Global burden and drivers of hyperglycemia: Estimates and predictions from 1990 to 2050

Hui-Ling Qiu; Shujun Fan; Kaixin Zhou; Zhini He; Matthew H E M Browning; Luke D Knibbs; Tianyu Zhao; Ya-Na Luo; Xiao-Xuan Liu; Li-Xin Hu; Jia-Xin Li; Yi-Dan Zhang; Yu-Ting Xie; Joachim Heinrich; Guang-Hui Dong; Bo-Yi Yang

doi:10.1016/j.xinn.2023.100450

Global burden and drivers of hyperglycemia: Estimates and predictions from 1990 to 2050

Innovation (Camb). 2023 May 26;4(4):100450. doi: 10.1016/j.xinn.2023.100450. eCollection 2023 Jul 10.

Authors

Hui-Ling Qiu¹, Shujun Fan^{2

3}, Kaixin Zhou⁴, Zhini He^{5

6}, Matthew H E M Browning⁷, Luke D Knibbs⁸, Tianyu Zhao⁹, Ya-Na Luo¹, Xiao-Xuan Liu¹, Li-Xin Hu¹, Jia-Xin Li¹, Yi-Dan Zhang¹, Yu-Ting Xie¹, Joachim Heinrich^{10

11

12}, Guang-Hui Dong¹, Bo-Yi Yang¹

Affiliations

¹ Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
² Guangzhou Joint Research Center for Disease Surveillance and Risk Assessment, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
³ Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou 511436, China.
⁴ College of Life Sciences, University of Chinese Academy of Sciences, Beijing 101408, China.
⁵ Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Guangzhou, Guangdong, China.
⁶ School of Public Health, Southern Medical University, Guangzhou 510515, China.
⁷ Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC 29634, USA.
⁸ School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia.
⁹ Institute of Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany.
¹⁰ Institute of Epidemiology, Helmholtz Zentrum München-German Research Centre for Environmental Health, 85764 Neuherberg, Germany.
¹¹ Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilians University of Munich, Munich, Germany.
¹² Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia.

Abstract

Hyperglycemia is a key risk factor for death and disability worldwide. To better inform prevention strategies, we aimed to delineate and predict the temporal, spatial, and demographic patterns in mean fasting plasma glucose (FPG) levels and their related disease burden globally. Based on the Global Burden of Disease Study 2019, we estimated the distributions of mean FPG levels and high FPG-related disease burden by age, sex, year, socioeconomic status (SES), and geographical region from 1990 to 2050. We also investigated the possible associations of demographic, behavioral, dietary, metabolic, and environmental factors with FPG levels and high FPG-related disease burden. In 2019, the global mean FPG level was 5.40 mmol/L (95% uncertainty interval [UI]: 4.86-6.00), and high FPG contributed to 83.0 deaths (95% UI, 64.5-107.1) and 2,104.3 DALYs (95% UI: 1,740.7-2,520.7) per 100,000 people. For both historical (1990-2019) and future (2020-2050) periods, the mean FPG levels and the high FPG-related disease burden increased globally, with greater increases among the middle-aged and elderly, and people in low-to-middle SES countries, relative to their counterparts. Aging, unhealthy lifestyles, elevated body mass index, and lower air temperatures were potential risk factors for high FPG levels and the high FPG-related disease burden. This study demonstrates that high FPG continues to contribute to the global disease burden and is expected to do so for at least the next 30 years. Older people and those living in low-to-middle SES countries should receive more attention in glycemic management health interventions. In addition, effective interventions that target identified risk factors should be adopted to handle the increasingly large disease burden of high FPG.