Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK.
Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Diab Vasc Dis Res. 2023 Nov-Dec;20(6):14791641231221763. doi: 10.1177/14791641231221763.
This observational study assesses trends in type 1 diabetes mellitus (T1DM) disease burden across the 19 countries of the European Union (EU) 15+ between 1990 and 2019.
The Global Burden of Disease Study database was used to gather T1DM age-standardised incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life-year (DALY) rates per 100,000 for each EU15+ country (1990 - 2019). Joinpoint regression analysis was used to describe the trends.
From 1990 to 2019, T1DM ASIRs and ASPRs increased globally except for females in Finland (-2.9% and -9.4%), the largest increase in ASPR for males and females was observed in France (+144.4% and +137.5% respectively). All had reductions in ASMRs for males and females, with the largest observed in Spain (-56.7% and -79.0% respectively). Trends in DALYs were variable across countries, with increases in DALYs noted in 14/19 for males, and 9/19 for females. Denmark, Finland, Norway, Netherlands, and Sweden had a reduction in DALYs for both males and females.
Mortality from T1DM is reducing across EU15+ countries, despite concomitant increases in incidence and prevalence rates. Trends in DALYs are variable across countries, reflecting differential trends in the disease burden across countries with similarly high health expenditure.
本观察性研究评估了 1990 年至 2019 年期间欧盟 15 国（EU15）19 个国家 1 型糖尿病（T1DM）疾病负担的趋势。
使用全球疾病负担研究数据库收集每个 EU15 国家（1990-2019 年）每 10 万人的 T1DM 年龄标准化发病率（ASIR）、患病率（ASPR）、死亡率（ASMR）和伤残调整生命年（DALY）率。采用 Joinpoint 回归分析描述趋势。
从 1990 年到 2019 年，T1DM 的 ASIR 和 ASPR 除芬兰女性（-2.9%和-9.4%）外，全球均呈上升趋势，ASPR 男性和女性的最大增幅分别在法国（+144.4%和+137.5%）。男女的 ASMR 均有所下降，西班牙降幅最大（分别为-56.7%和-79.0%）。各国的 DALY 趋势各不相同，男性中有 14/19 个国家和女性中有 9/19 个国家的 DALY 增加。丹麦、芬兰、挪威、荷兰和瑞典的男性和女性 DALY 均有所减少。
尽管 T1DM 的发病率和患病率同时上升，但欧盟 15 国的 T1DM 死亡率正在下降。各国的 DALY 趋势各不相同，反映了在具有相似高健康支出的国家中，疾病负担的差异趋势。
