Chin Med J (Engl). 2025 May 16.
BACKGROUND: Type 2 diabetes is common in China without comprehensive summary and future anticipation of its incidence, prevalence, associated death, and disability. This analysis described the epidemiological transition of type 2 diabetes in the past three decades and projected the trend in the future three decades in China.
METHODS: Age-, sex-, and year-specific incidence, prevalence, death, and disability-adjusted life years (DALYs) for people with 15 years or older and diabetes or high fasting glucose in China and related countries from 1990 to 2021 were obtained from the Global Burden of Disease. We obtained the trends of age-, sex-, and year-specific rates and absolute numbers of incidence, prevalence, deaths, and DALYs attributable to type 2 diabetes in China from 1990 to 2021. Using the Lee-Carter model, we projected the incidence, prevalence, deaths, and DALYs attributable to type 2 diabetes to 2050 stratified by age and sex.
RESULTS: The age-standardized incidence of type 2 diabetes was 341.5 per 100,000 persons (1.6 times in 1990) and the age-standardized prevalence was 9960.0 per 100,000 persons (2.5 times in 1990) in China 2021. In 2021, there were 0.9 million deaths and 26.8 million DALYs due to type 2 diabetes or hyperglycemia, as 2.9 and 2.7 times the data in 1990, respectively. In the projection, the age-standardized incidence (449.5 per 100,000 persons in 2050) will continue to increase but the growing rate will slow down in the future decades. With the population aging, there will be estimated 211.2 million Chinese people with type 2 diabetes with an anticipated age-standardized prevalence of 18,171.2 per 100,000 persons, 244.6 per 100,000 deaths, and 4720.2 per 100,000 DALYs in 2050. The incidence of type 2 diabetes kept growing among adolescents and young adults in the past three decades (128.7, 439.9, and estimated 1870.8 per 100,000 persons in 1990, 2021, and 2050, respectively).
CONCLUSIONS: The incidence, prevalence, and disease burden of type 2 diabetes grew rapidly in China in the past three decades. The greatest challenges in the future three decades will be the prevention of type 2 diabetes in young people and the care for elder adults.
Keywords: Burden; Death; Disability-adjusted life years; Incidence; Prevalence; Projections; Type 2 diabetes