Cited by 4,684Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and ResearchGlobal Health and Epidemiology

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Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Open access
Ong, Kanyin Liane, Stafford, Lauryn K, McLaughlin, Susan A, Boyko, Edward J, Vollset, Stein Emil, Smith, Amanda E, Dalton, Bronte E, Duprey, Joe, Cruz, Jessica A, Hagins, Hailey, Lindstedt, Paulina A, Aali, Amirali, Abate, Yohannes Habtegiorgis, Abate, Melsew Dagne, Abbasian, Mohammadreza, Abbasi-Kangevari, Zeinab, Abbasi-Kangevari, Mohsen, Abd ElHafeez, Samar, Abd-Rabu, Rami, Abdulah, Deldar Morad, Abdullah, Abu Yousuf Md, Abedi, Vida, Abidi, Hassan, Aboagye, Richard Gyan, Abolhassani, Hassan, Abu-Gharbieh, Eman, Abu-Zaid, Ahmed, Adane, Tigist Demssew, Adane, Denberu Eshetie, Addo, Isaac Yeboah, Adegboye, Oyelola A, Adekanmbi, Victor, Adepoju, Abiola Victor, Adnani, Qorinah Estiningtyas Sakilah, Afolabi, Rotimi Felix, Agarwal, Gina, Aghdam, Zahra Babaei, Agudelo-Botero, Marcela, Aguilera Arriagada, Constanza Elizabeth, Agyemang-Duah, Williams, Ahinkorah, Bright Opoku, Ahmad, Danish, Ahmad, Rizwan, Ahmad, Sajjad, Ahmad, Aqeel, Ahmadi, Ali, Ahmadi, Keivan, Ahmed, Ayman, Ahmed, Ali, 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Abstract

BACKGROUND: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. METHODS: Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. FINDINGS: In 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8-6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7-9·9]) and, at the regional level, in Oceania (12·3% [11·5-13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1-79·5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1-96·8) of diabetes cases and 95·4% (94·9-95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5-71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5-30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22-1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1-17·6) in north Africa and the Middle East and 11·3% (10·8-11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. INTERPRETATION: Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. FUNDING: Bill & Melinda Gates Foundation.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In 2021, an estimated 529 million people worldwide were living with diabetes, with a global age-standardised prevalence of 6·1%, and type 2 diabetes accounted for 96·0% of cases and 95·4% of diabetes DALYs. Projections indicate more than 1·31 billion people will have diabetes by 2050, with no countries or territories expected to see prevalence decrease.

Key findings

In 2021, there were 529 million (95% UI 500–564) people with diabetes globally, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5); type 2 diabetes made up 96·0% (95·1–96·8) of cases and 95·4% (94·9–95·9) of DALYs.

  • The highest age-standardised rates were in north Africa and the Middle East (9·3% [8·7–9·9]) and, regionally, Oceania (12·3% [11·5–13·0]); Qatar had the highest age-specific prevalence at 76·1% (73·1–79·5) in people aged 75–79 years.
  • High BMI was the leading risk factor, accounting for 52·2% (25·5–71·8) of global type 2 diabetes DALYs in 2021, and its contribution rose by 24·3% (18·5–30·4) between 1990 and 2021.
  • By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with global age-standardised total prevalence expected to reach 9·8% (9·4–10·2); 89 (43·6%) of 204 countries and territories are projected to exceed 10%, and no countries are expected to see a decrease.

Methods

The study produced estimates for 204 countries and territories across 25 age groups for males and females separately and combined, covering prevalence, mortality, YLLs, YLDs, and DALYs from 1990 to 2021, plus type-specific proportions, risk-attributable burden, and forecasts to 2050.

  • Mortality was modelled with CODEm using 25 666 location-years of vital registration and verbal autopsy data; non-fatal estimates used DisMod-MR 2.1 with 1527 location-years from 172 countries, and type 2 diabetes was computed by subtracting type 1 diabetes from total diabetes.
  • Risk-attributable type 2 diabetes burden was estimated for 16 risk factors using comparative risk assessment; forecasting used regression models with Socio-demographic Index for type 1 diabetes and high BMI for type 2 diabetes.

