Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021
Kanyin Liane Ong(University of Washington), Lauryn K Stafford(University of Washington), Susan A. McLaughlin(University of Washington), Edward J. Boyko, Stein Emil Vollset(University of Washington), Amanda Smith(University of Washington), Bronte Dalton(University of Washington), J Duprey(University of Washington), Jessica A Cruz(University of Washington), Hailey Hagins(University of Washington), Paulina A Lindstedt(University of Washington), Amirali Aali(University of Washington), Yohannes Abate(University of Washington), Melsew Dagne Abate(University of Washington), Mohammadreza Abbasian(University of Washington), Zeinab Abbasi-Kangevari(University of Washington), Mohsen Abbasi‐Kangevari(University of Washington), Samar Abd ElHafeez(University of Washington), Rami Abd‐Rabu(University of Washington), Deldar Morad Abdulah(University of Washington), Abu Yousuf Md Abdullah(University of Washington), Vida Abedi(University of Washington), Hassan Abidi(University of Washington), Richard Gyan Aboagye(University of Washington), Hassan Abolhassani(University of Washington), Eman Abu‐Gharbieh(University of Washington), Ahmed Abu‐Zaid(University of Washington), Tigist Demssew Adane(University of Washington), Denberu Eshetie Adane(University of Washington), Isaac Yeboah Addo(University of Washington), Oyelola A. Adegboye(University of Washington), Victor Adekanmbi(University of Washington), Victor Abiola Adepoju(University of Washington), Qorinah Estiningtyas Sakilah Adnani(University of Washington), Rotimi Felix Afolabi(University of Washington), Gina Agarwal(University of Washington), Zahra Babaei Aghdam(University of Washington), Marcela Agudelo‐Botero(University of Washington), Constanza Elizabeth Aguilera Arriagada, Williams Agyemang‐Duah(University of Washington), Bright Opoku Ahinkorah(University of Washington), Danish Ahmad(University of Washington), Rizwan Ahmad(University of Washington), Sajjad Ahmad(University of Washington), Aqeel Ahmad(University of Washington), Ali Ahmadi(University of Washington), Keivan Ahmadi(University of Washington), Ayman Ahmed(University of Washington), Ali Ahmed(University of Washington), Luai A. Ahmed(University of Washington), Syed Anees Ahmed(University of Washington), Marjan Ajami(University of Washington), Rufus Akinyemi(University of Washington), Hanadi Al Hamad(University of Washington), Syed Mahfuz Al Hasan, Tareq Mohammed Ali AL-Ahdal(University of Washington), Tariq A. Alalwan(University of Washington), Ziyad Al‐Aly(University of Washington), Mohammad T AlBataineh(University of Washington), Jacqueline Elizabeth Alcalde‐Rabanal(University of Washington), Sharifullah Alemi(University of Washington), Hassam Ali(University of Washington), Tahereh Alinia(University of Washington), Syed Mohamed Aljunid(University of Washington), Sami Almustanyir(University of Washington), Rajaa Al‐Raddadi(University of Washington), Nelson Alvis‐Guzmán(University of Washington), Firehiwot Amare(University of Washington), Edward Kwabena Ameyaw(University of Washington), Sohrab Amiri(University of Washington), Ganiyu Adeniyi Amusa(University of Washington), Cătălina Liliana Andrei(University of Washington), Ranjit Mohan Anjana(University of Washington), Adnan Ansar(University of Washington), Golnoosh Ansari(University of Washington), Alireza Ansari‐Moghaddam(University of Washington), Anayochukwu Edward Anyasodor(University of Washington), Jalal Arabloo(University of Washington), Aleksandr Y. Aravkin(University of Washington), Demelash Areda(University of Washington), Hidayat Arifin(University of Washington), Mesay Arkew(University of Washington), Benedetta