Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug;65(8):1339-1352.
doi: 10.1007/s00125-022-05713-6. Epub 2022 May 19.

Low- and middle-income countries demonstrate rapid growth of type 2 diabetes: an analysis based on Global Burden of Disease 1990-2019 data

Jinli Liu  1   2 , Ruhai Bai  3 , Zhonglin Chai  4 , Mark E Cooper  4 , Paul Z Zimmet  4 , Lei Zhang  5   6   7   8
Affiliations

Low- and middle-income countries demonstrate rapid growth of type 2 diabetes: an analysis based on Global Burden of Disease 1990-2019 data

Jinli Liu et al. Diabetologia. 2022 Aug.

Abstract

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 .

Keywords: DALYs; Death; Population attributable fraction; Type 2 diabetes mellitus.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Age-standardised death (a) and DALY (b) rate of type 2 diabetes per 100,000 person-years by country and territory, 2019
Fig. 2
Fig. 2
Annualised rate of change in ASDR (a) and age-standardised DALY rate (b) of type 2 diabetes, globally, and by different income countries, 1990–1999, 2000–2009 and 2010–2019
Fig. 3
Fig. 3
PAFs of death (a) and DALYs (b) attributed to risk factors for type 2 diabetes, 2019
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. International Diabetes Federation (2019) IDF Diabetes Atlas, 9th edition. International Diabetes Federation, Brussels. https://www.diabetesatlas.org/en/resources/. Accessed 9 December 2020
    1. Zimmet PZ, Magliano DJ, Herman WH, Shaw JE. Diabetes: a 21st century challenge. Lancet Diabetes Endocrinol. 2014;2(1):56–64. doi: 10.1016/S2213-8587(13)70112-8. - DOI - PubMed
    1. Roglic G, Unwin N. Mortality attributable to diabetes: estimates for the year 2010. Diabetes Res Clin Pract. 2010;87(1):15–19. doi: 10.1016/j.diabres.2009.10.006. - DOI - PubMed
    1. GBD 2019 Diseases and Injuries Collaborators Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet. 2020;396(10258):1204–1222. doi: 10.1016/S0140-6736(20)30925-9. - DOI - PMC - PubMed
    1. Zimmet P, Alberti KG, Magliano DJ, Bennett PH. Diabetes mellitus statistics on prevalence and mortality: facts and fallacies. Nat Rev Endocrinol. 2016;12(10):616–622. doi: 10.1038/nrendo.2016.105. - DOI - PubMed

Publication types