The prevalence of diabetes has been increasing worldwide due to the rise in obesity, highlighting the need for prevention and control of type 2 diabetes (T2D), according to results of a study published in The Lancet. The authors said understanding disparities in risk factors and diabetes burden in various populations can help inform public health strategies.
In 2020, The Lancet published findings from a commission on diabetes that showed the burden of diabetes for individuals in low-income and middle-income countries accounted for approximately 80% of diabetes cases. The authors of the current study aimed to estimate the total diabetes and type-specific diabetes prevalence and burden from 1990 to 2021, breaking down the estimates by location, age, and sex. Furthermore, they forecasted the global and location-specific prevalence through 2050, according to the study authors.
In the study, investigators identified 27,193 various data sources and they applied the methodological framework from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. The analysis does not include the potential impact of COVID-19 on diabetes prevalence and burden. The authors primarily report on diabetes prevalence and burden; however, they also provide mortality estimates in the analysis.
According to the authors, there were approximately 529 million individuals worldwide living with diabetes in 2021, accounting for a global age-standardized prevalence of 6.1%. Investigators estimated that approximately 485 million adults aged 20 to 79 years old had diabetes in 2021 compared with approximately 321 million individuals aged 18 years and older who had diabetes in 2010.
The investigators found that North Africa and the Middle East had an age-standardized total diabetes prevalence of 9.3%, and Oceania had the highest regional age-standardized prevalence of 12.3%. Further, Eastern sub-Saharan Africa had the lowest regional diabetes prevalence at 2.9%. The study authors reported that 43 countries and territories in 2021 exceeded a prevalence of 10%.
For type-specific diabetes, T2D accounted for approximately 96% of all diabetes cases. Furthermore, there were 37.8 million total diabetes-related years of life lost (YLL) and 41.4 million years lived with disability (YLD). T2D accounted for approximately 94% of YLLs and 96.6% of YLDs, according to the study authors.
Investigators analyzed 16 risk factors, finding that high body mass index (BMI) was the primary risk factor for T2D worldwide, accounting for 52.2% of disability adjusted life years (DALYs). Further, dietary risks accounted for 25.7%, environmental or occupational risks for 19.6%, tobacco use for 12.1%, and low physical activity accounted for 7.4%.
Key Takeaways
- Diabetes prevalence has been steadily increasing worldwide, reaching 6.1% in 2021, affecting over 529 million people. This trend is projected to continue, with an estimated global prevalence of 9.8% by 2050.
- Type 2 diabetes (T2D) is the main driver of the global diabetes burden, accounting for nearly all diabetes cases (96%) and disability-adjusted life years (DALYs).
- High body mass index (BMI) is the leading risk factor for T2D globally, contributing to over half of T2D-related DALYs. This risk factor's impact is projected to increase further by 2050.
High BMI accounted for more than 60% of T2D DALYs in North Africa and the Middle East, Latin America and the Caribbean, central Europe, eastern Europe, and central Asia. More than 60% of DALYs for high-income North America were found to be from high BMI. The proportion of global T2D DALYs from BMI increased from 42.2% in 1990 to 52.2% in 2021, according to the study authors.
Between 2021 and 2050, the global diabetes prevalence is estimated to increase by 59.7%, from 6.1% in 2021 to 9.8% in 2025. This would make up approximately 1.31 billion individuals living with diabetes in 2025. The authors expect it to be driven by T2D, rising from 5.9% in 2021 to 9.5% in 2050, accounting for more than 1.27 billion individuals.
Reference
GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021 [published correction appears in Lancet. 2023 Sep 30;402(10408):1132]. Lancet. 2023;402(10397):203-234. doi:10.1016/S0140-6736(23)01301-6
