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.
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 / Ong, Kanyin Liane; Stafford, Lauryn K; McLaughlin, Susan A; Boyko, Edward J; Vollset, Stein Emil; Smith, Amanda E; Dalton, Bronte E; Duprey, Joe; Cruz, Jessica A; Hagins, Hailey; Lindstedt, Paulina A; Aali, Amirali; Abate, Yohannes Habtegiorgis; Abate, Melsew Dagne; Abbasian, Mohammadreza; Abbasi-Kangevari, Zeinab; Abbasi-Kangevari, Mohsen; Abd ElHafeez, Samar; Abd-Rabu, Rami; Abdulah, Deldar Morad; Abdullah, Abu Yousuf Md; Abedi, Vida; Abidi, Hassan; Aboagye, Richard Gyan; Abolhassani, Hassan; Abu-Gharbieh, Eman; Abu-Zaid, Ahmed; Adane, Tigist Demssew; Adane, Denberu Eshetie; Addo, Isaac Yeboah; Adegboye, Oyelola A; Adekanmbi, Victor; Adepoju, Abiola Victor; Adnani, Qorinah Estiningtyas Sakilah; Afolabi, Rotimi Felix; Agarwal, Gina; Aghdam, Zahra Babaei; Agudelo-Botero, Marcela; Aguilera Arriagada, Constanza Elizabeth; Agyemang-Duah, Williams; Ahinkorah, Bright Opoku; Ahmad, Danish; Ahmad, Rizwan; Ahmad, Sajjad; Ahmad, Aqeel; Ahmadi, Ali; Ahmadi, Keivan; Ahmed, Ayman; Ahmed, Ali; Ahmed, Luai A; Ahmed, Syed Anees; Ajami, Marjan; Akinyemi, Rufus Olusola; Al Hamad, Hanadi; Al Hasan, Syed Mahfuz; AL-Ahdal, Tareq Mohammed Ali; Alalwan, Tariq A; Al-Aly, Ziyad; AlBataineh, Mohammad T; Alcalde-Rabanal, Jacqueline Elizabeth; Alemi, Sharifullah; Ali, Hassam; Alinia, Tahereh; Aljunid, Syed Mohamed; Almustanyir, Sami; Al-Raddadi, Rajaa M; Alvis-Guzman, Nelson; Amare, Firehiwot; Ameyaw, Edward Kwabena; Amiri, Sohrab; Amusa, Ganiyu Adeniyi; Andrei, Catalina Liliana; Anjana, Ranjit Mohan; Ansar, Adnan; Ansari, Golnoosh; Ansari-Moghaddam, Alireza; Anyasodor, Anayochukwu Edward; Arabloo, Jalal; Aravkin, Aleksandr Y; Areda, Demelash; Arifin, Hidayat; Arkew, Mesay; Armocida, Benedetta; Ärnlöv, Johan; Artamonov, Anton A; Arulappan, Judie; Aruleba, Raphael Taiwo; Arumugam, Ashokan; Aryan, Zahra; Asemu, Mulu Tiruneh; Asghari-Jafarabadi, Mohammad; Askari, Elaheh; Asmelash, Daniel; Astell-Burt, Thomas; Athar, Mohammad; Athari, Seyyed Shamsadin; Atout, Maha Moh'd Wahbi; Avila-Burgos, Leticia; Awaisu, Ahmed; Azadnajafabad, Sina; B, Darshan B; Babamohamadi, Hassan; Badar, Muhammad; Badawi, Alaa; Badiye, Ashish D; Baghcheghi, Nayereh; Bagheri, Nasser; Bagherieh, Sara; Bah, Sulaiman; Bahadory, Saeed; Bai, Ruhai; Baig, Atif Amin; Baltatu, Ovidiu Constantin; Baradaran, Hamid Reza; Barchitta, Martina; Bardhan, Mainak; Barengo, Noel C; Bärnighausen, Till Winfried; Barone, Mark Thomaz Ugliara; Barone-Adesi, Francesco; Barrow, Amadou; Bashiri, Hamideh; Basiru, Afisu; Basu, Sanjay; Basu, Saurav; Batiha, Abdul-Monim Mohammad; Batra, Kavita; Bayih, Mulat Tirfie; Bayileyegn, Nebiyou Simegnew; Behnoush, Amir