Armocida(University of Washington), Johan Ärnlöv(University of Washington), Anton A Artamonov(University of Washington), Judie Arulappan(University of Washington), Raphael Taiwo Aruleba(University of Washington), Ashokan Arumugam(University of Washington), Zahra Aryan(University of Washington), Mulu Tiruneh(University of Washington), Mohammad Asghari Jafarabadi(University of Washington), Elaheh Askari(University of Washington), Daniel Asmelash(University of Washington), Thomas Astell‐Burt(University of Washington), Mohammad Athar(University of Washington), Seyyed Shamsadin Athari(University of Washington), Maha Atout(University of Washington), Leticia Ávila‐Burgos(University of Washington), Ahmed Awaisu(University of Washington), Sina Azadnajafabad(University of Washington), B B Darshan(University of Washington), Hassan Babamohamadi(University of Washington), Muhammad Badar(University of Washington), Alaa Badawi(University of Washington), Ashish Badiye(University of Washington), Nayereh Baghcheghi(University of Washington), Nasser Bagheri(University of Washington), Sara Bagherieh(University of Washington), Sulaiman Bah(University of Washington), Saeed Bahadory(University of Washington), Ruhai Bai(University of Washington), Atif Amin Baig(University of Washington), Ovidiu Constantin Baltatu(University of Washington), Hamid Reza Baradaran(University of Washington), Martina Barchitta(University of Washington), Mainak Bardhan(University of Washington), Noël C. Barengo(University of Washington), Till Bärnighausen(University of Washington), Mark Thomaz Ugliara Barone(University of Washington), Francesco Barone‐Adesi(University of Washington), Amadou Barrow(University of Washington), Hamideh Bashiri(University of Washington), Afisu Basiru(University of Washington), Sanjay Basu(University of Washington), Saurav Basu(University of Washington), Abdul‐Monim Batiha(University of Washington), Kavita Batra(University of Washington), Mulat Tirfie Bayih(University of Washington), Nebiyou Simegnew Bayileyegn, Amir Hossein Behnoush(University of Washington), Alehegn Bekele Bekele(University of Washington), Melaku Ashagrie Belete(University of Washington), Uzma Belgaumi(University of Washington), Luı́s Belo(University of Washington), Derrick Bennett(University of Washington), Isabela M. Benseñor(University of Washington), Kidanemaryam Berhe(University of Washington), Alemshet Yirga Berhie(University of Washington), Sonu Bhaskar(University of Washington), Ajay Nagesh Bhat(University of Washington), Jasvinder Singh Bhatti(University of Washington), Boris Bikbov(University of Washington), Faiq Bilal(University of Washington), Bagas Suryo Bintoro(University of Washington), Saeid Bitaraf(University of Washington), Veera Raghavulu Bitra(University of Washington), Vesna Bjegović-Mikanović(University of Washington), Virgínia Bodolica(University of Washington), Archith Boloor(University of Washington), Michael Bräuer(University of Washington), Javier Brazo‐Sayavera(University of Washington), Hermann Brenner(University of Washington), Zahid A Butt(University of Washington), Daniela Călina(University of Washington), Luciana Aparecida Campos(University of Washington), Ismael Campos‐Nonato(University of Washington), Yin Cao(University of Washington), Chao Cao(University of Washington), Josip Car(University of Washington), Márcia Carvalho(University of Washington), Carlos A Castañeda-Orjuela(University of Washington), Ferrán Catalá-López(University of Washington), Ester Cerin(University of Washington), Joshua Chadwick(University of Washington), Eeshwar K Chandrasekar, Gashaw Sisay Chanie(University of Washington), Jaykaran Charan(University of Washington), Vijay Kumar