Global Spatiotemporal Trends and Influencing Factors of Type 2 Diabetes Mellitus Mortality: Estimates and Predictions from 1990 to 2040

Yue Zhang¹Huan Deng²Jian Zu^1*Yujiao Deng³Jingyue Tan¹Zhanpeng Yang¹Yang Jiao⁴Xiaomeng Cui⁵Lei Zhang⁶Fanpu Ji^2,5,7,8,9*Yuan Wang^5*

• ¹School of Mathematics and Statistics, Xi’an Jiaotong University, Xi’an, China
• ²National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
• ³Division of Gastroenterology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
• ⁴Department of Endocrinology, the Second Affiliated Hospital of Xi’an Jiaotong University,, Xi’an, China
• ⁵Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi’an, Shaanxi Province, China
• ⁶China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China
• ⁷Key Laboratory of Environment and Genes Related to Diseases, Xi'an, Jiaotong University, Ministry of Education of China, Xi'an, China
• ⁸Key Laboratory of Surgical Critical Care and Life Support (Xi'an Jiaotong University), Ministry of Education, Xi'an, China
• ⁹Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China

Background: To predict global spatiotemporal trends and influencing factors of Type 2 diabetes mellitus (T2DM) mortality. Materials and Methods: Based on the Global Burden of Disease 2021 database, we utilized Bayesian Age-Period-Cohort model to predict age-standardized mortality rate (ASMR) of T2DM in 2022–2040. The common spatial pattern and risk factors were forecasted using Bayesian spatio-temporal model. Decomposition analysis determined the contribution of influencing factors to T2DM deaths. Frontier analysis estimated the gaps between countries and the potential to reduce ASMR. Results: The global deaths of T2DM have been growing, with ASMR showing an increasing and then gradually decreasing trend in 1990–2040 (AAPC1990–2021, 0.31 [0.21–0.42]; AAPC2022–2040, -0.16 [-0.17 to -0.15]), and they are projected to reach 2,756,631 and 18.63 (8.82–28.43) per 100,000 person by 2040, respectively. The ASMR of males is always higher than that of females except Eastern Mediterranean and increases fastest in the 15–49 years group. South-East Asia will has the largest number of deaths (1,035,666 in 2040) and the fastest growth (AAPC2022–2040, 0.22 [0.216–0.228]) in 2022–2040, but Africa will always have the highest ASMR. Age structure contributes more than 58.80% to the increase in deaths except Africa. There are 72 countries with higher ASMR in 2040 compared to 2021, and 86 countries will have heavier burden in 2022–2040. High-middle SDI countries have higher ASMR with huge potential to reduce them. Conclusions: The global deaths of T2DM have been growing, Africa will always have the highest ASMR. Age structure will be the main factor influencing T2DM mortality across regions.