Abstract
Backgroud:Diabetes mellitus is a common chronic disease and a severe public health issue. The incidence trends for type 1 diabetes (TIDM) and type 2 diabetes (T2DM) have rarely been studied on a global scale. We aimed to determine the temporal and geographical trends of diabetes globally. Methods:We collected detailed information on diabetes during 1990-2017 based on the 2017 Global Burden of Disease Study and calculated the estimated annual percentage changes (EAPCs) in age-standardized incidence rate (ASR) of diabetes mellitus according to sex, region, and disease type. Results:The incidence of diabetes mellitus increased by 102.9% worldwide, from 11,303,084 cases in 1990 to 22,935,630 cases in 2017, while the ASR increased from 233.6 per 100,000 person-year (py) to 284.6 per 100,000py [EAPC=0.87, 95% confidence interval (CI):0.79,0.96]. The global ASRs of T1DM and T2DM demonstrated significantly increasing trends during 1990-2017, with EAPC of 0.34(95% CI:0.30,0.39) and 0.89 (95% CI:0.80,0.97), respectively. The incidence trends also varied considerably by regions and countries. The increase in ASR was largest in high-SDI regions (EAPC=1.05, 95% CI:0.92,1.17) and smallest in low-SDI regions (EAPC=0.79, 95% CI:0.71,0.88).The EAPC of diabetes mellitus showed a declining trend in countries with a high human development index (HDI). Conclusions: Diabetes mellitus is a worldwide public health problem. Both the number of cases and ASR of diabetes mellitus increased significantly during 1990-2017 worldwide, but the temporal trends varied markedly across regions and countries.In addition, the ASR of T1DM differed with latitude and the farther away from the equator, the higher the ASR in 2017.