Limitations

Stated by the paper: self-reported diabetes not validated by blood glucose tests was excluded; estimates and forecasts do not reflect COVID-19 impacts in 2020–2021; ICD coding variation and reallocation of unspecified diabetes deaths relied on data from high-income and high-middle-income locations; single glucose tests may overestimate prevalence; blood collection method was missing for about half of data sources; gestational and monogenic diabetes were not modelled; all individuals younger than 15 years were assumed to have type 1 diabetes; and risk factor analyses were limited to modifiable risk–outcome pairs, with no cohort effects except tobacco.

  • Evident from the text: type 2 diabetes estimates were derived by subtracting type 1 diabetes from total diabetes because available data labelled as type 2 were not considered accurate, so type 2 estimates depend on the type 1 model; forecasts use only SDI for type 1 and high BMI for type 2 as predictors, not all known risk factors.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/s0140-6736(23)01301-6

Cites

90 of 90 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Figure 1 Age-standardised total diabetes prevalence rates in 2021 ATG=Antigua and Barbuda. VCT=Saint Vincent and the Grenadines. LCA=Saint Lucia. TTO=Trinidad and Tobago. Isl=Islands. FSM=Federated States of Micronesia. TLS=Timor-Leste.
Figure 1 Age-standardised total diabetes prevalence rates in 2021 ATG=Antigua and Barbuda. VCT=Saint Vincent and the Grenadines. LCA=Saint Lucia. TTO=Trinidad and Tobago. Isl=Islands. FSM=Federated States of Micronesia. TLS=Timor-Leste.CC BY · PubMed Central
Figure 2 Prevalence of total diabetes by age and GBD super-region in 2021 The shaded areas represent 95% uncertainty intervals. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study.
Figure 2 Prevalence of total diabetes by age and GBD super-region in 2021 The shaded areas represent 95% uncertainty intervals. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study.CC BY · PubMed Central
Figure 3 Change from 1990 to 2021 in population attributable fraction for high BMI in relation to type 2 diabetes, by GBD super-region BMI=body-mass index. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study.
Figure 3 Change from 1990 to 2021 in population attributable fraction for high BMI in relation to type 2 diabetes, by GBD super-region BMI=body-mass index. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study.CC BY · PubMed Central
Figure 4 Global age-standardised prevalence of type 1 and type 2 diabetes from 1990 through 2050 forecasts The shaded area represents 95% uncertainty intervals. Total diabetes is the sum of type 1 and type 2 diabetes.
Figure 4 Global age-standardised prevalence of type 1 and type 2 diabetes from 1990 through 2050 forecasts The shaded area represents 95% uncertainty intervals. Total diabetes is the sum of type 1 and type 2 diabetes.CC BY · PubMed Central

Verification

Claims the paper makes

97 Own result · 15 Own method · 10 Partly supported · 8 Own interpretation · 4 Sources not found · 3 Supported so far · 2 Supported · 2 Couldn’t confirm · 2 No full text of the sources · 2 No basis given · 1 Not checked yet · accuracy not yet measured

Show all 76 claims

  • It may state two separate claims as one. 31
  • Probably not a substantial claim. 44
  • The quote only partly states this claim. 1
70 of 70
  • The authors state this as an assumption.

    All deaths due to diabetes in people younger than 15 years were from type 1 diabetes.

    “We assumed that all deaths due to diabetes in people younger than 15 years were from type 1 diabetes.”
  • The authors state this as an assumption.

    There was no remission (no cure) in the type 1 diabetes model.

    “We assumed there was no remission (ie, no cure).”
  • The authors state this as an assumption.

    Annual remission in the total diabetes model could be no more than 1%.

    “and assumed that annual remission could be no more than 1% (appendix sections 4.3.1 and 4.3.2).”
  • The authors state this as an assumption.

    All diabetes cases in people aged younger than 15 years were type 1 diabetes.

