Comparative diabetes mellitus burden trends across global, Chinese, US, and Indian populations using GBD 2021 database

Abstract

Diabetic mellitus (DM) poses a significant challenge and stress to global health, comparing the burden of disease in the world's three most populous countries while projecting changes in trends in age-standardized rate (ASR) -deaths and disability adjusted life years (DALYs) up to 2050. Using GBD2021 data, we examined DM trends in China, US, India and globally for 1990-2021, and projected deaths and DALYs for DM (types 1 and 2) for 2022-2050 using Bayesian age-period-cohort (BAPC) model. It was found that the ASR-DALYs and deaths for T1DM are trending downward globally, while those for T2DM are trending upward. In terms of gender differences, the burden of T1DM by gender was insignificant, whereas the burden of disease was significantly higher in men with T2DM than in women. The burden of disease for T1DM peaks around the ages of 40-44 years, while the burden of disease for T2DM peaks at 65-69 years. Population growth and ageing are major factors influencing the disease burden of diabetes. The projection of ASR-deaths and DALYs globally for 2022-2050 showed a decreasing trend in T1DM and an increasing trend in T2DM (especially in China and India). The increasing burden of T2DM disease globally and in three countries by 2050 should be taken seriously.

Keywords: Burden; Diabetes mellitus; Disability adjusted life years; Global epidemiology; Mortality.

Fig. 1

Global distribution of DM burden in 2021. (A) Deaths-Number of DM. (B) DALYs-Number of DM. (C) Deaths-ASR of DM. (D) DALYs-ASR of DM.

Fig. 2

Distribution of different DM types. (A) Distribution of DM Deaths in 1990. (B) Distribution of DM DALYs in 1990. (C) Distribution of DM Deaths in 2021. (D) Distribution of DM DALYs in 2021.

Fig. 3

Joinpoint regression analysis of T1DM and T2DM Trends. (A) ASR-Deaths in T1DM. (B) ASR-DALYs in T1DM. (C) ASR-Deaths in T2DM. (D) ASR-DALYs in T2DM.

Fig. 4

Distribution of deaths due to T1DM and T2DM (stratified by sex and age) worldwide, in the United States, China, and India in 2021. (A) Deaths caused by T1DM. (B) DALYs caused by T1DM. (C) Deaths caused by T2DM. (D) DALYs caused by T2DM.

Fig. 5

The APC analyzes T1DM outcomes in deaths and DALYs. (A) Age-cohort analysis. (B) Age-period analysis. (C) Period-cohort analysis.

Fig. 6

The APC analyzes T2DM outcomes in deaths and DALYs. (A) Age-cohort analysis. (B) Age-period analysis. (C) Period-cohort analysis.

Fig. 7

Decomposition analysis results of DM-related deaths and DALYs. (A) Different decomposition factors for DM Globally, in India, China, and the United States, by gender. (B) Different decomposition factors for T1DM. (C) Different decomposition factors for T2DM.

Fig. 8

Visualization of SII and CIX results of deaths and DALYs related to T1DM and T2DM. (A) The SII and CIX analysis of Deaths for T1DM. (B) The SII and CIX analysis of DALYs for T1DM. (C) The SII and CIX analysis of Deaths for T2DM. (D) The SII and CIX analysis of DALYs for T2DM.

Fig. 9

Predictions of DM burden using the BAPC forecasting model for global, China, United States, and India (up to 2050). (A) BAPC model predicted T1DM ASR-Deaths. (B) BAPC model predicted T1DM ASR-DALYs. (C) BAPC model predicted T2DM ASR-Deaths. (D) BAPC model predicted T2DM ASR-DALYs.)

Fig. 10

Prediction of Deaths-ASR and DALYs-ASR for specific age-cohorts affected by DM globally, in China, the US, and India. (A) Predictions of T1DM-related Deaths-ASR in the 35–54 age group for global, US, China, and India. (B) Predictions of T1DM-related DALYs-ASR in the 35–54 age group for global, US, China, and India. (C) Predictions of T2DM-related Deaths-ASR in the 60–84 age group for global, US, China, and India. (D) Predictions of T2DM-related DALYs-ASR in the 60–84 age group for global, US, China, and India.