Hossein; Bekele, Alehegn Bekele; Belete, Melaku Ashagrie; Belgaumi, Uzma Iqbal; Belo, Luis; Bennett, Derrick A; Bensenor, Isabela M; Berhe, Kidanemaryam; Berhie, Alemshet Yirga; Bhaskar, Sonu; Bhat, Ajay Nagesh; Bhatti, Jasvinder Singh; Bikbov, Boris; Bilal, Faiq; Bintoro, Bagas Suryo; Bitaraf, Saeid; Bitra, Veera R; Bjegovic-Mikanovic, Vesna; Bodolica, Virginia; Boloor, Archith; Brauer, Michael; Brazo-Sayavera, Javier; Brenner, Hermann; Butt, Zahid A; Calina, Daniela; Campos, Luciana Aparecida; Campos-Nonato, Ismael R; Cao, Yin; Cao, Chao; Car, Josip; Carvalho, Márcia; Castañeda-Orjuela, Carlos A; Catalá-López, Ferrán; Cerin, Ester; Chadwick, Joshua; Chandrasekar, Eeshwar K; Chanie, Gashaw Sisay; Charan, Jaykaran; Chattu, Vijay Kumar; Chauhan, Kirti; Cheema, Huzaifa Ahmad; Chekol Abebe, Endeshaw; Chen, Simiao; Cherbuin, Nicolas; Chichagi, Fatemeh; Chidambaram, Saravana Babu; Cho, William C S; Choudhari, Sonali Gajanan; Chowdhury, Rajiv; Chowdhury, Enayet Karim; Chu, Dinh-Toi; Chukwu, Isaac Sunday; Chung, Sheng-Chia; Coberly, Kaleb; Columbus, Alyssa; Contreras, Daniela; Cousin, Ewerton; Criqui, Michael H; Cruz-Martins, Natália; Cuschieri, Sarah; Dabo, Bashir; Dadras, Omid; Dai, Xiaochen; Damasceno, Albertino Antonio Moura; Dandona, Rakhi; Dandona, Lalit; Das, Saswati; Dascalu, Ana Maria; Dash, Nihar Ranjan; Dashti, Mohsen; Dávila-Cervantes, Claudio Alberto; De la Cruz-Góngora, Vanessa; Debele, Gebiso Roba; Delpasand, Kourosh; Demisse, Fitsum Wolde; Demissie, Getu Debalkie; Deng, Xinlei; Denova-Gutiérrez, Edgar; Deo, Salil V; Dervišević, Emina; Desai, Hardik Dineshbhai; Desale, Aragaw Tesfaw; Dessie, Anteneh Mengist; Desta, Fikreab; Dewan, Syed Masudur Rahman; Dey, Sourav; Dhama, Kuldeep; Dhimal, Meghnath; Diao, Nancy; Diaz, Daniel; Dinu, Monica; Diress, Mengistie; Djalalinia, Shirin; Doan, Linh Phuong; Dongarwar, Deepa; dos Santos Figueiredo, Francisco Winter; Duncan, Bruce B; Dutta, Siddhartha; Dziedzic, Arkadiusz Marian; Edinur, Hisham Atan; Ekholuenetale, Michael; Ekundayo, Temitope Cyrus; Elgendy, Islam Y; Elhadi, Muhammed; El-Huneidi, Waseem; Elmeligy, Omar Abdelsadek Abdou; Elmonem, Mohamed A; Endeshaw, Destaw; Esayas, Hawi Leul; Eshetu, Habitu Birhan; Etaee, Farshid; Fadhil, Ibtihal; Fagbamigbe, Adeniyi Francis; Fahim, Ayesha; Falahi, Shahab; Faris, MoezAlIslam Ezzat Mahmoud; Farrokhpour, Hossein; Farzadfar, Farshad; Fatehizadeh, Ali; Fazli, Ghazal; Feng, Xiaoqi; Ferede, Tomas Y; Fischer, Florian; Flood, David; Forouhari, Ali; Foroumadi, Roham; Foroutan Koudehi, Masoumeh; Gaidhane, Abhay Motiramji; Gaihre, Santosh; Gaipov, Abduzhappar; Galali, Yaseen; Ganesan, Balasankar; Garcia-Gordillo, MA; Gautam, Rupesh K; Gebrehiwot, Mesfin; Gebrekidan, Kahsu