Temporal Trends in the Burden of Diabetes and Its Risk Factors Across the Western Pacific Region Between 1990 and 2044: A Systematic Analysis of the Global Burden of Disease Study 2019

Abstract

Aims

We aimed to assess changes in the burden of diabetes in the Western Pacific region (WPR) between 1990 and 2019, project future trends for 2020–2044, and identify the factors influencing these trends.

Materials and Methods

Data from the Global Burden of Disease Study 2019 were used to calculate the age-standardised incidence rate (ASIR), age-standardised death rate (ASDR) and age-standardised disability-adjusted life years (DALYs) rate for diabetes in the region. The Nordpred model was used to predict diabetes-related ASIR and ASDR trends over the next 25 years, and an age-period-cohort (APC) model analysed the effects of age, period and cohort. We examined the associations of ASIR, ASDR and age-standardised DALYs rate per 100,000 population with the socio-demographic index (SDI).

Results

We observed an increasing trend in the incidence. Mortality increased in the lower-middle income group and decreased slowly in the high- and upper-middle income groups. High body mass index significantly affected diabetes, with an increasing influence over time, whereas that of tobacco showed a decreasing trend. The incidence of diabetes showed a trend towards occurring at a younger age, in a manner consistent with the economic development trend. Diabetes incidence and mortality showed the opposite trend in the high-income group, with an increase in SDI.

Conclusions

The burden of diabetes is increasing in the WPR, in association with urbanisation and unhealthy lifestyles. Targeting the risk factors that affect all stages of the disease and managing them through multi-agency collaboration may improve the quality of life in patients living with the condition.