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

Parekh, U.; Sanabria, J.; Krishan, K.; Boloor, A.; Mirfakhraie, R.; Ribeiro, D.; Asmelash, D.; Jayapal, S.K.; Sawhney, M.; Rezaei, N.; Bah, S.; Athar, M.; Kuttikkattu, A.; Bhaskar, S.; Rapaka, D.; Areda, D.; Barengo, N.C.; Koohestani, H.R.; Dongarwar, D.; Rwegerera, G.M.; Gebrehiwot, M.; Odukoya, O.O.; Iyasu, A.N.; Rahmani, S.; Shokri, F.; Skryabina, A.A.; Seylani, A.; Tesler, R.; Alinia, T.; Hasani, H.; Dadras, O.; Saber-Ayad, M.M.; Parekh, T.; Edinur, H.A.; Yonemoto, N.; Sahebkar, A.; Bodolica, V.; Taheri, E.; Mahmoudi, R.; Hossain, S.; Le, T.T.T.; Haddadi, R.; Gaidhane, A.M.; Deo, S.V.; Somayaji, R.; Kim, M.S.; Cao, C.; Rasali, D.P.; Chowdhury, R.; Chung, S.-C.; Amusa, G.A.; Adegboye, O.A.; Etaee, F.; Akinyemi, R.O.; Zaman, S.B.; Safi, S.Z.; Suleman, M.; Smith, A.E.; Chen, S.; Karaye, I.M.; Valizadeh, R.; Bardhan, M.; Majeed, A.; Wei, M.Y.W.; Salehi, M.A.; Coberly, K.; Armocida, B.; Khanal, S.; Mai, A.T.; Lee, P.H.; Mohamed, N.S.; Mwita, J.C.; Jayawardena, R.; Sun, J.; Choudhari, S.G.; Hosseinzadeh, M.; Kandel, H.; Bekele, A.B.; Ekholuenetale, M.; Khatatbeh, M.M.; Sabzmakan, L.; Kazemian, S.; Shaikh, M.A.; Qattea, I.; Hankey, G.J.; Mahmoud, M.A.; Shobeiri, P.; Kabthymer, R.H.; Dascalu, A.M.; Berhie, A.Y.; Qadir, M.M.F.; Rezazadeh, H.; Addo, I.Y.; Sharif-Askari, N.S.; Yada, D.Y.; Awaisu, A.; Mojiri-Forushani, H.; Bitaraf, S.; Kostev, K.; Baig, A.A.; Marateb, H.R.; Wu, Y.; Nigatu, Y.T.; Joseph, N.; Getacher, L.; Adane, T.D.; Chu, D.-T.; Kundu, S.; Legesse, S.M.; Mahjoub, S.; Ghassemi, F.; Tonelli, M.; Dutta, S.; Temsah, M.-H.; Pandi-Perumal, S.R.; Feng, X.; Sahoo, S.S.; Garcia-Gordillo, M.A.; Ghalibaf, A.M.; Columbus, A.; Gebremeskel, T.G.; Mirza-Aghazadeh-Attari, M.; Mohammadi, M.; Taheri, M.; Ismail, N.E.; Sundström, J.; Khan, A.; Moradi, Y.; Dziedzic, A.M.; Niazi, R.K.; Rahimifard, M.; Tiyuri, A.; Saleh, M.A.; Diao, N.; Taye, B.T.; Pandey, A.; Asemu, M.T.; Kuddus, M.; Huda, M.N.; Kuddus, M.A.; Owolabi, M.O.; Nguyen, H.T.H.; Dabo, B.; Shivalli, S.; Kumar, H.; Brenner, H.; Flood, D.; Okekunle, A.P.; Vollset, S.E.; Hosseinzadeh, H.; Jonas, J.B.; Hamidi, S.; Makris, K.C.; Al-Aly, Z.; Fahim, A.; Jin, Y.; Hajibeygi, R.; Roustazadeh, A.; Avila-Burgos, L.; Dewan, S.M.R.; Harandi, H.; Endeshaw, D.; Fazli, G.; Lee, S.W.; Lallukka, T.; Heidari, G.; Chandrasekar, E.K.; Montazeri, F.; Golechha, M.; Nayak, B.P.; Lee, W.-C.; Saddik, B.; Oulhaj, A.; Haubold, J.; Bilal, F.; Tabatabaeizadeh, S.-A.; Holla, R.; Tan, K.-K.; Zhang, Z.-J.; Noreen, M.; Rashedi, S.; Lo, C.