    “For data from people aged younger than 15 years, we assumed that all diabetes cases were type 1 diabetes”
  • The authors state this as an assumption.

    All patients aged younger than 15 years with diabetes had sought hospital care due to their insulin dependence.

    “and that all patients had sought hospital care due to their insulin dependence.”
  • The authors state this as an assumption.

    Reporting bias in self-reported diabetes data changes over time and across location.

    “we assumed that reporting bias would change over time and across location (eg, due to variability in diagnostic and screening efficacy), thus making bias adjustment challenging.”
  • The authors state this as an assumption.

    All individuals younger than 15 years have type 1 diabetes.

    “GBD currently assumes that all individuals younger than 15 years have type 1 diabetes.”
  • The authors state this as an assumption.

    SDI is a good proxy for better access to care leading to a lower case fatality rate, and to increases in type 1 diabetes prevalence.

    “However, we believe that SDI is a good proxy for better access to care leading to a lower case fatality rate, and to increases in type 1 diabetes prevalence.”
  • The paper relies on this without support.

    Type 1 and type 2 diabetes differ with respect to risk factor profiles and underlying pathophysiology.

    “Differences between type 1 and type 2 diabetes with respect to risk factor profiles and underlying pathophysiology”
  • The paper relies on this without support.

    Hyperglycaemia leads to similar complications for both type 1 and type 2 diabetes.

    “given that hyperglycaemia leads to similar complications for both types”
  • The paper relies on this without support.

    Type 2 diabetes can in some cases be prevented.

    “Although type 2 diabetes can in some cases be prevented”
  • The paper relies on this without support.

    Management of hyperglycaemia has the potential to improve outcomes.

    “management of hyperglycaemia has the potential to improve outcomes”
  • The paper relies on this without support.

    Type 2 diabetes continues to be a major public health problem due to high rates of obesity.

    “the disease continues to be a major public health problem due to high rates of obesity that place an increasing burden on individuals and health-care systems alike”
13 of 13

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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

