Diabetes burden, trends, and inequalities in western pacific region, 1990-2019: A population-based study

Yanli Cao; Chenye Jin; Jing Zhang; Hao Sun; Bing Ma; Xue Yang; Tingting Liu; Kaijie Yang; Yongze Li

doi:10.1016/j.dsx.2023.102852

Diabetes burden, trends, and inequalities in western pacific region, 1990-2019: A population-based study

Diabetes Metab Syndr. 2023 Sep;17(9):102852. doi: 10.1016/j.dsx.2023.102852. Epub 2023 Sep 11.

Authors

Yanli Cao¹, Chenye Jin², Jing Zhang³, Hao Sun⁴, Bing Ma⁴, Xue Yang¹, Tingting Liu¹, Kaijie Yang¹, Yongze Li⁵

Affiliations

¹ Department of Endocrinology and Metabolism, The Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Disease, The First Hospital of China Medical University, Shenyang, Liaoning, China.
² Department of Rheumatology and Immunology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
³ Department of Biostatistics and Epidemiology, School of Public Health, Health Science Center, Shenzhen University, Shenzhen, Guangdong, China.
⁴ Department of Clinical Epidemiology and Evidence-based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China.
⁵ Department of Endocrinology and Metabolism, The Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Disease, The First Hospital of China Medical University, Shenyang, Liaoning, China. Electronic address: yzli87@cmu.edu.cn.

PMID: 37714053
DOI: 10.1016/j.dsx.2023.102852

Abstract

Aims: The aim was to describe the diabetes regional burden, trends, and inequalities in the Western Pacific region.

Methods: The Global Burden of Disease 2019 study was used to evaluate the prevalence, incidence, mortality, disability-adjusted life year (DALY) rates and average annual percentage changes (AAPCs) in diabetes in the Western Pacific region from 1990 to 2019. Cross-country inequalities in the DALY rates of diabetes were estimated between 1990 and 2019.

Results: The age-standardized incidence of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in the Western Pacific region increased from 2.6 to 3.8 per 100,000 population (AAPC, 0.97 [95% CI 0.84 to 1.1]) and from 174.8 to 207.3 per 100,000 population (AAPC, 0.63 [95% CI 0.48 to 0.77]) between 1990 and 2019, respectively. The most substantial increase in the incidence of T1DM and T2DM was found in the groups aged 70 years and older (AAPC, 2.38 [95% CI 2.19 to 2.58]) and 15-49 years (AAPC, 1.58 [95% CI 1.43 to 1.72]) from 1990 to 2019, respectively. Age-standardized DALYs for T1DM decreased but those for T2DM increased between 1990 and 2019. The relative concentration index of DALYs in T1DM and T2DM changed from 0.11 in 1990 to -0.08 in 2019 and from 0.03 in 1990 to -0.04 in 2019, respectively.

Conclusions: Over three decades, diabetes incidence in the Western Pacific region rose substantially, with inequalities among countries. The burden shifted from higher to lower sociodemographic index countries. Diabetes remains a public health challenge, especially among young populations. Urgent interventions for prevention and early detection are crucial.

Keywords: Diabetes; Disease burden; Epidemiology; Inequalities; Western pacific region.