-H.; Nauman, J.; Rengasamy, K.R.R.; Sarasmita, M.A.; Zastrozhin, M.S.; Kaambwa, B.; Alvis-Guzman, N.; Duncan, B.B.; Heidari, M.; Mohammadian-Hafshejani, A.; Mini, G.K.; McLaughlin, S.A.; Batra, K.; Bikbov, B.; Sepanlou, S.G.; Almustanyir, S.; Zarea, K.; Xia, J.; Hwang, B.-F.; Schuermans, A.; Rafique, I.; Chauhan, K.; Okwute, P.G.; Upadhyay, E.; Campos, L.A.; Mokdad, A.H.; Bjegovic-Mikanovic, V.; Nguyen, P.T.; Thangaraju, P.; Ningrum, D.N.A.; Babamohamadi, H.; Denova-Gutierrez, E.; Ortiz, A.; Lucchetti, G.; Mekonnen, T.; Karanth, S.D.; Najmuldeen, H.H.R.; Askari, E.; Perna, S.; Morovatdar, N.; Bagheri, N.; El-Huneidi, W.; Okonji, O.C.; Adekanmbi, V.; Haj-Mirzaian, A.; Rahnavard, N.; Mohammadi, E.; Nagaraju, S.P.; Mons, U.; Sarabi, M.M.; Criqui, M.H.; Trico, D.; Patel, J.R.; Nargus, S.; Kebede, S.A.; Cherbuin, N.; Aali, A.; Dandona, L.; Gudayu, T.W.; Le, T.T.B.; Agarwal, G.; Solikhah, S.; Wagaye, B.; Abdulah, D.M.; Murray, C.J.L.; Haile, T.G.; van Daalen, K.R.; Varthya, S.B.; Ram, P.; Nainu, F.; Rahman, M.A.; Sabour, S.; Hossain, M.S.; Iwu, C.C.D.; Ullah, S.; Rahimi, M.; Panagiotakos, D.; Jamalpoor, Z.; Meshkat, M.; Rahman, M.H.U.; Ranjha, M.M.A.Z.; Ansar, A.; Schmidt, M.I.; Andrei, C.L.; Marzo, R.R.; Mahmudul Hasan, S.M.; Mestrovic, T.; Berhe, K.; Arnlov, J.; Baradaran, H.R.; Bennett, D.A.; Delpasand, K.; Moazen, B.; Tovani-Palone, M.R.; Monasta, L.; Tat, N.Y.; Osuagwu, U.L.; Rawal, L.; Cerin, E.; Lenzi, J.; Iyamu, I.O.; Amiri, S.; Iqbal, A.; Mossialos, E.; Belete, M.A.; Pepito, V.C.F.; Farzadfar, F.; Cruz, J.A.; Ahmad, A.; Kimokoti, R.W.; Zou, Z.; Simpson, C.R.; Badiye, A.D.; Riahi, S.M.; Vos, T.; Al Hamad, H.; Joukar, F.; Hiraike, Y.; Barrow, A.; Charan, J.; Kompani, F.; Al Hasan, S.M.A.; Vo, D.C.; Wang, F.; Aljunid, S.M.; Masoudi, R.; Rodrigues, M.; Dhama, K.; Hassanipour, S.; Catala-Lopez, F.; Dandona, R.; Vaziri, S.; Bitra, V.R.; Athari, S.S.; Adnani, Q.E.S.; Bashiri, H.; Mazzaglia, G.; Gaipov, A.; Diaz, D.; Nzoputam, O.J.; Masoudi, S.; Mahmoudimanesh, M.; Ojha, V.A.; Rezaeian, M.; Malik, I.; Vart, P.; Dalton, B.E.; Islam, R.M.; Nassereldine, H.; Ansari-Moghaddam, A.; Liu, X.; Haque, S.; Mahasha, P.W.; Abdullah, A.Y.M.; Singh, S.; Cousin, E.; Bai, R.; Tripathy, J.P.; Dessie, A.M.; Petermann-Rocha, F.E.; Iso, H.; Forouhari, A.; Stafford, L.K.; Malik, A.A.; Negash, H.; Miazgowski, T.; Jeong, W.; Palladino, R.; Tufa, D.G.; Zielińska, M.; Campos-Nonato, I.R.; Sethi, Y.; Ahmed, L.A.; Yohannis, H.K.; Hannan, M.A.; Hassen, M.B.; Latief, K.; Jacob, L.; Tsegay, G.M.; Cheema, H.A.; Asghari-Jafarabadi, M.; 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dc.contributor.author	Shafie, M.
