Diabetes in China: Burden Analysis between 1990 and 2019 and Incidence Prediction between 2020 and 2030

Abstract

Background Diabetes is highly prevalent in China, the prevention and treatment of it and its related complications need a lot of medical resources. Local reports have revealed that although the mortality of diabetes is declining, the burden of diabetes is still increasing. Objective To understand the epidemiological characteristics and burden of diabetes in China from 1990—2019, forecast the incidence of diabetes in China from 2020 to 2030, to provide data for evaluating and formulating diabetes-related prevention and treatment policies and measures. Methods In August 2022, this study used data from the Global Burden of Disease Study 2019. Temporal trends of the incidence, mortality, disability-adjusted life years (DALY), years of life lost (YLL), and years lost due to a disability (YLD) of diabetes in China from 1990 to 2019 were described. The Bayesian-age-period-cohort analysis was used to predict the incidence of diabetes in China from 2020 to 2030. Results Compared with 1990, in 2019, the crude prevalence of diabetes increased to 265.45/100 000, with an increase of 63.12%, the standardized prevalence of diabetes increased to 204.31/100 000, with an increase of 15.93%, the crude mortality rate of diabetes increased to 12.16/100 000, with an increase of 105.41%, and the standardized mortality rate of diabetes increased to 9.44/100 000, with an increase of 2.61%. The YLL rate decreased from 204.71/100 000 in 1990 to 178.45/100 000 in 2019. The YLD rate increased from 260.74/100 000 in 1990 to 316.30/100 000 in 2019. The DALY rate increased from 465.46/100 000 in 1990 to 494.76/100 000 in 2019. Compared with 1990, the DALY rate of diabetes increased by 21.08% in males and decreased by 6.68% in females. The YLL rate, YLD rate and DALY rate increased with age in 2019. According to the prediction of the standardized incidence of diabetes in China from 2020 to 2030, the overall standardized incidence of diabetes would present a decreasing trend during the period, and the standardized incidence of diabetes in 2030 would decrease by 11.45% in men and 18.60% in women compared with 2020. Conclusion The burden of diabetes in China is still heavy, with a large number of illness cases and decreased cases, mainly manifested by a high burden caused by diabetes-related disability. Attention should be paid to early prevention of diabetes to reduce the occurrence of complications. The disease burden of males and middle-aged and elderly people is heavy, so sufficient attention should be paid to them. Although the predicted diabetes incidence will reduce between 2020 and 2030, the number of patients is still increasing, so the prevention and control of diabetes should not be slack.

Keywords

• diabetes mellitus|burden of illness|incidence|mortality|forecasting|disability-adjusted life year|year of life lost|year lived with disability|bayesian age-period-cohort analysis