Gebrekirstos; Gebremeskel, Teferi Gebru; Getacher, Lemma; Ghadirian, Fataneh; Ghamari, Seyyed-Hadi; Ghasemi Nour, Mohammad; Ghassemi, Fariba; Golechha, Mahaveer; Goleij, Pouya; Golinelli, Davide; Gopalani, Sameer Vali; Guadie, Habtamu Alganeh; Guan, Shi-Yang; Gudayu, Temesgen Worku; Guimarães, Rafael Alves; Guled, Rashid Abdi; Gupta, Rajeev; Gupta, Kartik; Gupta, Veer Bala; Gupta, Vivek Kumar; Gyawali, Bishal; Haddadi, Rasool; Hadi, Najah R; Haile, Teklehaimanot Gereziher; Hajibeygi, Ramtin; Haj-Mirzaian, Arvin; Halwani, Rabih; Hamidi, Samer; Hankey, Graeme J; Hannan, Md Abdul; Haque, Shafiul; Harandi, Hamid; Harlianto, Netanja I; Hasan, S M Mahmudul; Hasan, Syed Shahzad; Hasani, Hamidreza; Hassanipour, Soheil; Hassen, Mohammed Bheser; Haubold, Johannes; Hayat, Khezar; Heidari, Golnaz; Heidari, Mohammad; Hessami, Kamran; Hiraike, Yuta; Holla, Ramesh; Hossain, Sahadat; Hossain, Md Shakhaoat; Hosseini, Mohammad-Salar; Hosseinzadeh, Mehdi; Hosseinzadeh, Hassan; Huang, Junjie; Huda, Md Nazmul; Hussain, Salman; Huynh, Hong-Han; Hwang, Bing-Fang; Ibitoye, Segun Emmanuel; Ikeda, Nayu; Ilic, Irena M; Ilic, Milena D; Inbaraj, Leeberk Raja; Iqbal, Afrin; Islam, Sheikh Mohammed Shariful; Islam, Rakibul M; Ismail, Nahlah Elkudssiah; Iso, Hiroyasu; Isola, Gaetano; Itumalla, Ramaiah; Iwagami, Masao; Iwu, Chidozie C D; Iyamu, Ihoghosa Osamuyi; Iyasu, Assefa N; Jacob, Louis; Jafarzadeh, Abdollah; Jahrami, Haitham; Jain, Rajesh; Jaja, Chinwe; Jamalpoor, Zahra; Jamshidi, Elham; Janakiraman, Balamurugan; Jayanna, Krishnamurthy; Jayapal, Sathish Kumar; Jayaram, Shubha; Jayawardena, Ranil; Jebai, Rime; Jeong, Wonjeong; Jin, Yinzi; Jokar, Mohammad; Jonas, Jost B; Joseph, Nitin; Joseph, Abel; Joshua, Charity Ehimwenma; Joukar, Farahnaz; Jozwiak, Jacek Jerzy; Kaambwa, Billingsley; Kabir, Ali; Kabthymer, Robel Hussen; Kadashetti, Vidya; Kahe, Farima; Kalhor, Rohollah; Kandel, Himal; Karanth, Shama D; Karaye, Ibraheem M; Karkhah, Samad; Katoto, Patrick DMC; Kaur, Navjot; Kazemian, Sina; Kebede, Sewnet Adem; Khader, Yousef Saleh; Khajuria, Himanshu; Khalaji, Amirmohammad; Khan, Moien AB; Khan, Maseer; Khan, Ajmal; Khanal, Saval; Khatatbeh, Moawiah Mohammad; Khater, Amir M; Khateri, Sorour; khorashadizadeh, Fatemeh; Khubchandani, Jagdish; Kibret, Biruk Getahun; Kim, Min Seo; Kimokoti, Ruth W; Kisa, Adnan; Kivimäki, Mika; Kolahi, Ali-Asghar; Komaki, Somayeh; Kompani, Farzad; Koohestani, Hamid Reza; Korzh, Oleksii; Kostev, Karel; Kothari, Nikhil; Koyanagi, Ai; Krishan, Kewal; Krishnamoorthy, Yuvaraj; Kuate Defo, Barthelemy; Kuddus, Mohammed; Kuddus, Md Abdul; Kumar, Rakesh; Kumar, Harish; Kundu, Satyajit; Kurniasari, Maria Dyah; Kuttikkattu, Ambily; La Vecchia, Carlo; Lallukka, Tea; Larijani, Bagher; Larsson, Anders