Secular incidence trends and effect of population aging on mortality due to type 1 and type 2 diabetes mellitus in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019

Yongze Li; Chenxi Guo; Yanli Cao

doi:10.1136/bmjdrc-2021-002529

Secular incidence trends and effect of population aging on mortality due to type 1 and type 2 diabetes mellitus in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019

BMJ Open Diabetes Res Care. 2021 Nov;9(2):e002529. doi: 10.1136/bmjdrc-2021-002529.

Authors

Yongze Li¹, Chenxi Guo², Yanli Cao³

Affiliations

¹ Department of Endocrinology and Metabolism, The Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, China.
² Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey, USA.
³ Department of Endocrinology and Metabolism, The Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, China vanilla421@163.com.

Abstract

Introduction: Diabetes and population aging have become public health issues of global concern. The secular incidence trends and the impact of population aging on mortality due to type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in China remain unclear.

Research design and methods: The incidence and mortality rates of T1DM and T2DM from 1990 to 2019 were abstracted from the Global Burden of Disease Study (GBD) 2019 database. Joinpoint regression and age-period-cohort models were used to calculate the average annual percentage change and relative risk (RR), respectively. A decomposition method was used to attribute changes in total deaths to population growth, population aging, and the mortality rate change from 1990 to 2019.

Results: From 1990 to 2019, the T1DM age-standardized incidence rate (ASIR) increased by 2.01% (95% CI 1.78% to 2.23%) in males and 1.70% (1.61% to 1.80%) in females, and the T1DM age-standardized mortality rate (ASMR) decreased by 1.96% (-2.22% to -1.71%) in males and 4.02% (-4.48% to -3.57%) in females. The T2DM ASIR increased by 0.81% (0.62% to 0.99%) in males and 0.37% (0.16% to 0.58%) in females, and the T2DM ASMR increased by 1.06% (0.87% to 1.25%) in males and decreased by 0.24% (-0.54% to 0.07%) in females. Compared with 1990, the proportions of deaths attributed to population aging ranged from 18.85% (T1DM) to 148.21% (T2DM) for males and 29.80% (T1DM) to 118.82% (T2DM) for females in 2019.

Conclusions: The T1DM and T2DM incidence rates continually increased in China, particularly among young individuals. T1DM-related mortality decreased, while T2DM-related mortality increased in males. Population aging might be associated with a substantial change in the number of deaths from 1990 to 2019. To address the increase in T2DM-related deaths due to population aging, policymakers should promote aging-related health research and implement proven, cost-effective T2DM interventions.

Keywords: aging; epidemiology; public health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aging
Diabetes Mellitus, Type 1* / epidemiology
Diabetes Mellitus, Type 2* / epidemiology
Female
Global Burden of Disease
Humans
Incidence
Male