Chen Xing, Zhang Luying, Chen Wen
Department of Health Economics, School of Public Health, Fudan University, Shanghai, China.
BMC Med. 2025 Jan 29;23(1):48. doi: 10.1186/s12916-025-03890-w.
Adolescent diabetes is one of the major public health problems worldwide. This study aims to estimate the burden of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in adolescents from 1990 to 2021, and to predict diabetes prevalence through 2030.
We extracted epidemiologic data from the Global Burden of Disease (GBD) on T1DM and T2DM among adolescents aged 10-24 years in 204 countries and territories worldwide. This study calculated the age-standardized prevalence rate (ASPR) and age-standardized DALY rate (ASDR) in adolescents based on the world standard population for cross-country comparisons. Average annual percentage changes (AAPC) in age-standardized rate were calculated by linkage point regression. Correlation analyses were used to identify the relationship between age-standardized rate and sociodemographic index (SDI). The Bayesian age-period-cohort (BAPC) model was used to predict changes in the diabetes prevalence among adolescents from 2022 to 2030.
In 2021, 3.4 million adolescents were living with T1DM, with an ASPR of 180.96 (95% CI 180.77-181.15), and 14.6 million were living with T2DM, with ASPR of 1190.73 (1190.13-1191.34). As national and territory SDI levels rise, the prevalence rate of T1DM increases (r = 0.44, p < 0.01), and the prevalence rate of T2DM decreases (r = - 0.18, p < 0.01). Compared with males, females had a greater age-standardized prevalence of T1DM (185.49 [185.21-185.76] vs. 176.66 [176.39-176.92]), whereas males had a greater ASPR of T2DM than females did (1241.45 [1240.58-1242.31] vs. 1138.24 [1137.40-1139.09]). This study found a negative correlation between the SDI and the ASDR for both T1DM (r = - 0.51, p < 0.01) and T2DM (r = - 0.62, p < 0.01) in adolescents. For T2DM patients, 32.84% of DALYs were attributed to high BMI, which increased by 40.78% during the study period. By 2030, 3.7 million people are projected to have T1DM, and 14.6 million are projected to have T2DM.
Among adolescents, the burden of T1DM and T2DM is increasing and varies by region, sex, and SDI. Therefore, targeted interventions based on regional features are needed to prevent and control adolescent diabetes. Moreover, more efforts are needed to control climate change and obesity to reduce the adolescent diabetes burden.
青少年糖尿病是全球主要的公共卫生问题之一。本研究旨在估算1990年至2021年期间青少年1型糖尿病（T1DM）和2型糖尿病（T2DM）的负担，并预测到2030年的糖尿病患病率。
我们从全球疾病负担（GBD）中提取了全球204个国家和地区10至24岁青少年中T1DM和T2DM的流行病学数据。本研究基于世界标准人口计算青少年的年龄标准化患病率（ASPR）和年龄标准化伤残调整生命年率（ASDR），以进行跨国比较。年龄标准化率的平均年度百分比变化（AAPC）通过连接点回归计算。相关性分析用于确定年龄标准化率与社会人口学指数（SDI）之间的关系。贝叶斯年龄-时期-队列（BAPC）模型用于预测2022年至2030年青少年糖尿病患病率的变化。
2021年，340万青少年患有T1DM，ASPR为180.96（95%CI 180.77-181.15），1460万青少年患有T2DM，ASPR为1190.73（1190.13-1191.34）。随着国家和地区SDI水平的提高，T1DM的患病率增加（r = 0.44，p < 0.01），T2DM的患病率降低（r = -0.18，p < 0.01）。与男性相比，女性T1DM的年龄标准化患病率更高（185.49 [185.21-185.76] 对 176.66 [176.39-176.92]），而男性T2DM的ASPR高于女性（1241.45 [1240.58-1242.31] 对 1138.24 [1137.40-1139.09]）。本研究发现，青少年中T1DM（r = -0.51，p < 0.01）和T2DM（r = -0.62，p < 0.01）的SDI与ASDR之间均呈负相关。对于T2DM患者，32.84%的伤残调整生命年归因于高BMI，在研究期间增加了40.78%。到2030年，预计将有370万人患有T1DM，1460万人患有T2DM。
在青少年中，T1DM和T2DM的负担正在增加，并且因地区、性别和SDI而异。因此，需要根据区域特征进行有针对性的干预措施，以预防和控制青少年糖尿病。此外，需要做出更多努力来控制气候变化和肥胖，以减轻青少年糖尿病负担。
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