Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025

Abstract

Diabetes mellitus is a leading cause of mortality and reduced life expectancy. We aim to estimate the burden of diabetes by type, year, regions, and socioeconomic status in 195 countries and territories over the past 28 years, which provide information to achieve the goal of World Health Organization Global Action Plan for the Prevention and Control of Noncommunicable Diseases in 2025. Data were obtained from the Global Burden of Disease Study 2017. Overall, the global burden of diabetes had increased significantly since 1990. Both the trend and magnitude of diabetes related diseases burden varied substantially across regions and countries. In 2017, global incidence, prevalence, death, and disability-adjusted life-years (DALYs) associated with diabetes were 22.9 million, 476.0 million, 1.37 million, and 67.9 million, with a projection to 26.6 million, 570.9 million, 1.59 million, and 79.3 million in 2025, respectively. The trend of global type 2 diabetes burden was similar to that of total diabetes (including type 1 diabetes and type 2 diabetes), while global age-standardized rate of mortality and DALYs for type 1 diabetes declined. Globally, metabolic risks (high BMI) and behavioral factors (inappropriate diet, smoking, and low physical activity) contributed the most attributable death and DALYs of diabetes. These estimations could be useful in policy-making, priority setting, and resource allocation in diabetes prevention and treatment.

Figure 1

Global burden of diabetes mellitus from 1990 to 2025. (A) Incidence number; (B) Age-standardized incidence rate; (C) Prevalence number; (D) Age-standardized prevalence rate; (E) Death number; (F) Age-standardized mortality rate; (G) DALYs number; (H) Age-standardized DALYs rate. DALYs: disability-adjusted life-years.

Figure 2

Global map of health burden of diabetes mellitus in 2017. (A) Prevalence number; (B) Death number; (C) DALYs number. DALYs: disability-adjusted life-years. Maps was based on EChart which is an open-source visualization library (under an Apache 2.0 license: https://github.com/apache/incubator-echarts/blob/master/LICENSE; URL of Echart: https://echarts.apache.org/zh/index.html), and implemented in Java (version JDK 1.8.0) using the software of IntelliJ IDEA Community Edition 2018.3.2.

Figure 3

Global burden of diabetes mellitus in different World Bank Income Level regions from 1990 to 2017: (A) Age-standardized incidence rate, (B) Age-standardized prevalence rate, (C) Age-standardized mortality rate; (D) Age-standardized DALYs rate. WBLI: World Bank low income; WBLMI: World Bank lower middle income; WBUMI: World Bank upper middle income; WBHI: World Bank high income.

Figure 4

Age-standardized mortality rate and DALYs rate of diabetes attributable to risks by SDI level in 2017. (A) Age-standardized mortality rate; (B) Age-standardized DALYs rate. SDI: Socio-demographic Index.