Global burden and trends of chronic kidney disease due to type 2 diabetes mellitus caused by dietary risks: insights from the global burden of disease study 2021

Yunfeng Yu^1*Gang Hu²Xinyu Yang¹Yuman Yin¹Rong Yu^1*

• ¹Hunan University of Chinese Medicine, Changsha, China
• ²The First Hospital of Hunan University of Chinese Medicine, Changsha, China

Objective: The burden of dietary risk-induced diseases, including chronic kidney disease due to type 2 diabetes mellitus caused by dietary risks (CKD-T2DM-DR), has been consistently underestimated. This study aims to investigate the burden of CKD-T2DM-DR from 1990 to 2021 globally and regionally. Methods: The global burden of disease (GBD) database served as the data source for analyzing the mortality, age-standardized DALY rate (ASDR), estimated annual percentage change (EAPC), disability-adjusted life years (DALYs), and age-standardized mortality rate (ASMR) of CKD-T2DM-DR worldwide from 1990 to 2021. Subsequently, the ASMR, ASDR, and EAPC were further evaluated in different regions, age, gender, and socio-demographic index (SDI) groups. Finally, the burden of CKD-T2DM-DR induced by different dietary risks was reported and compared. Results: Globally, the mortality, DALYs, ASDR, and ASMR of CKD-T2DM-DR were on the rise from 1990 to 2021. The global mortality of CKD-T2DM-DR in 2021 was 79,988, ASMR was 0.96 per 100,000 population, DALYs were 1,999,209, and ASDR was 23.21 per 100,000 population. Regionally, low SDI regions exhibited the highest ASDR (27.41 per 100,000 population) and ASMR (1.16 per 100,000 population), whereas high-middle SDI regions recorded the lowest ASDR (14.7 per 100,000 population) and ASMR (0.59 per 100,000 population). High SDI regions presented a rapid increase in ASDR and ASMR, with EAPCs of 1.02 and 1.4, respectively. The correlation analysis supported that ASDR and ASMR were negatively associated with SDI. Additionally, the global burden of CKD-T2DM-DR increased with age and was higher in men than in women. Among the seven associated dietary risks, the DALY and mortality percents of CKD-T2DM caused by diet low in fruit were the highest, at 4.57% and 4.31%, respectively. Conclusion: The global burden of CKD-T2DM-DR has been steadily increasing with significant regional variability. Low SDI regions are most severely affected by this challenge, while high SDI regions are experiencing a rapid increase in the burden. The diet low in fruit was identified as the primary dietary risk for CKD-T2DM. This highlights the urgent need for rapid growth in the targeted prevention and health care strategies to alleviate the global burden of CKD-T2DM-DR.