, Bogdan
– sequence: 541
  givenname: Patrick Godwin
  surname: Okwute
  fullname: Okwute, Patrick Godwin
– sequence: 542
  givenname: Isaac Iyinoluwa
  surname: Olufadewa
  fullname: Olufadewa, Isaac Iyinoluwa
– sequence: 545
  givenname: Alberto
  surname: Ortiz
  fullname: Ortiz, Alberto
– sequence: 551
  givenname: Raffaele
  surname: Palladino
  fullname: Palladino, Raffaele
– sequence: 561
  givenname: Maja
  surname: Pasovic
  fullname: Pasovic, Maja
– sequence: 564
  givenname: Uttam
  surname: Paudel
  fullname: Paudel, Uttam
– sequence: 566
  givenname: Marcos
  surname: Pereira
  fullname: Pereira, Marcos
– sequence: 570
  givenname: Fanny Emily
  surname: Petermann-Rocha
  fullname: Petermann-Rocha, Fanny Emily
– sequence: 590
  givenname: Vahid
  surname: Rahmanian
  fullname: Rahmanian, Vahid
– sequence: 591
  givenname: Setyaningrum
  surname: Rahmawaty
  fullname: Rahmawaty, Setyaningrum
– sequence: 606
  givenname: Zubair Ahmed
  surname: Ratan
  fullname: Ratan, Zubair Ahmed
– sequence: 607
  givenname: Salman
  surname: Rawaf
  fullname: Rawaf, Salman
– sequence: 611
  givenname: Kannan RR
  surname: Rengasamy
  fullname: Rengasamy, Kannan RR
– sequence: 617
  givenname: Hossein
  surname: Rezazadeh
  fullname: Rezazadeh, Hossein
– sequence: 619
  givenname: Yohanes Andy
  surname: Rias
  fullname: Rias, Yohanes Andy
– sequence: 628
  givenname: Godfrey M
  surname: Rwegerera
  fullname: Rwegerera, Godfrey M
– sequence: 637
  givenname: Sare
  surname: Safi
  fullname: Safi, Sare
– sequence: 644
  givenname: Harihar
  surname: Sahoo
  fullname: Sahoo, Harihar
– sequence: 678
  givenname: Sadaf
  surname: Sharfaei
  fullname: Sharfaei, Sadaf
– sequence: 692
  givenname: Surjit
  surname: Singh
  fullname: Singh, Surjit
– sequence: 703
  givenname: Muhammad
  surname: Suleman
  fullname: Suleman, Muhammad
– sequence: 713
  givenname: Jacques JL Lukenze
  surname: Tamuzi
  fullname: Tamuzi, Jacques JL Lukenze
– sequence: 714
  givenname: Ker-Kan
  surname: Tan
  fullname: Tan, Ker-Kan
– sequence: 716
  givenname: Birhan Tsegaw
  surname: Taye
  fullname: Taye, Birhan Tsegaw
– sequence: 718
  givenname: Mohamad-Hani
  surname: Temsah
  fullname: Temsah, Mohamad-Hani
– sequence: 719
  givenname: Riki
  surname: Tesler
  fullname: Tesler, Riki
– sequence: 728
  givenname: Marcos Roberto
  surname: Tovani-Palone
  fullname: Tovani-Palone, Marcos Roberto
– sequence: 744
  givenname: Shoban Babu
  surname: Varthya
  fullname: Varthya, Shoban Babu
– sequence: 770
  givenname: Metin
  surname: Yesiltepe
  fullname: Yesiltepe, Metin
– sequence: 772
  givenname: Hunachew Kibret
  surname: Yohannis
  fullname: Yohannis, Hunachew Kibret
– sequence: 773
  givenname: Naohiro
  surname: Yonemoto
  fullname: Yonemoto, Naohiro
– sequence: 779
  givenname: Armin
  surname: Zarrintan
  fullname: Zarrintan, Armin
– sequence: 781
  givenname: Naod Gebrekrstos
  surname: Zeru
  fullname: Zeru, Naod Gebrekrstos
– sequence: 782
  givenname: Zhi-Jiang
  surname: Zhang
  fullname: Zhang, Zhi-Jiang
BackLink https://www.ncbi.nlm.nih.gov/pubmed/37356446$$D View this record in MEDLINE/PubMed
https://urn.kb.se/resolve?urn=urn:nbn:se:du-47221$$DView record from Swedish Publication Index
https://gup.ub.gu.se/publication/335543$$DView record from Swedish Publication Index (Göteborgs universitet)
http://kipublications.ki.se/Default.aspx?queryparsed=id:153970094$$DView record from Swedish Publication Index (Karolinska Institutet)
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Contributor Alemi, Sharifullah
Ansari, Golnoosh
Arifin, Hidayat
Addo, Isaac Yeboah
Asmelash, Daniel
Athari, Seyyed Shamsadin
Alvis-Guzman, Nelson
Ali, Hassam
Abbasi-Kangevari, Mohsen
Askari, Elaheh
Agyemang-Duah, Williams
Arulappan, Judie
Areda, Demelash
Ahmadi, Keivan
Smith, Amanda E
Ansari-Moghaddam, Alireza
Abdulah, Deldar Morad
Adnani, Qorinah Estiningtyas Sakilah
Ansar, Adnan
Abate, Melsew Dagne
Andrei, Catalina Liliana
Akinyemi, Rufus Olusola
Abd-Rabu, Rami
Aguilera Arriagada, Constanza Elizabeth
Aryan, Zahra
Ahmed, Luai A
Lindstedt, Paulina A
Abbasian, Mohammadreza
Al Hamad, Hanadi
Aboagye, Richard Gyan
Alcalde-Rabanal, Jacqueline Elizabeth
Armocida, Benedetta
Abolhassani, Hassan
Ameyaw, Edward Kwabena
Astell-Burt, Thomas
Anjana, Ranjit Mohan
Ahmadi, Ali
Ärnlöv, Johan
Ajami, Marjan
Asghari-Jafarabadi, Mohammad
Adekanmbi, Victor
Ong, Kanyin Liane
McLaughlin, Susan A
Afolabi, Rotimi Felix
Awaisu, Ahmed
Aali, Amirali
Arumugam, Ashokan
Ahmed, Ayman
Al-Aly, Ziyad
Azadnajafabad, Sina
Aruleba, Raphael Taiwo
Aghdam, Zahra Babaei
Alalwan, Tariq A
Abat
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Snippet Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent...
Summary Background Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using...
Background Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most...
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SubjectTerms Age
Age composition
Aged
Allmänmedicin
Autopsies
Autopsy
Bayes Theorem
Bayesian analysis
Charities
Collaboration
Computation
Death
Diabetes
Diabetes mellitus (insulin dependent)
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 1 - epidemiology
Diabetes Mellitus, Type 2 - epidemiology
Disease
Estimates
Female
General Medicine
Global Burden of Disease
Global Health
Health risks
Humans
Injury analysis
Life Expectancy
Life span
Male
Mathematical models
Mortality
Older people
Physical activity
Population
Populations
Prevalence
Public health
Quality-Adjusted Life Years
Risk assessment
Risk Factors
Risk management
Sex
Tobacco
Title Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021
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