Global, regional, and national burdens of type 1 and type 2 diabetes mellitus in adolescents from 1990 to 2021, with forecasts to 2030: a systematic analysis of the global burden of disease study 2021

Abstract

Background: Adolescent diabetes is one of the major public health problems worldwide. This study aims to estimate the burden of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in adolescents from 1990 to 2021, and to predict diabetes prevalence through 2030.

Methods: We extracted epidemiologic data from the Global Burden of Disease (GBD) on T1DM and T2DM among adolescents aged 10-24 years in 204 countries and territories worldwide. This study calculated the age-standardized prevalence rate (ASPR) and age-standardized DALY rate (ASDR) in adolescents based on the world standard population for cross-country comparisons. Average annual percentage changes (AAPC) in age-standardized rate were calculated by linkage point regression. Correlation analyses were used to identify the relationship between age-standardized rate and sociodemographic index (SDI). The Bayesian age-period-cohort (BAPC) model was used to predict changes in the diabetes prevalence among adolescents from 2022 to 2030.

Results: In 2021, 3.4 million adolescents were living with T1DM, with an ASPR of 180.96 (95% CI 180.77-181.15), and 14.6 million were living with T2DM, with ASPR of 1190.73 (1190.13-1191.34). As national and territory SDI levels rise, the prevalence rate of T1DM increases (r = 0.44, p < 0.01), and the prevalence rate of T2DM decreases (r = - 0.18, p < 0.01). Compared with males, females had a greater age-standardized prevalence of T1DM (185.49 [185.21-185.76] vs. 176.66 [176.39-176.92]), whereas males had a greater ASPR of T2DM than females did (1241.45 [1240.58-1242.31] vs. 1138.24 [1137.40-1139.09]). This study found a negative correlation between the SDI and the ASDR for both T1DM (r = - 0.51, p < 0.01) and T2DM (r = - 0.62, p < 0.01) in adolescents. For T2DM patients, 32.84% of DALYs were attributed to high BMI, which increased by 40.78% during the study period. By 2030, 3.7 million people are projected to have T1DM, and 14.6 million are projected to have T2DM.

Conclusions: Among adolescents, the burden of T1DM and T2DM is increasing and varies by region, sex, and SDI. Therefore, targeted interventions based on regional features are needed to prevent and control adolescent diabetes. Moreover, more efforts are needed to control climate change and obesity to reduce the adolescent diabetes burden.

Keywords: Adolescent; Diabetes mellitus; Disease burden.

Fig. 1

Age-standardized prevalence rate of type 1 and type 2 diabetes mellitus among adolescents in 2021. A Type 1 diabetes mellitus. B Type 2 diabetes mellitus

Fig. 2

Male-to-female prevalence numbers difference and age-standardized prevalence rates ratio for diabetes mellitus among adolescents from 1990 to 2021

Fig. 3

Global prevalence of type 1 and type 2 diabetes in adolescents by age, 1990–2021 and by GBD super-region, 2021. A Global prevalence of T1DM by age, 1990–2021. B Global prevalence of T2DM by age, 1990–2021. C Prevalence of T1DM by GBD super-region, 2021. D Prevalence of T2DM by GBD super-region, 2021. CE&EE&CA: Central Europe, Eastern Europe, and Central Asia; HI: high-income; SA&EA&Oc: Southeast Asia, East Asia, and Oceania; LA&Ca: Latin America and Caribbean; NA&ME: North Africa and Middle East; SA: South Asia; SSA: Sub-Saharan Africa

Fig. 4

Age-standardized DALY rates for type 1 and type 2 diabetes mellitus for 21 GBD regions by sociodemographic index, 1990–2021. A Type 1 diabetes mellitus. B Type 2 diabetes mellitus

Fig. 5

The proportion of DALY attributable to risk factors for type 1 and 2 diabetes mellitus in adolescents, by Global Burden of Disease regions, 2021

Fig. 6

Age-standardized prevalence of type 1 and type 2 diabetes mellitus from 1990 through 2030 forecasts. A Type 1 diabetes mellitus. B Type 2 diabetes mellitus