Global Burden of Diabetes Increasing Among Older Adults

The global burden of diabetes significantly increased between 1990 and 2019 among older adults, according to study findings published in Wiley.

As the world’s population shifts toward older age groups, especially in Asia, Europe, and the United States, the prevalence of diabetes has grown among adults older than 70 years of age. However, global epidemiological data on diabetes burden among this age group remains insufficient.

To better describe the global burden diabetes among individuals aged 70 years or older, researchers in China conducted a systematic analysis using data from the Institute for Health Metrics and Evaluation Global Burden of Diseases, Injuries, and Risk Factors Study 2019, which encompasses the 204 countries and territories of the World Health Organization. 

Outcomes were the prevalence, mortality, and disability-adjusted life-years (DALYs) of diabetes between 1990 and 2019 among individuals aged 70 years or older. The researchers also used the sociodemographic index to evaluate the relationship between a country’s socioeconomic development status and diabetes outcomes. 

The study included a total of 110.1 million adults aged at least 70 years with diabetes. Among this population in 2019, the researchers noted a worldwide diabetes-related:

• Prevalence rate of 23.7% (95% CI, 21.8-25.8);
• Total deaths of 0.84 million (95% CI, 0.76-0.90);
• Mortality rate of 181.9 deaths per 100,000 population (95% CI, 163.0-194.7);
• DALYs of 20.9 million (95% CI, 17.9-24.4); and,
• DALY rate of 4512.3 per 100,000 population (95% CI, 3861.3-5264.2).

Over the past 30 years in this population, the researchers noted increases in worldwide diabetes-related:

• Annual prevalence (221.5%; 95% CI, 216.7-225.9);
• Annual prevalence rate (39.7%; 95% CI, 37.7-41.7);   
• Annual deaths (167.7%; 95% CI, 151.8-182.8);
• Annual mortality rate (16.4%; 95% CI, 9.43-22.9);
• Annual DALYs (181.3%; 95% CI, 169.6-192.2); and,
• Annual DALY rate (22.3%; 95% CI, 17.2-27.0).

The subgroup analysis revealed no significant differences in overall prevalence, mortality, or DALY rates between older men and women. However, the researchers noted a higher prevalence rate among men aged older than 90 years compared with women of the same age. Between 1990 and 2019, diabetes prevalence rates increased more among men compared with women across all age groups.

Across geographical regions between 1990 and 2019, the prevalence rate of diabetes increased significantly in 21 regions, including Central Asia (98%; 95% CI, 88-109) and North Africa and the Middle East (78%; 95% CI, 72-85). The researchers also noted a significant increase in diabetes-related mortality and DALY rates in more than half of the regions.

High-income regions followed expected trends, whereas many middle-income regions varied widely. In 2019, diabetes-related DALY rates were inversely correlated with sociodemographic index (correlation coefficient, -0.16; P =.02), whereas mortality and prevalence demonstrated a similar pattern.

On a global scale, diabetes-related deaths were most commonly attributed to high body mass index (29.4%), dietary risks (25.8%), and air pollution (18.8%).

Study limitations include a lack of data input in lower sociodemographic index settings, the inability to draw a causal conclusion, and the lack of age-standardized data. 

“In regions with lower levels of sociodemographic development, the burden of diabetes in the elderly is relatively high, which indicates the areas in greatest need,” the researchers concluded. “These data suggest that in ageing societies, the population with diabetes poses inevitable public health and economic challenges.” 

This article originally appeared on Endocrinology Advisor