Trends and regional disparities in the diabetes burden across Asia, 1990–2021: Insights from the global burden of disease study

Abstract

Background

Diabetes mellitus (DM) has emerged as a major contributor to the non-communicable disease burden in Asia. Understanding temporal, regional, and demographic patterns is essential for guiding prevention and control efforts.

Methods

We analyzed age-standardized prevalence, incidence, and mortality for DM from the Global Burden of Disease 1990–2021 dataset, encompassing both type 1 and type 2 diabetes across Asian countries and subregions. Joinpoint regression analysis (permutation tests; NCI Joinpoint v5.2.0) was applied to detect significant inflection points as well as to estimate annual percentage changes (APCs) and Average Annual Percent Changes (AAPCs) in trends.

Results

By 2021, an estimated 314 million individuals in Asia were living with DM, with an age-standardized prevalence rate (ASPR) of 6,098.31 per 100,000, incidence rate (ASIR) of 277.23, and death rate (ASDR) of 18.78. From 1990 to 2021, ASPR, ASIR, and ASDR increased with average annual percent changes (AAPCs) of 1.92%, 1.60%, and 0.35%, respectively. Central Asia demonstrated the highest increases in prevalence (AAPC: 2.73%) and mortality (1.73%), while East Asia showed slower growth and declining mortality (–0.31%). High-income Asia Pacific experienced rising prevalence but a marked decline in mortality (–2.86%). Southeast Asia recorded a sharp recent surge in prevalence (APC: 5.61% during 2019–2021). Male patients consistently had higher prevalence and mortality than females. At the national level, Brunei, Mongolia, and Malaysia had the highest prevalence, while Pakistan and the Philippines reported disproportionately high mortality.

Conclusion

The diabetes burden in Asia has risen substantially, with pronounced regional, temporal, and sex-based disparities. These findings highlight the urgent need for tailored, region-specific public health strategies to mitigate the growing impact of DM.