dc.contributor.author	Shah, N.S.
dc.contributor.author	Shahid, S.
dc.contributor.author	Shaikh, M.A.
dc.contributor.author	Shanawaz, M.
dc.contributor.author	Shannawaz, M.
dc.contributor.author	Sharfaei, S.
dc.contributor.author	Shashamo, B.B.
dc.contributor.author	Shiri, R.
dc.contributor.author	Shittu, A.
dc.contributor.author	Shivakumar, K.M.
dc.contributor.author	Shivalli, S.
dc.contributor.author	Shobeiri, P.
dc.contributor.author	Shokri, F.
dc.contributor.author	Shuval, K.
dc.contributor.author	Sibhat, M.M.
dc.contributor.author	Silva, L.M.R.
dc.contributor.author	Simpson, C.R.
dc.contributor.author	Singh, J.A.
dc.contributor.author	Singh, P.
dc.contributor.author	Singh, S.
dc.contributor.author	Siraj, M.S.
dc.contributor.author	Skryabina, A.A.
dc.contributor.author	Sohag, A.A.M.
dc.contributor.author	Soleimani, H.
dc.contributor.author	Solikhah, S.
dc.contributor.author	Soltani-Zangbar, M.S.
dc.contributor.author	Somayaji, R.
dc.contributor.author	Sorensen, R.J.D.
dc.contributor.author	Starodubova, A.V.
dc.contributor.author	Sujata, S.
dc.contributor.author	Suleman, M.
dc.contributor.author	Sun, J.
dc.contributor.author	Sundström, J.
dc.contributor.author	Tabarés-Seisdedos, R.
dc.contributor.author	Tabatabaei, S.M.
dc.contributor.author	Tabatabaeizadeh, S.-A.
dc.contributor.author	Tabish, M.
dc.contributor.author	Taheri, M.
dc.contributor.author	Taheri, E.
dc.contributor.author	Taki, E.
dc.contributor.author	Tamuzi, J.J.L.L.
dc.contributor.author	Tan, K.-K.
dc.contributor.author	Tat, N.Y.
dc.contributor.author	Taye, B.T.
dc.contributor.author	Temesgen, W.A.
dc.contributor.author	Temsah, M.-H.
dc.contributor.author	Tesler, R.
dc.contributor.author	Thangaraju, P.
dc.contributor.author	Thankappan, K.R.
dc.contributor.author	Thapa, R.
dc.contributor.author	Tharwat, S.
dc.contributor.author	Thomas, N.
dc.contributor.author	Ticoalu, J.H.V.
dc.contributor.author	Tiyuri, A.
dc.contributor.author	Tonelli, M.
dc.contributor.author	Tovani-Palone, M.R.
dc.contributor.author	Trico, D.
dc.contributor.author	Trihandini, I.
dc.contributor.author	Tripathy, J.P.
dc.contributor.author	Tromans, S.J.