2 of 2

Citations

Cites

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Metadata

Authors
Ong, K. L., Stafford, L. K., McLaughlin, S. A., Boyko, E. J., Vollset, S. E., Smith, A. E., Dalton, B. E., Duprey, J., Cruz, J. A., Hagins, H., Lindstedt, P. A., Aali, A., Abate, Y. H., Abate, M. D., Abbasian, M., Abbasi-Kangevari, Z., Abbasi-Kangevari, M., Abd ElHafeez, S., Abd-Rabu, R., Abdulah, D. M., Abdullah, A. Y. M., Abedi, V., Abidi, H., Aboagye, R. G., Abolhassani, H., Abu-Gharbieh, E., Abu-Zaid, A., Adane, T. D., Adane, D. E., Addo, I. Y., Adegboye, O. A., Adekanmbi, V., Adepoju, A. V., Adnani, Q. E. S., Afolabi, R. F., Agarwal, G., Aghdam, Z. B., Agudelo-Botero, M., Aguilera Arriagada, C. E., Agyemang-Duah, W., Ahinkorah, B. O., Ahmad, D., Ahmad, R., Ahmad, S., Ahmad, A., Ahmadi, A., Ahmadi, K., Ahmed, A., Ahmed, A., Ahmed, L. A., Ahmed, S. A., Ajami, M., Akinyemi, R. O., Al Hamad, H., Al Hasan, S. M., AL-Ahdal, T. M. A., Alalwan, T. A., Al-Aly, Z., AlBataineh, M. T., Alcalde-Rabanal, J. E., Alemi, S., Ali, H., Alinia, T., Aljunid, S. M., Almustanyir, S., Al-Raddadi, R. M., Alvis-Guzman, N., Amare, F., Ameyaw, E. K., Amiri, S., Amusa, G. A., Andrei, C. L., Anjana, R. M., Ansar, A., Ansari, G., Ansari-Moghaddam, A., Anyasodor, A. E., Arabloo, J., Aravkin, A. Y., Areda, D., Arifin, H., Arkew, M., Armocida, B., Ärnlöv, J., Artamonov, A. A., Arulappan, J., Aruleba, R. T., Arumugam, A., Aryan, Z., Asemu, M. T., Asghari-Jafarabadi, M., Askari, E., Asmelash, D., Astell-Burt, T., Athar, M., Athari, S. S., Atout, M. M. W., Avila-Burgos, L., Awaisu, A., Azadnajafabad, S., B, D. B., Babamohamadi, H., Badar, M., Badawi, A., Badiye, A. D., Baghcheghi, N., Bagheri, N., Bagherieh, S., Bah, S., Bahadory, S., Bai, R., Baig, A. A., Baltatu, O. C., Baradaran, H. R., Barchitta, M., Bardhan, M., Barengo, N. C., Bärnighausen, T. W., Barone, M. T. U., Barone-Adesi, F., Barrow, A., Bashiri, H., Basiru, A., Basu, S., Basu, S., Batiha, A.-M. M., Batra, K., Bayih, M. T., Bayileyegn, N. S., Behnoush, A. H., Bekele, A. B., Belete, M. A., Belgaumi, U. I., Belo, L., Bennett, D. A., Bensenor, I. M., Berhe, K., Berhie, A. Y., Bhaskar, S., Bhat, A. N., Bhatti, J. S., Bikbov, B., Bilal, F., Bintoro, B. S., Bitaraf, S., Bitra, V. R., Bjegovic-Mikanovic, V., Bodolica, V., Boloor, A., Brauer, M., Brazo-Sayavera, J., Brenner, H., Butt, Z. A., Calina, D., Campos, L. A., Campos-Nonato, I. R., Cao, Y., Cao, C., Car, J., Carvalho, M., Castañeda-Orjuela, C. A., Catalá-López, F., Cerin, E., Chadwick, J., Chandrasekar, E. K., Chanie, G. S., Charan, J., Chattu, V. K., Chauhan, K., Cheema, H. A., Chekol Abebe, E., Chen, S., Cherbuin, N., Chichagi, F., Chidambaram, S. B., Cho, W. C. S., Choudhari, S. G., Chowdhury, R., Chowdhury, E. K., Chu, D.-T., Chukwu, I. S., Chung, S.-C., Coberly, K., Columbus, A., Contreras, D., Cousin, E., Criqui, M. H., Cruz-Martins, N., Cuschieri, S., Dabo, B., Dadras, O., Dai, X., Damasceno, A. A. M., Dandona, R., Dandona, L., Das, S., Dascalu, A. M., Dash, N. R., Dashti, M., Dávila-Cervantes, C. A., De la Cruz-Góngora, V., Debele, G. R., Delpasand, K., Demisse, F. W., Demissie, G. D., Deng, X., Denova-Gutiérrez, E., Deo, S. V., Dervišević, E., Desai, H. D., Desale, A. T., Dessie, A. M., Desta, F., Dewan, S. M. R., Dey, S., Dhama, K., Dhimal, M., Diao, N., Diaz, D., Dinu, M., Diress, M., Djalalinia, S., Doan, L. P., Dongarwar, D., dos