The Future Diabetes Mortality: Challenges in Meeting the 2030 Sustainable Development Goal of Reducing Premature Mortality from Diabetes.

This study seeks to forecast the global burden of diabetes-related mortality by type, age group, WHO region, and income classification through 2030, and to assess progress toward Sustainable Development Goal (SDG) 3.4, which aims to reduce premature mortality (among people age 30-70 years) from noncommunicable diseases (including diabetes) by one-third. We analyzed diabetes mortality data from the Institute for Health Metrics and Evaluation, Global Burden of Disease 2019, covering 30 years (1990-2019). Using this historical dataset, we generated 11-year prospective forecasts (2020-2030) globally and stratified by diabetes type (type 1, type 2), age groups, WHO regions, and World Bank income classifications. We employed multiple time series and epidemic modeling approaches to enhance predictive accuracy, including ARIMA, GAM, GLM, Facebook's Prophet, n-sub-epidemic, and spatial wave models. We compared model outputs to identify consistent patterns and trends. Our forecasts indicate a substantial increase in global diabetes-related mortality, with type 2 diabetes driving the majority of deaths. By 2030, annual diabetes mortality is projected to reach 1.63 million deaths (95% PI: 1.48-1.91 million), reflecting a 10% increase compared to 2019. Particularly concerning is the projected rise in mortality among adults aged 15-49 and 50-69 years, especially in Southeast Asia and low- and middle-income countries. Mortality in upper-middle-income countries is also expected to increase significantly, exceeding a 50% rise compared to 2019. Diabetes-related deaths are rising globally, particularly in younger and middle-aged adults in resource-limited settings. These trends jeopardize the achievement of SDG 3.4. Urgent action is needed to strengthen prevention, early detection, and management strategies, especially in Southeast Asia and low-income regions. Our findings provide data-driven insights to inform global policy and target public health interventions.