dc.contributor.author	Tsegay, G.M.
dc.contributor.author	Tualeka, A.R.
dc.contributor.author	Tufa, D.G.
dc.contributor.author	Tyrovolas, S.
dc.contributor.author	Ullah, S.
dc.contributor.author	Upadhyay, E.
dc.contributor.author	Vahabi, S.M.
dc.contributor.author	Vaithinathan, A.G.
dc.contributor.author	Valizadeh, R.
dc.contributor.author	van Daalen, K.R.
dc.contributor.author	Vart, P.
dc.contributor.author	Varthya, S.B.
dc.contributor.author	Vasankari, T.J.
dc.contributor.author	Vaziri, S.
dc.contributor.author	Verma, M.V.
dc.contributor.author	Verras, G.-I.
dc.contributor.author	Vo, D.C.
dc.contributor.author	Wagaye, B.
dc.contributor.author	Waheed, Y.
dc.contributor.author	Wang, Z.
dc.contributor.author	Wang, Y.
dc.contributor.author	Wang, C.
dc.contributor.author	Wang, F.
dc.contributor.author	Wassie, G.T.
dc.contributor.author	Wei, M.Y.W.
dc.contributor.author	Weldemariam, A.H.
dc.contributor.author	Westerman, R.
dc.contributor.author	Wickramasinghe, N.D.
dc.contributor.author	Wu, Y.
dc.contributor.author	Wulandari, R.D.W.I.
dc.contributor.author	Xia, J.
dc.contributor.author	Xiao, H.
dc.contributor.author	Xu, S.
dc.contributor.author	Xu, X.
dc.contributor.author	Yada, D.Y.
dc.contributor.author	Yang, L.
dc.contributor.author	Yatsuya, H.
dc.contributor.author	Yesiltepe, M.
dc.contributor.author	Yi, S.
dc.contributor.author	Yohannis, H.K.
dc.contributor.author	Yonemoto, N.
dc.contributor.author	You, Y.
dc.contributor.author	Zaman, S.B.
dc.contributor.author	Zamora, N.
dc.contributor.author	Zare, I.
dc.contributor.author	Zarea, K.
dc.contributor.author	Zarrintan, A.
dc.contributor.author	Zastrozhin, M.S.
dc.contributor.author	Zeru, N.G.
dc.contributor.author	Zhang, Z.-J.
dc.contributor.author	Zhong, C.
dc.contributor.author	Zhou, J.
dc.contributor.author	Zielińska, M.
dc.contributor.author	Zikarg, Y.T.
dc.contributor.author	Zodpey, S.
dc.contributor.author	Zoladl, M.
dc.contributor.author	Zou, Z.
dc.contributor.author	Zumla, A.
dc.contributor.author	Zuniga, Y.M.H.
dc.contributor.author	Magliano, D.J.
dc.contributor.author	Murray, C.J.L.
dc.contributor.author	Hay, S.I.
dc.contributor.author	Vos, T.
dc.contributor.author	GBD 2021 Diabetes Collaborators
dc.date.accessioned	2023-12-05T17:48:00Z
dc.date.available	2023-12-05T17:48:00Z
dc.date.issued	2023
dc.identifier.uri	https://hdl.handle.net/20.500.12866/14635
dc.description.abstract	Background: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods: Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. Findings: In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. Interpretation: Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers.	en_US
dc.language.iso	eng
dc.publisher	Elsevier
dc.relation.ispartofseries	Lancet
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.rights.uri	https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject	Diabetes	en_US
dc.subject	Projections of prevalence	en_US
dc.subject	Systematic analysis	en_US
dc.subject	Global Burden of Disease Study	en_US
dc.subject.mesh	Diabetes Mellitus
dc.subject.mesh	Prevalencia
dc.subject.mesh	Revisión Sistemática
dc.subject.mesh	Estudios Transversales
dc.title	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	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.1016/S0140-6736(23)01301-6
dc.relation.issn	1474-547X

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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

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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

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