Huang Qian, Li Yang, Yu Minggang, Lv Zhizi, Lu Fengyi, Xu Ning, Zhang Qingqing, Shen Jiayun, Zhu Jinfeng, Jiang Hua
Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Front Endocrinol (Lausanne). 2025 Aug 14;16:1538143. doi: 10.3389/fendo.2025.1538143. eCollection 2025.
Type 2 diabetes mellitus (T2DM) presents a substantial strain on global healthcare systems. This study seeks to offer robust scientific evidence for the effective prevention and management of T2DM globally through a comprehensive analysis of the disease's burden, trends, and risk factors from 1990 to 2021, as well as future trajectories from 2022 to 2050.
Data for this study were sourced from the 2021 Global Burden of Disease (GBD) study. T2DM burden was assessed through incidence, prevalence, mortality, and disability-adjusted life years (DALYs), stratified by age, sex, sociodemographic index (SDI), 21 GBD regions, and 204 countries/territories. Trends from 1990 to 2021 were quantified by estimating annual percentage changes. Decomposition analysis identified the primary population-level drivers of T2DM burden changes. The population attributable fraction assessed the contribution of risk factors to the T2DM burden over the past 30 years, while the Bayesian age-period-cohort model was employed to predict the future burden driven by risk factors.
In 2021, T2DM affected 506.0 million individuals, with 23.9 million new cases, 1.6 million deaths, and 75.3 million DALYs. Between 1990 and 2021, both absolute and relative burdens of T2DM increased, particularly among males, older adults, and individuals under 40. Regions with higher SDI generally exhibited higher age-standardized incidence and prevalence rates, while those with lower SDI had elevated age-standardized mortality and DALY rates. Oceania stood out as an exception, with the highest relative burdens across all four indicators, most notably in the Marshall Islands and Fiji. The increases in incidence, DALYs, and prevalence were predominantly driven by population growth and epidemiological shifts, with aging contributing significantly to the rise in mortality. Elevated fasting plasma glucose, body mass index (BMI), and particulate pollution were major contributors to higher T2DM-related mortality and DALY rates. By 2050, high BMI, alcohol consumption, and sugary beverages are anticipated to increasingly influence the T2DM burden.
Focused, preventive interventions targeting key risk factors in high-burden groups can effectively reduce the global T2DM burden.
2型糖尿病（T2DM）给全球医疗系统带来了巨大压力。本研究旨在通过全面分析1990年至2021年该疾病的负担、趋势和风险因素，以及2022年至2050年的未来轨迹，为全球有效预防和管理T2DM提供有力的科学证据。
本研究的数据来源于2021年全球疾病负担（GBD）研究。通过发病率、患病率、死亡率和伤残调整生命年（DALYs）评估T2DM负担，按年龄、性别、社会人口指数（SDI）、21个GBD区域和204个国家/地区进行分层。通过估计年度百分比变化来量化1990年至2021年的趋势。分解分析确定了T2DM负担变化的主要人群层面驱动因素。人群归因分数评估了过去30年风险因素对T2DM负担的贡献，同时采用贝叶斯年龄-时期-队列模型预测由风险因素驱动的未来负担。
2021年，T2DM影响了5.06亿人有2390万新发病例。160万人死亡，7530万伤残调整生命年。1990年至2021年期间，T2DM的绝对和相对负担均有所增加，尤其是在男性、老年人和40岁以下人群中。SDI较高的地区通常表现出较高的年龄标准化发病率和患病率，而SDI较低的地区则有较高的年龄标准化死亡率和伤残调整生命年率。大洋洲是个例外，在所有四个指标上的相对负担最高，最明显的是在马绍尔群岛和斐济。发病率、伤残调整生命年和患病率的增加主要由人口增长和流行病学转变驱动，老龄化对死亡率的上升有显著贡献。空腹血糖升高、体重指数（BMI）和颗粒物污染是导致T2DM相关死亡率和伤残调整生命年率升高的主要因素。到2050年，高BMI、饮酒和含糖饮料预计将越来越多地影响T2DM负担。
针对高负担群体的关键风险因素进行有针对性的预防性干预，可以有效减轻全球T2DM负担。
