Global burden and future trends of type 2 diabetes mellitus-associated chronic kidney disease: analysis of the Global Burden of Disease Study 2021.
Level 3 - non-randomized controlled study
Global Burden of Disease descriptive epidemiological modeling and time-series projection (non-clinical design analogy).
PubMed 42525323 · doi:10.1007/s11096-026-02201-4
What was done
Data from the Global Burden of Disease (GBD) Study 2021 were used to analyze global, regional, and national incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for type 2 diabetes mellitus-associated chronic kidney disease (T2DM-associated CKD) from 1990 to 2021. Decomposition analysis quantified the contributions of population growth, aging, and epidemiological shifts. Risk factor analyses identified modifiable contributors to mortality and DALYs, and projections through 2040 were estimated using an age-period-cohort model (NORDPRED package).
What was found
From 1990 to 2021, the male age-standardized incidence rate rose from 19.07 (95% UI: 17.28–20.83) to 23.07 (21.40–24.72) per 100,000 population, with parallel increases in age-standardized DALY rates. High Socio-demographic Index (SDI) regions had the highest incidence, whereas low- and low-middle-SDI regions experienced disproportionately high mortality and disability burdens. East Asia and South Asia contributed the largest absolute numbers of incident cases, deaths, and DALYs. Principal drivers of rising incidence were population growth (49.61%) and aging (30.53%). High fasting plasma glucose and elevated body mass index were the top modifiable risk factors. Projections to 2040 indicate continuing incidence increases alongside stabilizing or declining mortality and DALY rates.
Why it matters
These findings highlight shifting geographic disparities and demographic drivers of diabetic kidney disease, supporting resource allocation and risk-factor prevention strategies for aging populations.
Limits
The study relies on GBD mathematical modeling rather than direct cohort follow-up, which is vulnerable to variations in primary data completeness and quality across developing countries. Female-specific incidence rates, absolute prevalence figures, and confidence intervals for several key metrics were omitted from the abstract.
Cited by
- supports Diabetes is the leading cause of kidney destruction and kidney disease.