Chattu(University of Washington), Kirti Chauhan(University of Washington), Huzaifa Ahmad Cheema(University of Washington), Endeshaw Chekol Abebe(University of Washington), Simiao Chen(University of Washington), Nicolas Cherbuin(University of Washington), Fatemeh Chichagi(University of Washington), Saravana Babu Chidambaram(University of Washington), William C. Cho(University of Washington), Sonali G Choudhari(University of Washington), Rajiv Chowdhury(University of Washington), E. Chowdhury(University of Washington), Dinh‐Toi Chu(University of Washington), Isaac Sunday Chukwu(University of Washington), Sheng‐Chia Chung(University of Washington), Kaleb Coberly(University of Washington), Alyssa Columbus(University of Washington), Daniela Contreras(University of Washington), Ewerton Cousin(University of Washington), Michael H Criqui(University of Washington), Natália Martins(University of Washington), Sarah Cuschieri(University of Washington), Bashir Dabo(University of Washington), Omid Dadras(University of Washington), Xiaochen Dai(University of Washington), Albertino Damasceno(University of Washington), Rakhi Dandona(University of Washington), Lalit Dandona(University of Washington), Saswati Das(University of Washington), Ana Maria Dascălu(University of Washington), Nihar Ranjan Dash(University of Washington), Mohsen Dashti(University of Washington), Claudio Alberto Dávila-Cervantes(University of Washington), Vanessa De la Cruz‐Góngora(University of Washington), Gebiso Roba Debele(University of Washington), Kourosh Delpasand(University of Washington), Fitsum Wolde Demisse, Getu Debalkie Demissie(University of Washington), Xin Deng(University of Washington), Edgar Denova‐Gutiérrez(University of Washington), Salil V. Deo(University of Washington), Emina Dervišević(University of Washington), Hardik Dineshbhai Desai(University of Washington), Aragaw Tesfaw Desale(University of Washington), Anteneh Mengist Dessie(University of Washington), Fikreab Desta(University of Washington), Syed Masudur Rahman Dewan(University of Washington), Sourav Dey(University of Washington), Kuldeep Dhama(University of Washington), Meghnath Dhimal(University of Washington), Nancy Diao(University of Washington), Daniel Díaz(University of Washington), Monica Dinu(University of Washington), Mengistie Diress(University of Washington), Shirin Djalalinia(University of Washington), Linh Phuong Doan(University of Washington), Deepa Dongarwar(University of Washington), Francisco Winter dos Santos Figueiredo(University of Washington), Bruce Bartholow Duncan(University of Washington), Siddhartha Dutta(University of Washington), Arkadiusz Dziedzic, Hisham Atan Edinur(University of Washington), Michael Ekholuenetale(University of Washington), Temitope Cyrus Ekundayo(University of Washington), Islam Y. Elgendy(University of Washington), Muhammed Elhadi(University of Washington), Waseem El‐Huneidi(University of Washington), Omar El Meligy(University of Washington), Mohamed A. Elmonem(University of Washington), Destaw Endeshaw(University of Washington), Hawi Leul Esayas(University of Washington), Habitu Birhan Eshetu(University of Washington), Farshid Etaee(University of Washington), Ibtihal Fadhil(University of Washington), Adeniyi Francis Fagbamigbe(University of Washington), Ayesha Fahim(University of Washington), Shahab Falahi(University of Washington), MoezAlIslam E. Faris(University of Washington), Hossein Farrokhpour(University of Washington), Farshad Farzadfar(University of Washington), Ali Fatehizadeh(University of Washington), Ghazal S. Fazli(University of Washington), Xiaoqi Feng(University of Washington), Tomas Y Ferede(University of Washington), Florian Fischer(University