Santos Figueiredo, F. W., Duncan, B. B., Dutta, S., Dziedzic, A. M., Edinur, H. A., Ekholuenetale, M., Ekundayo, T. C., Elgendy, I. Y., Elhadi, M., El-Huneidi, W., Elmeligy, O. A. A., Elmonem, M. A., Endeshaw, D., Esayas, H. L., Eshetu, H. B., Etaee, F., Fadhil, I., Fagbamigbe, A. F., Fahim, A., Falahi, S., Faris, M. E. M., Farrokhpour, H., Farzadfar, F., Fatehizadeh, A., Fazli, G., Feng, X., Ferede, T. Y., Fischer, F., Flood, D., Forouhari, A., Foroumadi, R., Foroutan Koudehi, M., Gaidhane, A. M., Gaihre, S., Gaipov, A., Galali, Y., Ganesan, B., Garcia-Gordillo, M., Gautam, R. K., Gebrehiwot, M., Gebrekidan, K. G., Gebremeskel, T. G., Getacher, L., Ghadirian, F., Ghamari, S.-H., Ghasemi Nour, M., Ghassemi, F., Golechha, M., Goleij, P., Golinelli, D., Gopalani, S. V., Guadie, H. A., Guan, S.-Y., Gudayu, T. W., Guimarães, R. A., Guled, R. A., Gupta, R., Gupta, K., Gupta, V. B., Gupta, V. K., Gyawali, B., Haddadi, R., Hadi, N. R., Haile, T. G., Hajibeygi, R., Haj-Mirzaian, A., Halwani, R., Hamidi, S., Hankey, G. J., Hannan, M. A., Haque, S., Harandi, H., Harlianto, N. I., Hasan, S. M. M., Hasan, S. S., Hasani, H., Hassanipour, S., Hassen, M. B., Haubold, J., Hayat, K., Heidari, G., Heidari, M., Hessami, K., Hiraike, Y., Holla, R., Hossain, S., Hossain, M. S., Hosseini, M.-S., Hosseinzadeh, M., Hosseinzadeh, H., Huang, J., Huda, M. N., Hussain, S., Huynh, H.-H., Hwang, B.-F., Ibitoye, S. E., Ikeda, N., Ilic, I. M., Ilic, M. D., Inbaraj, L. R., Iqbal, A., Islam, S. M. S., Islam, R. M., Ismail, N. E., Iso, H., Isola, G., Itumalla, R., Iwagami, M., Iwu, C. C. D., Iyamu, I. O., Iyasu, A. N., Jacob, L., Jafarzadeh, A., Jahrami, H., Jain, R., Jaja, C., Jamalpoor, Z., Jamshidi, E., Janakiraman, B., Jayanna, K., Jayapal, S. K., Jayaram, S., Jayawardena, R., Jebai, R., Jeong, W., Jin, Y., Jokar, M., Jonas, J. B., Joseph, N., Joseph, A., Joshua, C. E., Joukar, F., Jozwiak, J. J., Kaambwa, B., Kabir, A., Kabthymer, R. H., Kadashetti, V., Kahe, F., Kalhor, R., Kandel, H., Karanth, S. D., Karaye, I. M., Karkhah, S., Katoto, P. D., Kaur, N., Kazemian, S., Kebede, S. A., Khader, Y. S., Khajuria, H., Khalaji, A., Khan, M. A., Khan, M., Khan, A., Khanal, S., Khatatbeh, M. M., Khater, A. M., Khateri, S., khorashadizadeh, F., Khubchandani, J., Kibret, B. G., Kim, M. S., Kimokoti, R. W., Kisa, A., Kivimäki, M., Kolahi, A.-A., Komaki, S., Kompani, F., Koohestani, H. R., Korzh, O., Kostev, K., Kothari, N., Koyanagi, A., Krishan, K., Krishnamoorthy, Y., Kuate Defo, B., Kuddus, M., Kuddus, M. A., Kumar, R., Kumar, H., Kundu, S., Kurniasari, M. D., Kuttikkattu, A., La Vecchia, C., Lallukka, T., Larijani, B., Larsson, A. O., Latief, K., Lawal, B. K., Le, T. T. T., Le, T. T. B., Lee, S. W. H., Lee, M., Lee, W.-C., Lee, P. H., Lee, S.-W., Lee, S. W., Legesse, S. M., Lenzi, J., Li, Y., Li, M.-C., Lim, S. S., Lim, L.-L., Liu, X., Liu, C., Lo, C.