Key result
From 1990 to 2021, the age-standardized incidence rate of early-onset type 2 diabetes in China increased from 140.20 to 315.97 per 100,000 (AAPC 2.67%; 95% CI 2.60% to 2.75%; P<0.001).
Why the study?
Early-onset type 2 diabetes is an increasingly serious public health issue, particularly in China, motivating an analysis of its disease burden, secular trends, and attributable risk factors.
Observational
Effect estimate: AAPC 2.67% (95% CI 2.60% to 2.75%)
Absolute Event Rate: 315.97% vs 140.2%
p-value: p=< 0.001
The burden of early-onset type 2 diabetes in China has rapidly increased from 1990 to 2021, driven primarily by high BMI and environmental pollution, highlighting the need for targeted prevention strategies in younger populations.
May support youth obesity prevention in China; leaves open trials confirming high-BMI and pollution as drivers.
Background: Early-onset type 2 diabetes (T2D) is an increasingly serious public health issue, particularly in China. This study aimed to analyze the characteristics of disease burden, secular trend, and attributable risk factors of early-onset T2D in China. Methods: Using data from the Global Burden of Disease (GBD) 2021, we analyzed the age-standardized rate (ASR) of incidence, disability-adjusted life years (DALYs), and mortality rates of T2D among individuals aged 15 to 39 years in China from 1990 to 2021. Joinpoint regression analysis was employed to analyze secular trend, calculating the average annual percent change (AAPC). We also examined changes in the proportion of early-onset T2D within the total T2D burden and its attributable risk factors. Results: From 1990 to 2021, the ASR of incidence of early-onset T2D in China increased from 140.20 [95% uncertainty interval (UI): 89.14 to 204.74] to 315.97 (95% UI: 226.75 to 417.55) per 100,000, with an AAPC of 2.67% (95% CI: 2.60% to 2.75%, P < 0.001). DALYs rose from 116.29 (95% UI: 78.51 to 167.05) to 267.47 (95% UI: 171.08 to 387.38) per 100,000, with an AAPC of 2.75% (95% CI: 2.64% to 2.87%, P < 0.001). Mortality rates slightly decreased from 0.30 (95% UI: 0.24 to 0.38) to 0.28 (95% UI: 0.23 to 0.34) per 100,000, with an AAPC of −0.22% (95% CI: −0.33% to −0.11%, P < 0.001). The 15 to 19 years age group showed the fastest increase in incidence (AAPC: 4.08%, 95% CI: 3.93% to 4.29%, P < 0.001). The burden was consistently higher and increased more rapidly among males compared to females. The proportion of early-onset T2D within the total T2D burden fluctuated but remained higher than global levels. In 2021, high body mass index (BMI) was the primary attributable risk factor for DALYs of early-onset T2D (59.85%, 95% UI: 33.54% to 76.65%), and its contribution increased substantially from 40.08% (95% UI: 20.71% to 55.79%) in 1990, followed by ambient particulate matter pollution (14.77%, 95% UI: 8.24% to 21.24%) and diet high in red meat (9.33%, 95% UI: −1.42% to 20.06%). Conclusion: The disease burden of early-onset T2D in China is rapidly increasing, particularly among younger populations and males. Despite a slight decrease in mortality rates, the continued rapid increase in incidence and DALYs indicates a need for strengthened prevention and management strategies, especially interventions targeting younger age groups. High BMI and environmental pollution emerge as primary risk factors and should be prioritized in future interventions.
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Yang et al. (2024) conducted an observational in Early-onset type 2 diabetes. Calendar year (2021 vs 1990) vs. 1990 was evaluated on Age-standardized rate of incidence per 100,000 (AAPC 2.67%, 95% CI 2.60% to 2.75%, p=< 0.001). From 1990 to 2021, the age-standardized incidence rate of early-onset type 2 diabetes in China increased from 140.20 to 315.97 per 100,000 (AAPC 2.67%; 95% CI 2.60% to 2.75%; P<0.001).
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