of Washington), David Flood(University of Washington), Ali Forouhari(University of Washington), Roham Foroumadi(University of Washington), Masoumeh Foroutan Koudehi, Abhay Gaidhane(University of Washington), Santosh Gaihre(University of Washington), Abduzhappar Gaipov(University of Washington), Yaseen Galali(University of Washington), Balasankar Ganesan(University of Washington), Miguel Ángel García-Gordillo(University of Washington), Rupesh K. Gautam(University of Washington), Mesfin Gebrehiwot(University of Washington), Kahsu Gebrekirstos Gebrekidan, Teferi Gebru Gebremeskel(University of Washington), Lemma Getacher(University of Washington), Fataneh Ghadirian(University of Washington), Seyyed‐Hadi Ghamari(University of Washington), Mohammad Ghasemi Nour(University of Washington), Fariba Ghassemi(University of Washington), Mahaveer Golechha(University of Washington), Pouya Goleij(University of Washington), Davide Golinelli(University of Washington), Sameer Vali Gopalani(University of Washington), Habtamu Alganeh Guadie(University of Washington), Shi‐Yang Guan(University of Washington), Temesgen Worku Gudayu(University of Washington), Rafael Alves Guimarães, Rashid Abdi Guled(University of Washington), Rajeev Gupta(University of Washington), Kartik Gupta(University of Washington), Veer Bala Gupta(University of Washington), Vivek Gupta(University of Washington), Bishal Gyawali(University of Washington), Rasool Haddadi(University of Washington), Najah R Hadi(University of Washington), Teklehaimanot Gereziher Haile(University of Washington), Ramtin Hajibeygi(University of Washington), Arvin Haj‐Mirzaian(University of Washington), Rabih Halwani(University of Washington), Samer Hamidi(University of Washington), Graeme J. Hankey(University of Washington), Md. Abdul Hannan(University of Washington), Shafiul Haque(University of Washington), Hamid Harandi(University of Washington), Netanja I. Harlianto(University of Washington), S M Mahmudul Hasan(University of Washington), Syed Shahzad Hasan(University of Washington), Hamidreza Hasani(University of Washington), Soheil Hassanipour(University of Washington), Mohammed Bheser Hassen(University of Washington), Johannes Haubold(University of Washington), Khezar Hayat(University of Washington), Golnaz Heidari(University of Washington), Mohammad Heidari(University of Washington), Kamran Hessami(University of Washington), Yuta Hiraike(University of Washington), Ramesh Holla(University of Washington), Sahadat Hossain(University of Washington), Md Shakhaoat Hossain(University of Washington), Mohammad‐Salar Hosseini(University of Washington), Mehdi Hosseinzadeh(University of Washington), Hassan Hosseinzadeh(University of Washington), Junjie Huang(University of Washington), Md. Nazmul Huda(University of Washington), Salman Hussain(University of Washington), Hong-Han Huynh(University of Washington), Bing‐Fang Hwang(University of Washington), Segun Emmanuel Ibitoye(University of Washington), Nayu Ikeda(University of Washington), Irena Ilić(University of Washington), Milena Ilić(University of Washington), Leeberk Raja Inbaraj, Afrin Iqbal(University of Washington), Sheikh Mohammed Shariful Islam(University of Washington), Rakibul M. Islam(University of Washington), Nahlah Elkudssiah Ismail(University of Washington), Hiroyasu Iso(University of Washington), Gaetano Isola(University of Washington), Ramaiah Itumalla(University of Washington), Masao Iwagami(University of Washington), Chidozie C D Iwu, Ihoghosa Iyamu(University of Washington), Assefa N Iyasu(University of Washington), Louis Jacob(University of Washington), Abdollah Jafarzadeh(University of Washington), Haitham Jahrami(University of