O; Latief, Kamaluddin; Lawal, Basira Kankia; Le, Thao Thi Thu; Le, Trang Thi Bich; Lee, Shaun Wen Huey; Lee, Munjae; Lee, Wei-Chen; Lee, Paul H; Lee, Sang-woong; Lee, Seung Won; Legesse, Samson Mideksa; Lenzi, Jacopo; Li, Yongze; Li, Ming-Chieh; Lim, Stephen S; Lim, Lee-Ling; Liu, Xuefeng; Liu, Chaojie; Lo, Chun-Han; Lopes, Graciliana; Lorkowski, Stefan; Lozano, Rafael; Lucchetti, Giancarlo; Maghazachi, Azzam A; Mahasha, Phetole Walter; Mahjoub, Soleiman; Mahmoud, Mansour Adam; Mahmoudi, Razzagh; Mahmoudimanesh, Marzieh; Mai, Anh Tuan; Majeed, Azeem; Majma Sanaye, Pantea; Makris, Konstantinos Christos; Malhotra, Kashish; Malik, Ahmad Azam; Malik, Iram; Mallhi, Tauqeer Hussain; Malta, Deborah Carvalho; Mamun, Abdullah A; Mansouri, Borhan; Marateb, Hamid Reza; Mardi, Parham; Martini, Santi; Martorell, Miquel; Marzo, Roy Rillera; Masoudi, Reza; Masoudi, Sahar; Mathews, Elezebeth; Maugeri, Andrea; Mazzaglia, Giampiero; Mekonnen, Teferi; Meshkat, Mahboobeh; Mestrovic, Tomislav; Miao Jonasson, Junmei; Miazgowski, Tomasz; Michalek, Irmina Maria; Minh, Le Huu Nhat; Mini, GK; Miranda, J Jaime; Mirfakhraie, Reza; Mirrakhimov, Erkin M; Mirza-Aghazadeh-Attari, Mohammad; Misganaw, Awoke; Misgina, Kebede Haile; Mishra, Manish; Moazen, Babak; Mohamed, Nouh Saad; Mohammadi, Esmaeil; Mohammadi, Mohsen; Mohammadian-Hafshejani, Abdollah; Mohammadshahi, Marita; Mohseni, Alireza; Mojiri-forushani, Hoda; Mokdad, Ali H; Momtazmanesh, Sara; Monasta, Lorenzo; Moniruzzaman, Md; Mons, Ute; Montazeri, Fateme; Moodi Ghalibaf, AmirAli; Moradi, Yousef; Moradi, Maryam; Moradi Sarabi, Mostafa; Morovatdar, Negar; Morrison, Shane Douglas; Morze, Jakub; Mossialos, Elias; Mostafavi, Ebrahim; Mueller, Ulrich Otto; Mulita, Francesk; Mulita, Admir; Murillo-Zamora, Efrén; Musa, Kamarul Imran; Mwita, Julius C; Nagaraju, Shankar Prasad; Naghavi, Mohsen; Nainu, Firzan; Nair, Tapas Sadasivan; Najmuldeen, Hastyar Hama Rashid; Nangia, Vinay; Nargus, Shumaila; Naser, Abdallah Y; Nassereldine, Hasan; Natto, Zuhair S; Nauman, Javaid; Nayak, Biswa Prakash; Ndejjo, Rawlance; Negash, Hadush; Negoi, Ruxandra Irina; Nguyen, Hau Thi Hien; Nguyen, Dang H; Nguyen, Phat Tuan; Nguyen, Van Thanh; Nguyen, Hien Quang; Niazi, Robina Khan; Nigatu, Yeshambel T; Ningrum, Dina Nur Anggraini; Nizam, Muhammad A; Nnyanzi, Lawrence Achilles; Noreen, Mamoona; Noubiap, Jean Jacques; Nzoputam, Ogochukwu Janet; Nzoputam, Chimezie Igwegbe; Oancea, Bogdan; Odogwu, Nkechi Martina; Odukoya, Oluwakemi Ololade; Ojha, Vivek Anand; Okati-Aliabad, Hassan; Okekunle, Akinkunmi Paul; Okonji, Osaretin Christabel; Okwute, Patrick Godwin; Olufadewa, Isaac Iyinoluwa; Onwujekwe, Obinna E; Ordak, Michal; Ortiz, Alberto; Osuagwu, Uchechukwu Levi; Oulhaj, Abderrahim; Owolabi, Mayowa