-H., Lopes, G., Lorkowski, S., Lozano, R., Lucchetti, G., Maghazachi, A. A., Mahasha, P. W., Mahjoub, S., Mahmoud, M. A., Mahmoudi, R., Mahmoudimanesh, M., Mai, A. T., Majeed, A., Majma Sanaye, P., Makris, K. C., Malhotra, K., Malik, A. A., Malik, I., Mallhi, T. H., Malta, D. C., Mamun, A. A., Mansouri, B., Marateb, H. R., Mardi, P., Martini, S., Martorell, M., Marzo, R. R., Masoudi, R., Masoudi, S., Mathews, E., Maugeri, A., Mazzaglia, G., Mekonnen, T., Meshkat, M., Mestrovic, T., Miao Jonasson, J., Miazgowski, T., Michalek, I. M., Minh, L. H. N., Mini, G., Miranda, J. J., Mirfakhraie, R., Mirrakhimov, E. M., Mirza-Aghazadeh-Attari, M., Misganaw, A., Misgina, K. H., Mishra, M., Moazen, B., Mohamed, N. S., Mohammadi, E., Mohammadi, M., Mohammadian-Hafshejani, A., Mohammadshahi, M., Mohseni, A., Mojiri-forushani, H., Mokdad, A. H., Momtazmanesh, S., Monasta, L., Moniruzzaman, M., Mons, U., Montazeri, F., Moodi Ghalibaf, A., Moradi, Y., Moradi, M., Moradi Sarabi, M., Morovatdar, N., Morrison, S. D., Morze, J., Mossialos, E., Mostafavi, E., Mueller, U. O., Mulita, F., Mulita, A., Murillo-Zamora, E., Musa, K. I., Mwita, J. C., Nagaraju, S. P., Naghavi, M., Nainu, F., Nair, T. S., Najmuldeen, H. H. R., Nangia, V., Nargus, S., Naser, A. Y., Nassereldine, H., Natto, Z. S., Nauman, J., Nayak, B. P., Ndejjo, R., Negash, H., Negoi, R. I., Nguyen, H. T. H., Nguyen, D. H., Nguyen, P. T., Nguyen, V. T., Nguyen, H. Q., Niazi, R. K., Nigatu, Y. T., Ningrum, D. N. A., Nizam, M. A., Nnyanzi, L. A., Noreen, M., Noubiap, J. J., Nzoputam, O. J., Nzoputam, C. I., Oancea, B., Odogwu, N. M., Odukoya, O. O., Ojha, V. A., Okati-Aliabad, H., Okekunle, A. P., Okonji, O. C., Okwute, P. G., Olufadewa, I. I., Onwujekwe, O. E., Ordak, M., Ortiz, A., Osuagwu, U. L., Oulhaj, A., Owolabi, M. O., Padron-Monedero, A., Padubidri, J. R., Palladino, R., Panagiotakos, D., Panda-Jonas, S., Pandey, A., Pandey, A., Pandi-Perumal, S. R., Pantea Stoian, A. M., Pardhan, S., Parekh, T., Parekh, U., Pasovic, M., Patel, J., Patel, J. R., Paudel, U., Pepito, V. C. F., Pereira, M., Perico, N., Perna, S., Petcu, I.-R., Petermann-Rocha, F. E., Podder, V., Postma, M. J., Pourali, G., Pourtaheri, N., Prates, E. J. S., Qadir, M. M. F., Qattea, I., Raee, P., Rafique, I., Rahimi, M., Rahimifard, M., Rahimi-Movaghar, V., Rahman, M. O., Rahman, M. A., Rahman, M. H. U., Rahman, M., Rahman, M. M., Rahmani, M., Rahmani, S., Rahmanian, V., Rahmawaty, S., Rahnavard, N., Rajbhandari, B., Ram, P., Ramazanu, S., Rana, J., Rancic, N., Ranjha, M. M. A. N., Rao, C. R., Rapaka, D., Rasali, D. P., Rashedi, S., Rashedi, V., Rashid, A. M., Rashidi, M.-M., Ratan, Z. A., Rawaf, S., Rawal, L., Redwan, E. M. M., Remuzzi, G., Rengasamy, K. R., Renzaho, A. M. N., Reyes, L. F., Rezaei, N., Rezaei, N., Rezaeian, M., Rezazadeh, H., Riahi, S. M., Rias, Y. A., Riaz, M., Ribeiro, D., Rodrigues, M., Rodriguez, J. A. B., Roever, L., Rohloff, P., Roshandel, G., Roustazadeh, A., Rwegerera, G. M., Saad, A. M. A., Saber-Ayad, M. M., Sabour, S., Sabzmakan, L., Saddik, B., Sadeghi, E., Saeed, U., Saeedi Moghaddam, S., Safi, S., Safi, S. Z., Saghazadeh, A., Saheb Sharif-Askari, N., Saheb Sharif-Askari, F., Sahebkar, A., Sahoo, S. S., Sahoo, H., Saif-Ur-Rahman, K., Sajid, M. R., Salahi, S., Salahi, S., Saleh, M. A., Salehi, M. A., Salomon, J. A., Sanabria, J., Sanjeev, R. K., Sanmarchi, F., Santric-Milicevic, M. M., Sarasmita, M. A., Sargazi, S., Sathian, B., Sathish, T., Sawhney, M., Schlaich, M. P., Schmidt, M. I., Schuermans, A., Seidu, A.-A., Senthil Kumar, N., Sepanlou, S. 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M., Tualeka, A. R., Tufa, D. G., Tyrovolas, S., Ullah, S., Upadhyay, E., Vahabi, S. M., Vaithinathan, A. G., Valizadeh, R., van Daalen, K. R., Vart, P., Varthya, S. B., Vasankari, T. J., Vaziri, S., Verma, M. V., Verras, G.