Objective:To analyze the prevalence, disease burden of type 2 diabetes mellitus (T2DM) and risk factors in China from 1990 to 2021 predict future trends and provide evidence for the development of precise prevention and control policies.Methods:Based on the Global Burden of Disease Study 2021 database, the data on disease burden and risk factors of T2DM in China and in the world from 1990 to 2021 were extracted. Age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized disability adjusted life year rate (ASDR) were used to evaluate the prevalence and disease burden of T2DM. Joinpoint regression models were used to calculate the average annual percentage change (AAPC) to evaluate change trends. Bayesian age-period-cohort analysis models were constructed to predict the prevalence and disease burden of T2DM from 2022 to 2046.Results:In 2021, the ASIR, ASPR, and ASDR of T2DM in China were 308.37/100 000, 10 626.04/100 000, and 1 050.47/100 000, which increased by 12.92% (AAPC=0.388%, P=0.009), 61.60% (AAPC=1.546%, P<0.001), and 25.26% (AAPC=0.756%, P<0.001) compared with 1990, respectively. However, the ASMR dropped to 15.84/100 000, a decrease of 4.75% (AAPC=0.122%, P=0.154). The prediction results showed that the ASPR and ASDR of T2DM in China would continue to increase steadily from 2022 to 2046 , which would increase to 19 732.71/100 000 and 1 941.25/100 000 in 2046, while the ASIR and ASMR would decrease to 258.35/100 000 and 11.49/100 000 in 2046. It is predicted that the annual ASIR, ASPR, ASMR, and ASDR of T2DM in China would remain lower than the global levels from 2022 to 2046. The disease burden level of T2DM was higher in men and the elderly in China. Based on data from China and the world, metabolic factors (high FPG glucose and high BMI) are consistently the main risk factors leading to the disease burden of T2DM, and ambient particulate matter pollution is the main environmental factor. While the global disease burden of T2DM attributed to smoking has become stabilized, China still maintains a relatively high level and the level is predicted to keep rising in the future. Conclusions:The disease burden of T2DM continues to increase in China, posing significant challenges for prevention and treatment. The prevention and intervention strategies should focus on the key modifiable risk factors.

Objective:To analyze the prevalence, disease burden of type 2 diabetes mellitus (T2DM) and risk factors in China from 1990 to 2021 predict future trends and provide evidence for the development of precise prevention and control policies.Methods:Based on the Global Burden of Disease Study 2021 database, the data on disease burden and risk factors of T2DM in China and in the world from 1990 to 2021 were extracted. Age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized disability adjusted life year rate (ASDR) were used to evaluate the prevalence and disease burden of T2DM. Joinpoint regression models were used to calculate the average annual percentage change (AAPC) to evaluate change trends. Bayesian age-period-cohort analysis models were constructed to predict the prevalence and disease burden of T2DM from 2022 to 2046.Results:In 2021, the ASIR, ASPR, and ASDR of T2DM in China were 308.37/100 000, 10 626.04/100 000, and 1 050.47/100 000, which increased by 12.92% (AAPC=0.388%, P=0.009), 61.60% (AAPC=1.546%, P<0.001), and 25.26% (AAPC=0.756%, P<0.001) compared with 1990, respectively. However, the ASMR dropped to 15.84/100 000, a decrease of 4.75% (AAPC=0.122%, P=0.154). The prediction results showed that the ASPR and ASDR of T2DM in China would continue to increase steadily from 2022 to 2046 , which would increase to 19 732.71/100 000 and 1 941.25/100 000 in 2046, while the ASIR and ASMR would decrease to 258.35/100 000 and 11.49/100 000 in 2046. It is predicted that the annual ASIR, ASPR, ASMR, and ASDR of T2DM in China would remain lower than the global levels from 2022 to 2046. The disease burden level of T2DM was higher in men and the elderly in China. Based on data from China and the world, metabolic factors (high FPG glucose and high BMI) are consistently the main risk factors leading to the disease burden of T2DM, and ambient particulate matter pollution is the main environmental factor. While the global disease burden of T2DM attributed to smoking has become stabilized, China still maintains a relatively high level and the level is predicted to keep rising in the future. Conclusions:The disease burden of T2DM continues to increase in China, posing significant challenges for prevention and treatment. The prevention and intervention strategies should focus on the key modifiable risk factors.