Decoding the disproportionate risk factor landscape of global type 2 diabetes burden in adults: An attribution analysis from 1990 to 2050.

Introduction: Limited systematic assessments of risk factor contributions to the global burden of type 2 diabetes (T2D) across subpopulations hinder targeted policies and resource allocation.

Materials And Methods: Utilizing the Global Burden of Disease study (GBD) 2019, we analyzed the disability-adjusted life-years (DALYs) for T2D attributable to 15 risk factors in adults (aged 25+ years) globally and by sex, age, Socio-demographic Index (SDI), and GBD region, from 1990 to 2019. Additionally, we assessed future trends of these risk factors through 2050.

Results: High body-mass index (BMI) emerged as the predominant risk factor in all subpopulations in 2019, with its impact projected to double by 2050. During 1990-2019, males were more affected by smoking, while females by secondhand smoke and household air pollution. The related DALYs increased with age, except for high BMI and smoking peaking at 60-74 years. In 2019, diet high in processed meat ranked second in high SDI regions, contrasting with household air pollution in low SDI regions. National disparities were observed, with Fiji recording the highest rates of DALYs related to both high BMI and dietary risks in 2019, which were approximately 50 and 15 times higher than those observed in Japan, respectively.

Conclusions: Tailored interventions targeting major contributing risk factors specific to each subpopulation are key to the success of the global combat against T2D.