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Wei and Weldemariam, Abrha Hailay and Westerman, Ronny and Wickramasinghe, Nuwan Darshana and Wu, YiFan and Wulandari, Ratna D. W. I. and Xia, Juan and Xiao, Hong and Xu, Suowen and Xu, Xiaoyue and Yada, Dereje Y. and Yang, Lin and Yatsuya, Hiroshi and Yesiltepe, Metin and Yi, Siyan and Yohannis, Hunachew Kibret and Yonemoto, Naohiro and You, Yuyi and Zaman, Sojib Bin and Zamora, Nelson and Zare, Iman and Zarea, Kourosh and Zarrintan, Armin and Zastrozhin, Mikhail Sergeevich and Zeru, Naod Gebrekrstos and Zhang, Zhi-Jiang and Zhong, Chenwen and Zhou, Jingjing and Zielińska, Magdalena and Zikarg, Yossef Teshome and Zodpey, Sanjay and Zoladl, Mohammad and Zou, Zhiyong and Zumla, Alimuddin and Zuniga, Yves Miel H. and Magliano, Dianna J. and Murray, Christopher J. L. and Hay, Simon I. and Vos, Theo (2023) 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. The Lancet, 402 (10397). pp. 203-234. ISSN 01406736
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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. © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
| Item Type: | Article |
|---|---|
| Additional Information: | Cited by: 393; All Open Access, Hybrid Gold Open Access |
| Uncontrolled Keywords: | Aged; Bayes Theorem; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Global Burden of Disease; Global Health; Humans; Life Expectancy; Male; Prevalence; Quality-Adjusted Life Years; Risk Factors; alcohol consumption; Article; autopsy; body mass; Caribbean; demography; diabetes mellitus; disability-adjusted life year; disease burden; environmental factor; gestational diabetes; global disease burden; health survey; human; insulin dependent diabetes mellitus; life expectancy; Middle East; mortality; non insulin dependent diabetes mellitus; North Africa; Pacific islands; physical activity; prediction; prevalence; Qatar; registration; risk assessment; risk factor; South and Central America; standardization; systematic review; tobacco use; aged; Bayes theorem; female; global disease burden; global health; insulin dependent diabetes mellitus; male; non insulin dependent diabetes mellitus; quality adjusted life year |
| Subjects: | R Medicine > RA Public aspects of medicine |
| Divisions: | Faculty of Medicine, Public Health and Nursing > Public Health and Nutrition |
| Depositing User: | Annisa Fitria Nur Azizah Annisa Fitria Nur Azizah |
| Date Deposited: | 12 Jun 2024 00:25 |
| Last Modified: | 12 Jun 2024 00:25 |
| URI: | https://ir.lib.ugm.ac.id/id/eprint/2376 |
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