Objective To analyze the disease burden and future trends of chronic kidney disease attributable to type 2 diabetes mellitus (CKD-T2DM) among the elderly population globally and in China from 1990 to 2021, and to generate evidence to inform public health strategies and clinical decisions. Methods Data on the burden of CKD-T2DM among individuals aged ≥60 years globally and in China between 1990 and 2021 were obtained from the Global Burden of Disease 2021 database. The Joinpoint regression was employed to calculate the average annual percentage change (AAPC) of age-standardized prevalence rate and age-standardized disability-adjusted life years rate (ASDR), in order to assess temporal trends of the disease burden. The Bayesian age-period-cohort model was applied to project the number of prevalent cases and disability-adjusted life years (DALYs) associated with CKD-T2DM among the elderly population globally and in China from 2022 to 2035. Results Compared with 1990, the number of CKD-T2DM elderly cases globally and in China, including both males and females, increased significantly by 2021. However, the age-standardized prevalence rate demonstrated a significant decline from 1990 to 2021 (both AAPC<0, P<0.001). Similarly, the number of DALYs attributable to CKD-T2DM among the elderly in China also increased, whereas the ASDR showed a statistically significant decrease only among the overall and females’ populations during 1990-2021 (both AAPC<0, P<0.001). Globally, the number of DALYs also increased substantially, and the ASDR exhibited a significant overall upward trend from 1990 to 2021 across all groups (overall, male, and female populations; both AAPC>0, P<0.001). The age group with the most pronounced increase in prevalent cases was 65-69 years, whereas the highest increase in DALYs was observed in the 70-74 age group both globally and in China. Decomposition analysis indicated that population growth was the primary driver of increases in both the number of prevalent cases and DALYs attributable to CKD-T2DM among older adults across all regions. According to Bayesian age-period-cohort projections, the number of prevalent cases and DALYs associated with CKD-T2DM among the elderly is expected to continue increasing globally and in China from 2022 to 2035, with a more pronounced increase anticipated in China compared to the global trend. Conclusions The burden of CKD-T2DM among the elderly remains substantial both globally and in China, and is projected to increase in the coming years. There is an urgent need to develop and implement effective public health policies and targeted disease management strategies to mitigate its growing challenges.
ObjectiveTo analyze the global pattern, long-term trends, and regional and population heterogeneity in the burden of 375 diseases and injuries and 88 risk factors from 1990 to 2023 using data from the Global Burden of Disease Study 2023 (GBD 2023). MethodsPublicly available GBD 2023 estimates were extracted for incidence, deaths, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs), and age-standardized rates at the global level and by socio-demographic index (SDI), GBD region, age group, and sex. Descriptive analysis, ranking comparison, stratified analysis, and trend analysis were performed, and 95% uncertainty interval was used to assess the stability of estimates. ResultsIn 2023, non-communicable diseases were the leading contributor to global DALYs, accounting for 64.39% of DALYs across the three major disease and injury groups (communicable, maternal, neonatal, and nutritional diseases, non-communicable diseases, and injuries), and also had the highest age-standardized DALYs rate. From 1990 to 2023, age-standardized DALYs rates declined for three major disease and injury groups, with estimated annual percentage changes of ?2.69%, ?0.78%, and ?1.47%, respectively. Cardiovascular diseases ranked first by both DALYs and deaths in 2023, whereas respiratory infections and tuberculosis ranked first by incidence. Non-communicable diseases were the leading cause of disease burden across all SDI strata. As the SDI level declined, the burden of communicable, maternal, neonatal, and nutritional diseases, as well as injuries, increased markedly. Behavioral and metabolic risks remained the main contributors to attributable deaths and DALYs. ConclusionFrom 1990 to 2023, the global burden of disease continues to shift toward non-communicable diseases; however, some regions still face a double burden of infectious, maternal and child, injury-related, and chronic diseases. Integrating deaths, DALYs, YLLs, YLDs, and risk-attributable burden helps identify priority areas for prevention and resource allocation across regions and populations.