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. 2025 Aug 2;17(1):309.
doi: 10.1186/s13098-025-01885-4.

Trends and comparisons of diabetes burden in China and the world from 1990 to 2021,with forecasts to 2050:a systematic analysis of the global burden of disease study 2021

Chenqing Liu  1 , Yun Li  1 , Nan Wang  1 , Yandong Wu  2 , Jiaqi Liu  1 , Mengjie Ding  1 , Shuhan Liu  1 , Yibing Hao  1 , Ying Wu  3 , Shaopeng Liu  4   5
Affiliations

Trends and comparisons of diabetes burden in China and the world from 1990 to 2021,with forecasts to 2050:a systematic analysis of the global burden of disease study 2021

Chenqing Liu et al. Diabetol Metab Syndr. .

Abstract

Background: Diabetes is a major global public health issue. This study investigated the trends in the age-and gender-specific burden of diabetes in China and worldwide from 1990 to 2021, and predicted the prevalence of diabetes in 2050.

Methods: Using publicly available data from the Global Burden of Disease (GBD) database from 1990 to 2021, we comprehensively applied Joinpoint regression and age-period-cohort (APC) analysis to reveal the epidemiological characteristics, conducted decomposition analysis to identify the driving factors of burden changes, and used the autoregressive integrated moving average (ARIMA) model to project the disease burden of diabetes from 2022 to 2050.

Results: From 1990 to 2021, both in China and globally, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized disability-adjusted life year rate (ASDR) of diabetes showed an upward trend. In contrast, China's age-standardized mortality rate (ASMR) of diabetes decreased, while the global ASMR increased. The average annual percentage changes (AAPC) of China's ASIR, ASPR, ASMR, and ASDR were 1.29, 1.76,- 0.30, and 0.76% respectively, compared with 1.74, 2.10, 0.25, and 1.05% for the global diabetes burden.

Conclusions: In China, the incidence, prevalence, and Disability-Adjusted Life Years (DALYs) of diabetes increased, while the mortality rate decreased. It is projected that by 2050, the number of diabetes patients in China will reach 84.01 million, and globally, it will reach 1038.2 million. Given China's large population and the trend of population aging, it is essential to formulate targeted prevention and control strategies to address the challenge of diabetes.

Keywords: Diabetes; Disease burden; Global burden of disease; Public health.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: All authors have reviewed and approved the final manuscript and consent to its publication. This study contains no individual person’s data in any identifi-able form, and thus, additional consent for publication from participants is not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The APC of ASIR, ASPR, ASMR, and ASDR of diabetes in China from 1990 to 2021 (*means p-values < 0.05 and significant results). (a) ASIR; (b) ASPR; (c) ASMR; (d) ASDR
Fig. 2
Fig. 2
The APC of ASIR, ASPR, ASMR, and ASDR of diabetes in Global from 1990 to 2021 (*means p-values < 0.05 and significant results). (a) ASIR; (b) ASPR; (c) ASMR; (d) ASDR
Fig. 3
Fig. 3
Trend comparison of ASIR, ASPR, ASMR, and ASDR of diabetes in China and worldwide from 1990 to 2021
Fig.4
Fig.4
Incidence of diabetes in different age groups for men and women in China and globally, 1990 and 2021 (a) Incidence in China in 1990; (b) Global incidence in 1990; (c) incidence in China, 2021; (d) Global incidence, 2021
Fig.5
Fig.5
Mortality rates of diabetes among men and women of different age groups in China and globally in 1990 and 2021 (a) Mortality in China in 1990; (b) Global mortality in 1990 (c) Mortality in China in 2021 (d) Global mortality in 2021
Fig.6
Fig.6
Comparison of full-age cases and age-standardized rates of incidence, prevalence, mortality and DALYs among men and women in China from 1990 to 2021. (a) Incident cases and ASIR; (b) Prevalent cases and ASPR; (c) Death cases and ASMR; (d) DALYs counts and ASDR. Bar charts represent counts; lines represent age-standardized rates
Fig.7
Fig.7
Trends in the prevalence and mortality of diabetes in China from 1990 to 2021. (a) age effect of prevalence (b) period effect of prevalence (c) cohort effect of prevalence (d) age effect of mortality (e) period effect of mortality (f) cohort effect of mortality
Fig.8
Fig.8
Decomposition analysis on the incidence, prevalence, mortality and DALYs of diabetes by gender in China, 1990–2021 (a) incidence (b) prevalence (c) mortality (d). DALYs, black dots indicate the overall change value of the contribution of all 3 components
Fig.9
Fig.9
Prediction of diabetes prevalence in China and the world from 2022–2050. The red line represents the true trend of diabetes prevalence from 1990 to 2021. Yellow dotted lines and shaded areas represent predicted trends and their 95% CI
See this image and copyright information in PMC

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