Type 2 diabetes mellitus in Egypt: national burden, temporal patterns, and conditional incidence projections to 2050

Background Type 2 diabetes mellitus (T2DM) is an increasing public-health burden in Egypt. This study assessed national trends, the demographic and rate-related components of case growth, age-related patterns, and projected incidence. Methods Global Burden of Disease 2023 estimates were analyzed for T2DM prevalence, incidence, deaths, and disability-adjusted life years (DALYs) in Egypt during 1990–2023. Overall and sex-specific trends were assessed using log-linear and segmented log-linear regression, with estimated annual percentage changes and autocorrelation-consistent 95% confidence intervals. Symmetric decomposition partitioned incident-case growth at ages 15–89 into population growth, age structure, and rate changes; exploratory age–period–cohort analysis covered 1990–2019. Age-standardized incidence was projected to 2050 after model comparison using holdout and rolling-origin validation. Analyses used R version 4.5.3, with two-sided p < 0.05 considered statistically significant. Results In 2023, Egypt had an estimated 12.1 million prevalent T2DM cases and 604,386 new cases. Age-standardized prevalence and incidence reached 13,849.76 and 586.43 per 100,000, increasing by 2.86% and 2.66% annually during 1990–2023. Although mortality and DALY rates increased overall, segmented analysis showed a 1.21% annual mortality decline and slower DALY growth of 0.37% annually during 2012–2023. By 2023, these rates were 17.9% and 5.9% below their respective peaks. Females had higher incidence, mortality, and DALY rates, whereas males experienced faster long-term increases. Among individuals aged 15–89, decomposition analysis attributed the increase in T2DM cases to changes in age-specific incidence rates (51.2%), population growth (45.6%), and population aging (3.2%). Age–period–cohort analysis showed that fitted incidence was highest at ages 45–54, whereas the fastest annual increase occurred at ages 15–19. Age-standardized incidence was projected to reach 624 per 100,000 population in 2025 (95% prediction interval 619–628) and 1,223 in 2050 (1,073–1,394). Conclusion Egypt’s T2DM burden continues to grow, driven largely by increasing age-specific incidence and population growth. Projections suggest a substantial further rise in incidence by 2050, reinforcing the need for sustained prevention and early detection. National strategies should prioritize population-level risk reduction, timely diagnosis, and integrated care to reduce complications, disability, and premature mortality.