Washington), Rajesh Jain(University of Washington), C. Jaja(University of Washington), Zahra Jamalpoor(University of Washington), Elham Jamshidi(University of Washington), Balamurugan Janakiraman(University of Washington), Krishnamurthy Jayanna(University of Washington), Sathish Kumar Jayapal(University of Washington), Shubha Jayaram(University of Washington), Ranil Jayawardena(University of Washington), Rime Jebai, Wonjeong Jeong, Yinzi Jin, Mohammad Jokar(University of Washington), Jost B. Jonas(University of Washington), Nitin Joseph(University of Washington), Abel Joseph(University of Washington), Charity Ehimwenma Joshua(University of Washington), Farahnaz Joukar(University of Washington), Jacek Jerzy Jozwiak(University of Washington), Billingsley Kaambwa(University of Washington), Ali Kabir(University of Washington), Robel Hussen Kabthymer(University of Washington), Vidya Kadashetti(University of Washington), Farima Kahe(University of Washington), Rohollah Kalhor(University of Washington), Himal Kandel(University of Washington), Shama D. Karanth(University of Washington), Ibraheem M. Karaye(University of Washington), Samad Karkhah(University of Washington), Patrick DMC Katoto(University of Washington), Navjot Kaur(University of Washington), Sina Kazemian(University of Washington), Sewnet Adem Kebede(University of Washington), Yousef Khader(University of Washington), Himanshu Khajuria(University of Washington), Amirmohammad Khalaji(University of Washington), Moien AB Khan(University of Washington), Maseer Khan(University of Washington), Ajmal Khan(University of Washington), Saval Khanal(University of Washington), Moawiah Khatatbeh(University of Washington), Amir M Khater(University of Washington), Sorour Khateri(University of Washington), Fatemeh Khorashadizadeh(University of Washington), Jagdish Khubchandani(University of Washington), Biruk Getahun Kibret(University of Washington), Min Seo Kim(University of Washington), Ruth W Kimokoti(University of Washington), Adnan Kısa(University of Washington), Mika Kivimäki(University of Washington), Ali‐Asghar Kolahi(University of Washington), Somayeh Komaki(University of Washington), Farzad Kompani(University of Washington), Hamid Reza Koohestani(University of Washington), Oleksii Korzh(University of Washington), Karel Kostev(University of Washington), Nikhil Kothari(University of Washington), Ai Koyanagi(University of Washington), Kewal Krishan(University of Washington), Yuvaraj Krishnamoorthy(University of Washington), Barthélémy Kuate Defo(University of Washington), Mohammed Kuddus(University of Washington), Md Abdul Kuddus(University of Washington), Rakesh Kumar(University of Washington), Harish Kumar(University of Washington), Satyajit Kundu(University of Washington), Maria Dyah Kurniasari(University of Washington), Ambily Kuttikkattu(University of Washington), Carlo La Vecchia(University of Washington), Tea Lallukka(University of Washington), Bagher Larijani(University of Washington), Anders Larsson(University of Washington), Kamaluddin Latief(University of Washington), Basira Kankia Lawal(University of Washington), Thao T. Le(University of Washington), Trang Thi Bich Le(University of Washington), Shaun Wen Huey Lee(University of Washington), Munjae Lee(University of Washington), Wei‐Chen Lee(University of Washington), Paul H. Lee(University of Washington), Sang-woong Lee(University of Washington), Seung Won Lee(University of Washington), Samson Mideksa Legesse(University of Washington), Jacopo Lenzi(University of Washington), Yongze Li(University of Washington), Ming‐Chieh Li(University of Washington), Stephen S Lim(University of Washington), Lee‐Ling Lim(University of Washington), Xuefeng