Trends and disability-attributable risk factors of type 2 diabetes mellitus in Southeast Asia (1990-2019): An in-depth 30-year analysis from the Global Burden of Disease study.

BACKGROUND AND AIMS

To provide insight on targeted approach to mitigate diabetes burden, this research aims to analyze the trends of prevalence, mortality, and disability attributable to risk factors for type 2 diabetes mellitus (T2DM) from 1990 to 2019 in the Southeast Asia (SEA) region.

METHODS AND RESULTS

Age-standardized rates for prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) from 1990 to 2019 from the Global Burden of Disease Study were assessed. DALYs-related risk factors were estimated using multivariate regression analysis and estimated annual percentage change (EAPC) was calculated to quantify the temporal trends. Over 30 years, the SEA region experienced a 59.5 % rise in T2DM ASPR, 17.33 % in ASMR, and 26.97 % in DALYs. The T2DM DALYs rate per 100,000 population was 1002.91 (885.23-1132.40) in 1990 and 1273.42 (1103.92-1452.41) in 2019, increasing by 27 %. Cambodia and Indonesia had the highest worsening in three parameters, while most significant improvement in all parameters was observed in Singapore. The curvilinear association was demonstrated between ASMR and DALYs to Gross Domestic Product (GDP) per capita. Prominent risk factors affecting DALYs increase were high fasting plasma glucose (FPG) (p < 0.001), high body mass index (BMI) (p < 0.001), tobacco use (p = 0.012), and household pollution (p = 0.03). Men were more affected than women.

CONCLUSION

The burden of T2DM in the SEA region has increased significantly during the 30-year period. Policymakers should address high BMI, high FPG, smoking, and air pollution to regulate T2DM burden in SEA.