ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
Global, regional and national burden of type 2 diabetes attributable to air pollution, low physical activity and high body-mass index, 1990–2021: an analysis and prediction from the Global Burden of Disease Study 2021
Provisionally accepted
- 1Hangzhou First People's Hospital, Hangzhou, China
- 2Hangzhou Dianzi University, Hangzhou, China
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Background: Nowadays, type 2 diabetes mellitus (T2DM) poses a significant challenge to public health. However, the global temporal and spatial trend of the burden of T2DM attributable to air pollution, low physical activity and high body-mass index have not been fully examined. Methods: According to the global burden of diseases (GBD) study 2021, the mortality and disability⁃adjusted life years (DALYs) of T2DM attributable to air pollution, low physical activity and high body-mass index were analyzed by age, sex, year and country. The spatiotemporal trends from 1990 to 2021 are described by the estimated annual percentage change (EAPC) and the future trends from 2022 to 2036 are predicted by the autoregressive integrated moving average (ARIMA). Results: In 2021, more than half of the global burden of T2DM could be attributable to air pollution, low physical activity and high body-mass index with 1,154,841.6 deaths and 57,736,757.64 DALYs. Specifically, air pollution accounts for 24.41% of deaths and 22.35% of DALYs. The deaths and DALYs due to low physical activity are 12.92% and 9.57%, respectively. And, high body-mass index contributes to 62.67% of deaths and 68.08% of DALYs. The crude rate and age-standardized rate (ASR) of mortality and DALY of T2DM attributable to air pollution, low physical activity and high body-mass index increase from 1990 to 2021 and vary greatly in the various countries. It is predicted by the ARIMA that the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) of T2DM attributable to air pollution, low physical activity and high body-mass index would show an upward trend from 2022 to 2036. Conclusions: Globally, air pollution, low physical activity and high body-mass index are important risk factors for the burden of T2DM. It is suggested to take comprehensive measures for formation of effective prevention and control strategies to reduce the burden of T2DM.
Keywords: type 2 diabetes, disease burden, Air Pollution, low physical activity, High body-mass index
Received: 09 Oct 2025; Accepted: 25 Nov 2025.
Copyright: © 2025 Zheng, Luo, Xu, Feng, Fang, Li and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wei Han
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