Global burden and risk factors of type 2 diabetes mellitus from 1990 to 2021, and forecasts to 2050

Qian Huang^1*Yang Li¹Minggang Yu¹Zhizi Lv²Fengyi Lu¹Ning Xu¹Qingqing Zhang¹Jiayun Shen¹Jinfeng Zhu³HUA JIANG^1*

• ¹Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
• ²Nanjing Medical University, Nanjing, Jiangsu Province, China
• ³Changsha Medical University, Changsha, Hunan Province, China

deaths, and 75.3 million DALYs. Between 1990 and 2021, both absolute and relative burdens of T2DM increased, particularly among males, older adults, and individuals under 40. Regions with higher SDI generally exhibited higher age-standardized incidence and prevalence rates, while those with lower SDI had elevated age-standardized mortality and DALY rates. Oceania stood out as an exception, with the highest relative burdens across all four indicators, most notably in the Marshall Islands and Fiji. The increases in incidence, DALYs, and prevalence were predominantly driven by population growth and epidemiological shifts, with aging contributing significantly to the rise in mortality. Elevated fasting plasma glucose, body mass index (BMI), and particulate pollution were major contributors to higher T2DM-related mortality and DALY rates. By 2050, high BMI, alcohol consumption, and sugary beverages are anticipated to increasingly influence the T2DM burden. Conclusion: Focused, preventive interventions targeting key risk factors in high-burden groups can effectively reduce the global T2DM burden.