Centre for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health Zhejiang University School of Medicine, Hangzhou, China.
The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
Diabetes Obes Metab. 2024 Dec;26(12):5950-5959. doi: 10.1111/dom.15969. Epub 2024 Sep 30.
To explore the trend of burden and care quality of chronic kidney disease due to type 2 diabetes mellitus (CKD-T2DM) and their cross-country inequalities from 1990 to 2021.
Data were from the Global Burden of Disease 2021 study. Disease burden and care quality were quantified using the disability-adjusted life years rate and the quality-of-care index (QCI). Trend analyses of the age-standardized disability-adjusted life years rate (ASDR) and age-standardized QCI from 1990 to 2021 were conducted using the estimated annual percentage change. The associations of disease burden and care quality with the socio-demographic index (SDI) were explored. Cross-country inequalities in disease burden and care quality were assessed using the slope index of inequality (SII) and concentration index.
From 1990 to 2021, the global ASDR for CKD-T2DM increased, while the age-standardized QCI slightly decreased, with an estimated annual percentage change of 0.81 [95% confidence interval (CI): 0.75, 0.87] and -0.08 (95% CI: -0.09, -0.07). The ASDR escalated with increasing SDI, reaching a peak at mid-level SDI, followed by a decrease. The age-standardized QCI was higher with increasing SDI. Globally, ASDR concentrated on countries/territories with a lower SDI. The SII of ASDR was -96.64 (95% CI: -136.94, -56.35) in 1990 and -118.15 (95% CI: -166.36, -69.94) in 2021, with a concentration index of -0.1298 (95% CI: -0.1904, -0.0692) in 1990 and -0.1104 (95% CI: -0.1819, -0.0389) in 2021. In 1990 and 2021, countries/territories at higher SDI levels exhibited increased age-standardized QCI, indicated by an SII of 15.09 (95% CI: 10.74, 19.45) and 15.75 (95% CI: 10.92, 20.59), and a concentration index of 0.0393 (95% CI: 0.0283, 0.0503) and 0.0400 (95% CI: 0.0264, 0.0536).
Our study highlights considerable disparities in the burden and care quality of CKD-T2DM. Regions experiencing an increasing burden and a declining care quality simultaneously underscore the need for further research and tailored health interventions.
探讨 1990 年至 2021 年 2 型糖尿病相关慢性肾脏病（CKD-T2DM）的疾病负担和护理质量趋势及其国家间差异。
数据来自全球疾病负担 2021 研究。使用残疾调整生命年率和护理质量指数（QCI）来量化疾病负担和护理质量。使用估计的年变化百分比对 1990 年至 2021 年的年龄标准化残疾调整生命年率（ASDR）和年龄标准化 QCI 进行趋势分析。利用斜率指数不平等（SII）和集中指数评估疾病负担和护理质量的国家间不平等。
1990 年至 2021 年，全球 CKD-T2DM 的 ASDR 增加，而年龄标准化 QCI 略有下降，估计的年变化百分比分别为 0.81%（95%CI：0.75%，0.87%）和-0.08%（95%CI：-0.09%，-0.07%）。ASDR 随着 SDI 的增加而上升，在中 SDI 水平达到峰值，随后下降。年龄标准化 QCI 随 SDI 的增加而升高。全球范围内，ASDR 集中在 SDI 较低的国家/地区。1990 年 ASDR 的 SII 为-96.64（95%CI：-136.94，-56.35），2021 年为-118.15（95%CI：-166.36，-69.94），1990 年的集中指数为-0.1298（95%CI：-0.1904，-0.0692），2021 年为-0.1104（95%CI：-0.1819，-0.0389）。1990 年和 2021 年，SDI 水平较高的国家/地区的年龄标准化 QCI 有所增加，SII 分别为 15.09（95%CI：10.74，19.45）和 15.75（95%CI：10.92，20.59），集中指数分别为 0.0393（95%CI：0.0283，0.0503）和 0.0400（95%CI：0.0264，0.0536）。
本研究强调了 2 型糖尿病相关慢性肾脏病的负担和护理质量存在显著差异。同时，疾病负担增加和护理质量下降的地区需要进一步研究和有针对性的卫生干预措施。