-I., Vo, D. C., Wagaye, B., Waheed, Y., Wang, Z., Wang, Y., Wang, C., Wang, F., Wassie, G. T., Wei, M. Y. W., Weldemariam, A. H., Westerman, R., Wickramasinghe, N. D., Wu, Y., Wulandari, R. D., Xia, J., Xiao, H., Xu, S., Xu, X., Yada, D. Y., Yang, L., Yatsuya, H., Yesiltepe, M., Yi, S., Yohannis, H. K., Yonemoto, N., You, Y., Zaman, S. B., Zamora, N., Zare, I., Zarea, K., Zarrintan, A., Zastrozhin, M. S., Zeru, N. G., Zhang, Z.-J., Zhong, C., Zhou, J., Zielińska, M., Zikarg, Y. T., Zodpey, S., Zoladl, M., Zou, Z., Zumla, A., Zuniga, Y. M. H., Magliano, D. J., Murray, C. J. L., Hay, S. I., & Vos, T.
Affiliations
University of Washington (US)
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2023-07
Volume
402
Issue
10397
Pages
203-234
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
OpenAlex
W4381799391
Cited by
4,681
References
91
Citations by year
2026: 1296 · 2025: 1970 · 2024: 1249 · 2023: 162
FWCI
773.24
Type
journal article
Language
en
Open access
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  • Florence Research (University of Florence) (submittedVersion, cc-by-nc-nd)
  • Lirias (KU Leuven) (submittedVersion, cc-by)
  • PubMed Central (submittedVersion, cc-by)
  • UpSpace Institutional Repository (University of Pretoria) (submittedVersion, cc-by)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
  • AJOU Open Repository (Ajou University) (submittedVersion)
  • Digital Scholarship - UNLV (University of Nevada Reno) (submittedVersion, cc-by)
  • Charles Sturt University Research Output (CRO) (submittedVersion, cc-by)
  • Kharkiv National Medical University Repository (Kharkiv National Medical University) (submittedVersion)
  • Research Online (University of Wollongong) (submittedVersion)
  • National University of Singapore (submittedVersion)
  • FedUni ResearchOnline (Federation University Australia) (submittedVersion, cc-by)
  • KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
  • Aberdeen University Research Archive (Aberdeen University) (submittedVersion, cc-by)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
  • DR-NTU (Nanyang Technological University) (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, cc-by)
  • Estudo Geral (Universidad de Coimbra) (submittedVersion, cc-by)
  • Figshare (submittedVersion, cc-by)
  • Figshare (submittedVersion)
  • Työväentutkimus Vuosikirja (submittedVersion)
  • TeesRep (Teesside University) (submittedVersion, cc-by)
  • Intellectum (Universidad de La Sabana) (submittedVersion, cc-by-nc-nd)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
  • Huddersfield Research Portal (University of Huddersfield) (submittedVersion, cc-by)
  • Qatar University QSpace (Qatar University) (submittedVersion, cc-by-nc-nd)
  • Griffith Research Online (submittedVersion, cc-by)
  • Spiral (Imperial College London) (submittedVersion, other-oa)
  • Tampere University Institutional Repository (Tampere University) (submittedVersion, cc-by)
Funders
  • Heart Foundation
  • European Commission
  • Fundação de Amparo à Pesquisa do Estado de Minas Gerais
  • National Health and Medical Research Council
  • Taibah University
  • International Medical University
  • Ministry of Education
  • McGill University
  • Universitätsklinikum Essen
