Disease Burden of Type 2 Diabetes Among Young Adults in Asia: An Analysis From the Global Burden of Disease Study 2021

Background: Asia is experiencing the most significant and rapid increase in Type 2 diabetes mellitus (T2DM) globally. Previous studies have indicated a trend toward early onset of T2DM in this region. However, the burden of T2DM among young adults in Asia remains unclear. This study is aimed at exploring the burden of T2DM and its attributable risk factors in Asian adults aged 15-39 years from 1990 to 2021, which could generate insights into our further understanding and thus prevention and management of T2DM in this population. Methods: Data from Global Burden of Disease 2021 was used to estimate the trends in age-standardized incidence, disability-adjusted life years (DALYs), and mortality of T2DM among young adults in Asia from 1990 to 2021. We analyzed the association between country development level and T2DM burden and investigated the attributable risk factors for T2DM in 2021. Results: In 2021, total T2DM incidence, prevalence, DALYs, and deaths in Asian young adults were estimated to be 4.55, 59.69, 4.14 million, and 12,769, respectively. There was a consistent annual increase in age-standardized incidence (average annual percentage change [AAPC]: 2.39%) and DALYs (AAPC: 2.08%) and a fluctuating temporal trend in mortality (AAPC: 0.34%) between 1990 and 2021. Incidence and DALYs were higher in males than females in most age groups, although females under 20 years experienced higher DALYs compared to males. Mortality was higher in females before 2007 but lower thereafter. In both males and females, high body mass index was by far the primary attributable risk factor, accounting for 54.56% of T2DM DALYs overall. Conclusion: The burden of T2DM has increased among young adults in Asia, particularly among females under 20 years. Prevention and treatment of obesity should be prioritized to reduce the burden of T2DM in this population in Asia.