The rates of type 2 diabetes in adolescents and young adults have increased significantly globally in the past 30 years, researchers report today.
Data analysis from 204 countries and regions show that high body mass index was the main attributable risk factor, but countries with a low-middle and middle sociodemographic index and women aged under 30 were particularly affected, the study found.
Although data suggest that early onset of type 2 diabetes is increasingly common, no study has specifically described the global burden of early onset type 2 diabetes, or the variations between the sexes and in countries with different levels of socioeconomic development, according to the Chinese research team.
Writing in the latest edition of *The BMJ*, the researchers, led by the School of Public Health, Harbin Medical University, Harbin, used data from the Global Burden of Disease Study 2019 to estimate incidence, deaths and disability adjusted life years (DALYs) due to type 2 diabetes in adolescents from the age of 15 and young adults up to 39 years from between 1990 and 2019.
They also examined the proportional DALY attributable to different risk factors, and data were assessed by age, sex and sociodemographic index.
They found the age standardised incidence rate for type 2 diabetes in adolescents and young adults globally increased from 117 per 100,000 population in 1990 to 183 in 2019, while the age standardised DALY rate increased from 106 per 100,000 in 1990 to 150 per 100,000 in 2019.
The age standardised mortality rate rose from 0.74 per 100,000 in 1990 to 0.77 per 100,000 in 2019.
Countries with a low-middle and middle sociodemographic index had the highest age standardised incidence rate and age standardised DALY rate in 2019, while countries with a low sociodemographic index had the lowest age standardised incidence rate but the highest age standardised mortality rate.
In the under-30s, women had higher mortality and DALY rates than men, but differences between the sexes were reversed in the over 30s, except in countries with a low sociodemographic index.
While high body mass index was the main contributory factor across the board, there were other risk factors in different regions. In countries with a high sociodemographic index there were higher proportions of ambient particulate air pollution (12% v 7%) and smoking (13% v 4%), while in countries with a low sociodemographic index there were higher proportions of household air pollution from solid fuels (17% v 0.07%) and diet low in fruit (9% v 6%).
However, the researchers point to some study limitations, such as differences in the definition of type 2 diabetes and a high probability of underdiagnosis in many countries.
They add: “Our study showed a clear upward trend of the burden of early onset type 2 diabetes from 1990 to 2019.
“These findings provide a basis for understanding the epidemic nature of early onset type 2 diabetes and call for urgent actions to deal with the issue from a global perspective.”
Xie J, Wang M, Long Z et al. Global burden of type 2 diabetes in adolescents and young adults, 1990-2019: systematic analysis of the Global Burden of Disease Study. *BMJ* 8 December 2022
Leave a Reply