  • National Institute of Biomedical Innovation
  • King Abdulaziz City for Science and Technology
  • Universidad de La Sabana
  • University of Aberdeen
  • Manipal Academy of Higher Education
  • Public Health Agency of Canada
  • Ministero della Salute (34/2017)
  • Academy of Scientific Research and Technology
  • University of Sydney
  • Medical Research Council
  • Ateneo de Manila University
  • Deutsche Forschungsgemeinschaft (FU 356/12-2)
  • Wellcome Trust (221854/Z/20/Z, R024227)
  • Ministarstvo Prosvete, Nauke i Tehnološkog Razvoja (2011-2023)
  • Office of the Secretary of Transportation
  • China Medical University, Taiwan (CMU111-MF-55)
  • National Heart, Lung, and Blood Institute (CENTRO-04-3559-FSE-000162, K23HL157766)
  • Horizon 2020 Framework Programme (EDCTP-RIA2016E-1609)
  • Central University of Kerala
  • European and Developing Countries Clinical Trials Partnership
  • Belgian American Educational Foundation
  • JSS Academy of Higher Education and Research
  • Universiti Kebangsaan Malaysia
  • Chandigarh University
  • Korea Institute for Advancement of Technology
  • University Grants Commission
  • Marga und Walter Boll-Stiftung
  • Ministry of Higher Education, Malaysia (FRGS/1/2020/STG03/USM/03/5)
  • National Research Foundation of Korea (NRF-2021R1I1A4A01057428)
  • Ministry of Trade, Industry and Energy (P0017805)
  • National Natural Science Foundation of China (72204112)
  • National Institute on Aging (R01AG062553)
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico (304224/2022-7)
  • Instituto de Salud Carlos III (RD21/0005/0001)
  • National Science and Technology Council (NSTC 111-2410-H-003-100-SSS)
  • Bundesministerium für Bildung und Forschung (01EA1808A)
  • Research Council of Finland (350426)
  • Wellcome Trust DBT India Alliance (IA/CPHE/17/1/503345)
  • Applied Molecular Biosciences Unit (LA/P/0140/2020)
  • National Heart Foundation of Australia (102597)
  • Bill and Melinda Gates Foundation
  • Department of Biotechnology, Ministry of Science and Technology, India
  • King Abdulaziz University
  • Jazan University
  • Social Science Foundation of Jiangsu Province (21GLD008)
  • Fundação para a Ciência e a Tecnologia (UIDB/04084/2020, UIDP/04378/2020, UIDB/04378/2020)
  • Science and Technology Development Fund
  • Università ta' Malta
  • Australian Research Council (FT220100857)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Epidemiology
Keywords
diabetes mellitus, type 1 diabetes, type 2 diabetes, diabetes prevalence, diabetes mortality, disability-adjusted life years, years of life lost, years lived with disability, risk factors, body mass index, physical activity, tobacco use, alcohol consumption, dietary factors, sex differences, age differences, global burden of disease
MeSH terms
Global Burden of Disease, Aged, Bayes Theorem, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Life Expectancy, Male, Risk Factors, Global Health, Prevalence, Quality-Adjusted Life Years

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-16, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-16 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Cited sources are checked with a language model’s help (gpt-6-sol).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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