Tracking three decades of type 1 diabetes‐related chronic kidney disease in East Asia: Burden, age–sex patterns, and quality of care index

ABSTRACT Background The escalating burden of type 1 diabetes‐related chronic kidney disease (CKD‐T1DM) presents a critical public health challenge worldwide. This study aims to comprehensively evaluate the longitudinal trends in disease burden and healthcare quality for CKD‐T1DM in East Asia compared with global patterns from 1990 to 2023. Methods Utilizing data from the Global Burden of Disease (GBD) Study 2023, we analyzed the age‐standardized incidence (ASIR), mortality (ASMR), and disability‐adjusted life years (ASDR) rates of CKD‐T1DM. The Estimated Annual Percentage Change (EAPC) was calculated to quantify temporal trends. Additionally, a multidimensional quality of care index (QCI) was constructed using principal component analysis (PCA) based on four proxy indicators to assess and benchmark healthcare performance across East Asian countries. Results Contrary to the global trend of rising mortality and disability burdens, East Asia exhibited a significant concurrent decline in ASIR, ASMR, and ASDR from 1990 to 2023. However, substantial regional heterogeneity was observed: Japan and South Korea maintained consistently high QCI scores (63.8–75.0), while China, Mongolia, and North Korea lagged significantly behind. The study also confirmed a bimodal age‐specific incidence pattern peaking in adolescence (10–14 years) and older adulthood (55–69 years), alongside notable gender disparities in older populations. Conclusion East Asia has achieved remarkable progress in mitigating the CKD‐T1DM burden, diverging significantly from the global trajectory; however, deep structural inequities in care quality persist between high‐income and middle‐to‐low‐income nations. Integrating QCI into national monitoring systems and prioritizing comprehensive, lifespan‐oriented management strategies are essential to addressing these disparities and sustaining regional improvements.