Global burden of type 1 diabetes in adults aged 65 years and older, 1990-2019: population based study
- PMID: 38866425
- PMCID: PMC11167563
- DOI: 10.1136/bmj-2023-078432
Global burden of type 1 diabetes in adults aged 65 years and older, 1990-2019: population based study
Abstract
Objectives: To estimate the burden, trends, and inequalities of type 1 diabetes mellitus (T1DM) among older adults at global, regional, and national level from 1990 to 2019.
Design: Population based study.
Population: Adults aged ≥65 years from 21 regions and 204 countries and territories (Global Burden of Disease and Risk Factors Study 2019)from 1990 to 2019.
Main outcome measures: Primary outcomes were T1DM related age standardised prevalence, mortality, disability adjusted life years (DALYs), and average annual percentage change.
Results: The global age standardised prevalence of T1DM among adults aged ≥65 years increased from 400 (95% uncertainty interval (UI) 332 to 476) per 100 000 population in 1990 to 514 (417 to 624) per 100 000 population in 2019, with an average annual trend of 0.86% (95% confidence interval (CI) 0.79% to 0.93%); while mortality decreased from 4.74 (95% UI 3.44 to 5.9) per 100 000 population to 3.54 (2.91 to 4.59) per 100 000 population, with an average annual trend of -1.00% (95% CI -1.09% to -0.91%), and age standardised DALYs decreased from 113 (95% UI 89 to 137) per 100 000 population to 103 (85 to 127) per 100 000 population, with an average annual trend of -0.33% (95% CI -0.41% to -0.25%). The most significant decrease in DALYs was observed among those aged <79 years: 65-69 (-0.44% per year (95% CI -0.53% to -0.34%)), 70-74 (-0.34% per year (-0.41% to -0.27%)), and 75-79 years (-0.42% per year (-0.58% to -0.26%)). Mortality fell 13 times faster in countries with a high sociodemographic index versus countries with a low-middle sociodemographic index (-2.17% per year (95% CI -2.31% to -2.02%) v -0.16% per year (-0.45% to 0.12%)). While the highest prevalence remained in high income North America, Australasia, and western Europe, the highest DALY rates were found in southern sub-Saharan Africa, Oceania, and the Caribbean. A high fasting plasma glucose level remained the highest risk factor for DALYs among older adults during 1990-2019.
Conclusions: The life expectancy of older people with T1DM has increased since the 1990s along with a considerable decrease in associated mortality and DALYs. T1DM related mortality and DALYs were lower in women aged ≥65 years, those living in regions with a high sociodemographic index, and those aged <79 years. Management of high fasting plasma glucose remains a major challenge for older people with T1DM, and targeted clinical guidelines are needed.
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ.
Conflict of interest statement
Competing interests: All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/disclosure-of-interest/ and declare: support from the National Natural Science Foundation of China and the China Postdoctoral Science Foundation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Figures
![Fig 1](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/11167563/bin/yank078432.f1.gif)
![Fig 2](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/11167563/bin/yank078432.f2.gif)
![Fig 3](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/11167563/bin/yank078432.f3.gif)
![Fig 4](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/11167563/bin/yank078432.f4.gif)
Similar articles
-
Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021.Lancet. 2024 May 18;403(10440):2204-2256. doi: 10.1016/S0140-6736(24)00685-8. Lancet. 2024. PMID: 38762325 Free PMC article.
-
Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet. 2018 Nov 10;392(10159):1923-1994. doi: 10.1016/S0140-6736(18)32225-6. Epub 2018 Nov 8. Lancet. 2018. PMID: 30496105 Free PMC article.
-
Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021.Lancet. 2024 May 18;403(10440):2133-2161. doi: 10.1016/S0140-6736(24)00757-8. Epub 2024 Apr 17. Lancet. 2024. PMID: 38642570 Free PMC article.
-
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.Lancet. 2023 Jul 15;402(10397):203-234. doi: 10.1016/S0140-6736(23)01301-6. Epub 2023 Jun 22. Lancet. 2023. PMID: 37356446 Free PMC article.
-
Epidemiology of Cancer in Older Adults: A Systematic Review.Curr Oncol Rep. 2024 Jul 4. doi: 10.1007/s11912-024-01567-w. Online ahead of print. Curr Oncol Rep. 2024. PMID: 38963522 Review.
References
-
- World Health Organization (WHO) Diabetes . 2023. https://www.who.int/news-room/fact-sheets/detail/diabetes.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical