Global burden of type 1 diabetes in adults aged 65 years and older, 1990-2019: population based study
Authors' conclusion
The life expectancy of older people with T1DM has increased since the 1990s along with a considerable decrease in associated mortality and DALYs. T1DM related mortality and DALYs were lower in women aged ≥65 years, those living in regions with a high sociodemographic index, and those aged <79 years. Management of high fasting plasma glucose remains a major challenge for older people with T1DM, and targeted clinical guidelines are needed.
Study context
- Population
- Adults aged ≥65 years from 21 regions and 204 countries and territories (Global Burden of Disease Study 2019), 1990–2019204 countries and territories
- Outcome
- T1DM related age standardised prevalence, mortality, DALYs, and average annual percentage change
- Follow-up
- 1990 to 2019
Main finding
As reported in the abstract
- Global age standardised T1DM prevalence, 1990
- 400 per 100 000 (95% UI 332 to 476)
- Global age standardised T1DM prevalence, 2019
- 514 per 100 000 (95% UI 417 to 624)
- Prevalence, average annual trend
- 0.86% (95% CI 0.79% to 0.93%)
- Mortality, 1990
- 4.74 per 100 000 (95% UI 3.44 to 5.9)
- Mortality, 2019
- 3.54 per 100 000 (95% UI 2.91 to 4.59)
- Mortality, average annual trend
- −1.00% (95% CI −1.09% to −0.91%)
- Age standardised disability adjusted life years (DALYs), 1990
- 113 per 100 000 (95% UI 89 to 137)
- Age standardised DALYs, 2019
- 103 per 100 000 (95% UI 85 to 127)
- DALYs, average annual trend
- −0.33% (95% CI −0.41% to −0.25%)
Observational data: associations, not effects.
Further findings
DALY trend by age group · 1990 to 2019
Per year
- Age 65-69
- −0.44% (95% CI −0.53% to −0.34%)
- Age 70-74
- −0.34% (95% CI −0.41% to −0.27%)
- Age 75-79
- −0.42% (95% CI −0.58% to −0.26%)
- Most significant decrease in DALYs among those aged <79 years
Mortality trend by sociodemographic index (SDI) · 1990 to 2019
Per year
- High SDI countries
- −2.17% (95% CI −2.31% to −2.02%)
- Low-middle SDI countries
- −0.16% (95% CI −0.45% to 0.12%)
- Mortality fell 13 times faster in high vs low-middle SDI countries
Regional distribution
- Highest prevalence in high income North America, Australasia and western Europe
- Highest DALY rates in southern sub-Saharan Africa, Oceania and the Caribbean
Risk factors for DALYs · 1990-2019
- High fasting plasma glucose remained the highest risk factor for DALYs
Original publication
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