Liu(University of Washington), Chaojie Liu(University of Washington), Chun‐Han Lo(University of Washington), Graciliana Lopes(University of Washington), Stefan Lorkowski(University of Washington), Rafael Lozano(University of Washington), Giancarlo Lucchetti(University of Washington), Azzam A. Maghazachi(University of Washington), Phetole Walter Mahasha(University of Washington), Soleiman Mahjoub(University of Washington), Mansour Adam Mahmoud(University of Washington), Razzagh Mahmoudi(University of Washington), Marzieh Mahmoudimanesh(University of Washington), Anh Tuan Mai(University of Washington), Azeem Majeed(University of Washington), Pantea Majma Sanaye, Konstantinos C. Makris(University of Washington), Kashish Malhotra(University of Washington), Ahmad Azam Malik(University of Washington), Iram Malik(University of Washington), Tauqeer Hussain Mallhi(University of Washington), Déborah Carvalho Malta(University of Washington), Abdullah Al Mamun(University of Washington), Borhan Mansouri(University of Washington), Hamid Reza Marateb(University of Washington), Parham Mardi(University of Washington), Santi Martini(University of Washington), Miquel Martorell(University of Washington), Roy Rillera Marzo(University of Washington), Reza Masoudi(University of Washington), Sahar Masoudi(University of Washington), Elezebeth Mathews(University of Washington), Andrea Maugeri(University of Washington), Giampiero Mazzaglia, Teferi Mekonnen(University of Washington), Mahboobeh Meshkat, Tomislav Meštrović, Junmei Miao Jonasson, Tomasz Miazgowski, Irmina Maria Michałek, Le Huu Nhat Minh, GK Mini, J. Jaime Miranda, Reza Mirfakhraie(University of Washington), Erkin М Мirrakhimov, Mohammad Mirza‐Aghazadeh‐Attari(University of Washington), Awoke Misganaw, Kebede Haile Misgina, Manish Mishra, Babak Moazen, Nouh Saad Mohamed(University of Washington), Esmaeil Mohammadi, Mohsen Mohammadi(University of Washington), Abdollah Mohammadian-Hafshejani(University of Washington), Marita Mohammadshahi, Alireza Mohseni(University of Washington), Hoda Mojiri-Forushani, Ali H. Mokdad, Sara Momtazmanesh(University of Washington), Lorenzo Monasta, Md. Moniruzzaman(University of Washington), Ute Mons(University of Washington), Fateme Montazeri(University of Washington), AmirAli Moodi Ghalibaf(University of Washington), Yousef Moradi(University of Washington), Maryam Moradi(University of Washington), Mostafa Moradi Sarabi, Negar Morovatdar, Shane D. Morrison, Jakub Morze, Elías Mossialos, Ebrahim Mostafavi, Ulrich Müeller, Francesk Mulita, Admir Mulita, Efrén Murillo‐Zamora, Kamarul Imran Musa(University of Washington), Julius Chacha Mwita, Shankar Prasad Nagaraju, Mohsen Naghavi(University of Washington), Firzan Nainu, Tapas Sadasivan Nair, Hastyar Hama Rashid Najmuldeen, Vinay Nangia, Shumaila Nargus, Abdallah Y. Naser, Hasan Nassereldine(University of Washington), Zuhair S. Natto, Javaid Nauman, Biswa Prakash Nayak, Rawlance Ndejjo, Hadush Negash, Ruxandra Irina Negoi, Hau Thi Hien Nguyen, Dang Nguyen, Phat Tuan Nguyen, Văn Thành Nguyễn, Hien Quang Nguyen, Robina Khan Niazi, Yeshambel T. Nigatu, Dina Nur Anggraini Ningrum, Muhammad A Nizam(University of Washington), Lawrence Achilles Nnyanzi, Mamoona Noreen, Jean Jacques Noubiap, Ogochukwu Janet Nzoputam, Chimezie Igwegbe Nzoputam, Bogdan Oancea, Nkechi Martina Odogwu, Oluwakemi Ololade Odukoya, Vivek Anand Ojha, Hassan Okati‐Aliabad(University of Washington), Akinkunmi Paul Okekunle, Osaretin Christabel Okonji, Patrick Godwin Okwute, Isaac Iyinoluwa Olufadewa, Obinna Onwujekwe, Michał Ordak, Alberto Ortíz, Uchechukwu Levi Osuagwu, Abderrahim Oulhaj, Mayowa Owolabi, Alicia Padrón‐Monedero, Jagadish Rao