ESPE Yearbook of Paediatric Endocrinology

Brief summary: The authors used data from the Global Burden of Disease 2019 to examine the incidence, disability adjusted life years and mortality of early onset type 2 diabetes T2D) in those 15–39 years of age. This showed that early onset T2D is a growing global health problem in adolescents and young adults, particularly in low-middle- and middle-income countries.

Early onset of type 2 diabetes (T2D) is associated with longer lifetime exposure hyperglycemia and earlier onset of complications. The aim of this study was to provide more information about attributable risk factors for early onset T2D in different countries, analyzing secular trends and variations based on sociodemographic index. Significant estimation and modeling were needed due to limitations of the Global Burden of Disease 2019 survey. This study, however, found the highest age standardized incidence rate and age standardized disability adjusted life years (DALY) in countries with low-middle and middle sociodemographic index. This may be attributable to the rapid social and economic changes in these countries. Countries with low sociodemographic index had the lowest age standardized incidence rate, but the highest age standardized mortality rate, possibly due to poorer quality of diabetes care. At a regional level, the greatest burden of early onset T2D was seen in parts of Oceania and South Asia. Western Europe and southern Latin American had the fastest increase in age standardized incidence rate with the UK and Canada having the fastest increase on a country level. The age-standardized mortality rate in high, high-middle and low sociodemographic index countries showed a declining trend while this was unchanged in countries with a middle sociodemographic or increased in those with low-middle sociodemographic index. This may be due to slower changes in health systems compared to epidemiologic changes. High body mass index (BMI) was the main attributable risk factor for all regions by sociodemographic index. From 1990 to 2019, the proportion of T2D cases attributable to high BMI increased from 45% to 69% in women, and from 40% to 66% in men globally.