O; Padron-Monedero, Alicia; Padubidri, Jagadish Rao; Palladino, Raffaele; Panagiotakos, Demosthenes; Panda-Jonas, Songhomitra; Pandey, Ashok; Pandey, Anamika; Pandi-Perumal, Seithikurippu R; Pantea Stoian, Anca Mihaela; Pardhan, Shahina; Parekh, Tarang; Parekh, Utsav; Pasovic, Maja; Patel, Jay; Patel, Jenil R; Paudel, Uttam; Pepito, Veincent Christian Filipino; Pereira, Marcos; Perico, Norberto; Perna, Simone; Petcu, Ionela-Roxana; Petermann-Rocha, Fanny Emily; Podder, Vivek; Postma, Maarten J; Pourali, Ghazaleh; Pourtaheri, Naeimeh; Prates, Elton Junio Sady; Qadir, Mirza Muhammad Fahd; Qattea, Ibrahim; Raee, Pourya; Rafique, Ibrar; Rahimi, Mehran; Rahimifard, Mahban; Rahimi-Movaghar, Vafa; Rahman, Md Obaidur; Rahman, Muhammad Aziz; Rahman, Mohammad Hifz Ur; Rahman, Mosiur; Rahman, Md Mosfequr; Rahmani, Mohamed; Rahmani, Shayan; Rahmanian, Vahid; Rahmawaty, Setyaningrum; Rahnavard, Niloufar; Rajbhandari, Bibek; Ram, Pradhum; Ramazanu, Sheena; Rana, Juwel; Rancic, Nemanja; Ranjha, Muhammad Modassar Ali Nawaz; Rao, Chythra R; Rapaka, Deepthi; Rasali, Drona Prakash; Rashedi, Sina; Rashedi, Vahid; Rashid, Ahmed Mustafa; Rashidi, Mohammad-Mahdi; Ratan, Zubair Ahmed; Rawaf, Salman; Rawal, Lal; Redwan, Elrashdy Moustafa Mohamed; Remuzzi, Giuseppe; Rengasamy, Kannan RR; Renzaho, Andre M N; Reyes, Luis Felipe; Rezaei, Nima; Rezaei, Nazila; Rezaeian, Mohsen; Rezazadeh, Hossein; Riahi, Seyed Mohammad; Rias, Yohanes Andy; Riaz, Muhammad; Ribeiro, Daniela; Rodrigues, Mónica; Rodriguez, Jefferson Antonio Buendia; Roever, Leonardo; Rohloff, Peter; Roshandel, Gholamreza; Roustazadeh, Abazar; Rwegerera, Godfrey M; Saad, Aly M A; Saber-Ayad, Maha Mohamed; Sabour, Siamak; Sabzmakan, Leila; Saddik, Basema; Sadeghi, Erfan; Saeed, Umar; Saeedi Moghaddam, Sahar; Safi, Sare; Safi, Sher Zaman; Saghazadeh, Amene; Saheb Sharif-Askari, Narjes; Saheb Sharif-Askari, Fatemeh; Sahebkar, Amirhossein; Sahoo, Soumya Swaroop; Sahoo, Harihar; Saif-Ur-Rahman, KM; Sajid, Mirza Rizwan; Salahi, Sarvenaz; Salahi, Saina; Saleh, Mohamed A; Salehi, Mohammad Amin; Salomon, Joshua A; Sanabria, Juan; Sanjeev, Rama Krishna; Sanmarchi, Francesco; Santric-Milicevic, Milena M; Sarasmita, Made Ary; Sargazi, Saman; Sathian, Brijesh; Sathish, Thirunavukkarasu; Sawhney, Monika; Schlaich, Markus P; Schmidt, Maria Inês; Schuermans, Art; Seidu, Abdul-Aziz; Senthil Kumar, Nachimuthu; Sepanlou, Sadaf G; Sethi, Yashendra; Seylani, Allen; Shabany, Maryam; Shafaghat, Tahereh; Shafeghat, Melika; Shafie, Mahan; Shah, Nilay S; Shahid, Samiah; Shaikh, Masood Ali; Shanawaz, Mohd; Shannawaz, Mohammed; Sharfaei, Sadaf; Shashamo, Bereket Beyene; Shiri, Rahman; Shittu, Aminu; Shivakumar, K