Padubidri, Raffaele Palladino, Demosthenes B. Panagiotakos, Songhomitra Panda‐Jonas, Ashok Pandey(University of Washington), Anamika Pandey, Seithikurippu R. Pandi‐Perumal, Anca Pantea Stoian, Shahina Pardhan, Tarang Parekh, Utsav Parekh, Maja Pasovic, Jay Patel(University of Washington), Jenil Patel, Uttam Paudel, Veincent Christian Filipino Pepito, Marcos Pereira, Norberto Perico, Simone Perna, Ionela-Roxana Petcu, Fanny Emily Petermann-Rocha, Vivek Podder(University of Washington), Maarten J. Postma, Ghazaleh Pourali, Naeimeh Pourtaheri, Elton Junio Sady Prates, Mirza Muhammad Fahd Qadir, Ibrahim Qattea, Pourya Raee, Ibrar Rafique, Mehran Rahimi, Mahban Rahimifard, Vafa Rahimi‐Movaghar, Obaidur Rahman(University of Washington), Muhammad Aziz Rahman(University of Washington), Mohammad Hifz Ur Rahman(University of Washington), Mosiur Rahman(University of Washington), Md. Mosfequr Rahman(University of Washington), Mohamed Rahmani(University of Washington), Shayan Rahmani, Vahid Rahmanian, Setyaningrum Rahmawaty, Niloufar Rahnavard, Bibek Rajbhandari, Pradhum Ram(University of Washington), Sheena Ramazanu, Juwel Rana, Nemanja Rančić, Muhammad Modassar Ali Nawaz Ranjha, Chythra R Rao, Deepthi Rapaka, Drona Rasali, Sina Rashedi(University of Washington), Vahid Rashedi, Ahmed Mustafa Rashid(University of Washington), Mohammad‐Mahdi Rashidi, Zubair Ahmed Ratan, Salman Rawaf(University of Washington), Lal Rawal(University of Washington), Elrashdy M. Redwan, Giuseppe Remuzzi, Kannan R. R. Rengasamy, André M. N. Renzaho, Luis Felipe Reyes, Nima Rezaei, Nazila Rezaei, Mohsen Rezaeian(University of Washington), Hossein Rezazadeh(University of Washington), Seyed Mohammad Riahi, Yohanes Andy Rias, Muhammad Riaz(University of Washington), Daniela Ribeiro(University of Washington), Mónica Rodrigues(University of Washington), Jefferson Antonio Buendía, Leonardo Roever, Peter Rohloff, Gholamreza Roshandel, Abazar Roustazadeh, Godfrey Mutashambara Rwegerera, Aly M A Saad, Maha Saber-Ayad, Siamak Sabour, Leila Sabzmakan, Basema Saddik, Erfan Sadeghi, Umar Saeed(University of Washington), Sahar Saeedi Moghaddam(University of Washington), Sare Safi, Sher Zaman Safi, Amene Saghazadeh, Narjes Saheb Sharif‐Askari, Fatemeh Saheb Sharif‐Askari(University of Washington), Amirhossein Sahebkar, Soumya Swaroop Sahoo, Harihar Sahoo, KM Saif‐Ur‐Rahman, Mirza Rizwan Sajid, Sarvenaz Salahi, Saina Salahi, Mohamed A. Saleh(University of Washington), Mohammad Amin Salehi, Joshua A. Salomon(University of Washington), Juan Sanabria, Rama Krishna Sanjeev, Francesco Sanmarchi(University of Washington), Milena M Santric-Milicevic, Made Ary Sarasmita, Saman Sargazi, Brijesh Sathian, Thirunavukkarasu Sathish(University of Washington), Monika Sawhney, Markus P. Schlaich, María Inês Schmidt, Art Schuermans(University of Washington), Abdul-Aziz Seidu, Nachimuthu Senthil Kumar, Sadaf G Sepanlou, Yashendra Sethi, Allen Seylani, Maryam Shabani(University of Washington), Tahereh Shafaghat(University of Washington), Melika Shafeghat, Mahan Shafie, Nilay S. Shah(University of Washington), Samiah Shahid, Masood Ali Shaikh, Mohd Shanawaz(University of Washington), Mohammed Shannawaz(University of Washington), Sadaf Sharfaei, Bereket Beyene Shashamo, Rahman Shiri(University of Washington), Aminu Shittu, K. M. Shivakumar, Siddharudha Shivalli, Parnian Shobeiri, Fereshteh Shokri, Kerem Shuval, Migbar Mekonnen Sibhat, Luís R. Silva, Colin R Simpson, Ambrish Singh(University of Washington), Paramdeep Singh(University of Washington), Surjit Singh(University of Washington), Md Shahjahan Siraj, Anna Aleksandrovna Skryabina, Abdullah Al Mamun Sohag, Hamidreza Soleimani(University of Washington), Solikhah