Global Burden of type 2 diabetes in non-elderly individuals 1990 to 2021 and projections for 2050: a systematic analysis of the 2021 Global Burden of Disease - 08/05/25

Doi : 10.1016/j.diabet.2025.101660

Qian He ^1,^2,^{⁎
These authors contributed equally to this work.}, Wenjing Wu ^3,^{⁎
These authors contributed equally to this work.}, Junnian Chen ^4,^{⁎
These authors contributed equally to this work.}, Haofeng Zhou ⁵, Gangyu Ding ⁶, Shuiqing Lai ⁴, Andy Y.T. Kuo ⁷, Heng Wan ⁸, Beisi Lin ⁹, Hongjiang Wu ^10,^11,^{^{#
"These authors contributed equally as corresponding authors"},}^⁎ , Alice P.S. Kong ^10,^11,^12,^{^{#
"These authors contributed equally as corresponding authors"},}^⁎ , Haixia Guan ^4,^{^{#
"These authors contributed equally as corresponding authors"},}^⁎ , Huanyi Cao ^1,^{^{#
"These authors contributed equally as corresponding authors"},}^⁎
¹ Department of Endocrinology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
² Department of Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
³ Department of Nephrology, Hubei Provincial Hospital of Traditional Chinese Medicine, Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
⁴ Department of Endocrinology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
⁵ Department of Cardiology, Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
⁶ Department of Neurology, Jiading District Central Hospital Affiliated Shanghai University of Medicine &Health Sciences, Shanghai, China
⁷ Innodetection limited, Hong Kong SAR, China
⁸ Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
⁹ Department of Endocrinology and Metabolism, the third affiliated hospital of Sun Yat-sen University, Key Laboratory of Diabetology of Guangdong Province, Tianhe Road 600, Guangzhou, Guangdong Province, China
¹⁰ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
¹¹ Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
¹² Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China

^⁎⁎Corresponding authors: Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, ChinaDepartment of Medicine and TherapeuticsHong Kong Institute of Diabetes and Obesity, The Chinese University of Hong KongHong Kong SARChina^⁎⁎⁎Corresponding authors: Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Institute of Diabetes and Obesity, Hong Kong SAR, ChinaDepartment of Medicine and TherapeuticsLi Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Institute of Diabetes and ObesityHong Kong SARChina^⁎⁎⁎⁎Corresponding authors: Department of Endocrinology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of EndocrinologyGuangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangzhouChina^{⁎⁎⁎⁎⁎}Corresponding authors: Department of Endocrinology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of EndocrinologyGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina

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Abstract

Background

Type 2 diabetes (T2D) is increasingly becoming a major global health challenge. However, research on T2D in non-elderly populations remains insufficient.

Methods

We analyzed data from the Global Burden of Disease (GBD) study in 2021, focusing on diabetes-related indicators among individuals aged 15 to 59 across 204 countries and regions. This included prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALYs), categorized into 21 GBD regions according to the Sociodemographic Index (SDI). We employed join-point regression and Bayesian Age-Period-Cohort models to assess trends from 1990 to 2021 and forecast from 2021 to 2050.

Results

The global age-standardized incidence rate increased from 196.3 per 100,000 (95% UI, 145.2–257.4) in 1990 to 361.1 per 100,000 (95% UI, 275.2–458.4) in 2021. The prevalence, mortality rate, and DALYs exhibit a similar upward trend. Although both men and women have experienced rises in prevalence, incidence, mortality rate, and DALYs, men continue to lead these metrics across nearly all age groups. Low-middle SDI countries bear the most severe disease burden. A high body mass index is a major risk factor in this population. It is estimated that by 2050, approximately 1.195 billion non-elderly individuals worldwide will have T2D, with epidemiological changes being the primary driver of this disease burden.

Conclusions

This study on the burden of T2D reveals that its prevalence among non-elderly individuals is steadily increasing and is projected to affect over a billion people worldwide by 2050. Targeted measures are crucial to tackle this global health challenge for this population.

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Keywords : Average annual percentage change, Bayesian age-period-cohort model, Global burden of disease study, Type 2 diabetes