Burden of type 1 and type 2 diabetes and high fasting plasma glucose in Europe, 1990-2019: a comprehensive analysis from the global burden of disease study 2019

Front Endocrinol (Lausanne). 2023 Dec 13:14:1307432. doi: 10.3389/fendo.2023.1307432. eCollection 2023.

Abstract

Introduction: With population aging rampant globally, Europe faces unique challenges and achievements in chronic disease prevention. Despite this, comprehensive studies examining the diabetes burden remain absent. We investigated the burden of type 1 and type 2 diabetes, alongside high fasting plasma glucose (HFPG), in Europe from 1990-2019, to provide evidence for global diabetes strategies.

Methods: Disease burden estimates due to type 1 and type 2 diabetes and HFPG were extracted from the GBD 2019 across Eastern, Central, and Western Europe. We analyzed trends from 1990 to 2019 by Joinpoint regression, examined correlations between diabetes burden and Socio-demographic indices (SDI), healthcare access quality (HAQ), and prevalence using linear regression models. The Population Attributable Fraction (PAF) was used to described diabetes risks.

Results: In Europe, diabetes accounted for 596 age-standardized disability-adjusted life years (DALYs) per 100,000 people in 2019, lower than globally. The disease burden from type 1 and type 2 diabetes was markedly higher in males and escalated with increasing age. Most DALYs were due to type 2 diabetes, showing regional inconsistency, highest in Central Europe. From 1990-2019, age-standardized DALYs attributable to type 2 diabetes rose faster in Eastern and Central Europe, slower in Western Europe. HFPG led to 2794 crude DALYs per 100,000 people in 2019. Type 1 and type 2 diabetes burdens correlated positively with diabetes prevalence and negatively with SDI and HAQ. High BMI (PAF 60.1%) and dietary risks (PAF 34.6%) were significant risk factors.

Conclusion: Europe's diabetes burden was lower than the global average, but substantial from type 2 diabetes, reflecting regional heterogeneity. Altered DALYs composition suggested increased YLDs. Addressing the heavy burden of high fasting plasma glucose and the increasing burden of both types diabetes necessitate region-specific interventions to reduce type 2 diabetes risk, improve healthcare systems, and offer cost-effective care.

Keywords: Europe burden of disease; chronic noncommunicable diseases; high fasting plasma glucose; population attributable fraction; risk factors; type 1 and type2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose
  • Diabetes Mellitus, Type 2* / epidemiology
  • Europe / epidemiology
  • Fasting
  • Global Burden of Disease*
  • Humans
  • Male
  • Quality-Adjusted Life Years

Substances

  • Blood Glucose

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by grants from Fujian Provincial Natural Science Foundation (2018J01121), Fujian Provincial Health Technology Project (2020GGA026), Open Topic for the Year 2023 at the Nursing Humanities Research Center, a Humanities Society Science Research Base in Higher Education Institutions of Fujian Province (LLRW-202301), Key Commissioned Subject on Theoretical Research of Civil Affairs Policy in Fujian Province (FMZD202303), National Natural Science Foundation of China (Nos. 81800431 and 81800444), Fujian First Class Society Construction Project-Fujian Research Association for Medical and Health System Reform (FJKX-2022XYL009), and Research on Medical Humanities Education for Social Work Professionals in Hospice Care, Open Project of Medical Humanities Research Center, Fujian Medical University, 2022 (RW202206).