M; Shivalli, Siddharudha; Shobeiri, Parnian; Shokri, Fereshteh; Shuval, Kerem; Sibhat, Migbar Mekonnen; Silva, Luís Manuel Lopes Rodrigues; Simpson, Colin R; Singh, Jasvinder A; Singh, Paramdeep; Singh, Surjit; Siraj, Md Shahjahan; Skryabina, Anna Aleksandrovna; Sohag, Abdullah Al Mamun; Soleimani, Hamidreza; Solikhah, Solikhah; Soltani-Zangbar, Mohammad Sadegh; Somayaji, Ranjani; Sorensen, Reed J D; Starodubova, Antonina V; Sujata, Sujata; Suleman, Muhammad; Sun, Jing; Sundström, Johan; Tabarés-Seisdedos, Rafael; Tabatabaei, Seyyed Mohammad; Tabatabaeizadeh, Seyed-Amir; Tabish, Mohammad; Taheri, Majid; Taheri, Ensiyeh; Taki, Elahe; Tamuzi, Jacques JL Lukenze; Tan, Ker-Kan; Tat, Nathan Y; Taye, Birhan Tsegaw; Temesgen, Worku Animaw; Temsah, Mohamad-Hani; Tesler, Riki; Thangaraju, Pugazhenthan; Thankappan, Kavumpurathu Raman; Thapa, Rajshree; Tharwat, Samar; Thomas, Nihal; Ticoalu, Jansje Henny Vera; Tiyuri, Amir; Tonelli, Marcello; Tovani-Palone, Marcos Roberto; Trico, Domenico; Trihandini, Indang; Tripathy, Jaya Prasad; Tromans, Samuel Joseph; Tsegay, Guesh Mebrahtom; Tualeka, Abdul Rohim; Tufa, Derara Girma; Tyrovolas, Stefanos; Ullah, Sana; Upadhyay, Era; Vahabi, Seyed Mohammad; Vaithinathan, Asokan Govindaraj; Valizadeh, Rohollah; van Daalen, Kim Robin; Vart, Priya; Varthya, Shoban Babu; Vasankari, Tommi Juhani; Vaziri, Siavash; Verma, Madhur verma; Verras, Georgios-Ioannis; Vo, Danh Cao; Wagaye, Birhanu; Waheed, Yasir; Wang, Ziyue; Wang, Yanqing; Wang, Cong; Wang, Fang; Wassie, Gizachew Tadesse; Wei, Melissa Y Wei; Weldemariam, Abrha Hailay; Westerman, Ronny; Wickramasinghe, Nuwan Darshana; Wu, YiFan; Wulandari, Ratna DWI; Xia, Juan; Xiao, Hong; Xu, Suowen; Xu, Xiaoyue; Yada, Dereje Y; Yang, Lin; Yatsuya, Hiroshi; Yesiltepe, Metin; Yi, Siyan; Yohannis, Hunachew Kibret; Yonemoto, Naohiro; You, Yuyi; Zaman, Sojib Bin; Zamora, Nelson; Zare, Iman; Zarea, Kourosh; Zarrintan, Armin; Zastrozhin, Mikhail Sergeevich; Zeru, Naod Gebrekrstos; Zhang, Zhi-Jiang; Zhong, Chenwen; Zhou, Jingjing; Zielińska, Magdalena; Zikarg, Yossef Teshome; Zodpey, Sanjay; Zoladl, Mohammad; Zou, Zhiyong; Zumla, Alimuddin; Zuniga, Yves Miel H; Magliano, Dianna J; Murray, Christopher J L; Hay, Simon I; Vos, Theo. - In: THE LANCET. - ISSN 0140-6736. - ELETTRONICO. - (2023), pp. 0-0. [10.1016/S0140-6736(23)01301-6]
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
Dinu, MonicaMembro del Collaboration Group
;
2023
Abstract
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.File | Dimensione | Formato | |
---|---|---|---|
GBD - diabetes.pdf
accesso aperto
Tipologia:
Pdf editoriale (Version of record)
Licenza:
Open Access
Dimensione
7.53 MB
Formato
Adobe PDF
|
7.53 MB | Adobe PDF |
I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.