Solikhah, Mohammad Sadegh Soltani‐Zangbar, Ranjani Somayaji, Reed J D Sorensen, А. В. Стародубова, Sujata Sujata, Muhammad Suleman(University of Washington), Jing Sun, Johan Sundström(University of Washington), Rafael Tabarés‐Seisdedos(University of Washington), Seyyed Mohammad Tabatabaei, Seyed‐Amir Tabatabaeizadeh, Mohammad Tabish(University of Washington), Majid Taheri, Ensiyeh Taheri, Elahe Taki(University of Washington), Jacques Lukenze Tamuzi, Ker‐Kan Tan(University of Washington), Nathan Y Tat(University of Washington), Birhan Tsegaw Taye, Worku Animaw Temesgen(University of Washington), Mohamad‐Hani Temsah, Riki Tesler, Pugazhenthan Thangaraju, Kavumpurathu Raman Thankappan, Rajshree Thapa, Samar Tharwat(University of Washington), Nihal Thomas(University of Washington), Jansje Henny Vera Ticoalu, Amir Tiyuri(University of Washington), Marcello Tonelli, Marcos Roberto Tovani‐Palone, Domenico Tricò, Indang Trihandini, Jaya Prasad Tripathy, Samuel Tromans, Guesh Mebrahtom Tsegay, Abdul Rohim Tualeka, Derara Girma Tufa, Stefanos Tyrovolas, Sana Ullah(University of Washington), Era Upadhyay(University of Washington), Seyed Mohammad Vahabi, Asokan Govindaraj Vaithinathan, Rohollah Valizadeh(University of Washington), Kim Robin van Daalen, Priya Vart, Shoban Babu Varthya, Tommi Vasankari, Siavash Vaziri, Madhur Verma, Georgios‐Ioannis Verras, Danh Cao Vo(University of Washington), Birhanu Wagaye, Yasir Waheed, Ziyue Wang(University of Washington), Yanqing Wang(University of Washington), Cong Wang(University of Washington), Fang Wang(University of Washington), Gizachew Tadesse Wassie, Melissa Y. Wei(University of Washington), Abrha Hailay Weldemariam, Ronny Westerman, Nuwan Darshana Wickramasinghe, Yifan Wu(University of Washington), Ratna Dwi Wulandari, Juan Xia(University of Washington), Hong Xiao(University of Washington), Suowen Xu(University of Washington), Xiaoyue Xu(University of Washington), Dereje Y Yada(University of Washington), Lin Yang(University of Washington), Hiroshi Yatsuya, Metin Yeşiltepe, Siyan Yi(University of Washington), Hunachew Kibret Yohannis, Naohiro Yonemoto, Yuyi You(University of Washington), Sojib Bin Zaman, Nelson Zamora(University of Washington), Iman Zare(University of Washington), Kourosh Zarea(University of Washington), Armin Zarrintan, Михаил Сергеевич Застрожин, Naod Gebrekrstos Zeru, Zhi-Jiang Zhang, Chenwen Zhong, Jingjing Zhou, Magdalena Zielińska, Yossef Teshome Zikarg, Sanjay Zodpey(University of Washington), Mohammad Zoladl(University of Washington), Zhiyong Zou, Alimuddin Zumla, Yves Miel H Zuñiga, Dianna J. Magliano, Christopher J L Murray, Simon I Hay(University of Washington), Theo Vos
Cited by 4,124Open Access
Abstract
BACKGROUND: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. METHODS: Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. FINDINGS: In 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8-6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7-9·9]) and, at the regional level, in Oceania (12·3% [11·5-13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1-79·5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1-96·8) of diabetes cases and 95·4% (94·9-95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5-71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5-30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22-1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1-17·6) in north Africa and the Middle East and 11·3% (10·8-11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. INTERPRETATION: Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. FUNDING: Bill & Melinda Gates Foundation.
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