Global trends and age-period-cohort analysis for the disability adjusted life years and mortality of type 2 diabetes mellitus due to diet high in sugar-sweetened beverages

BackgroundSugar-sweetened beverages (SSBs) are calorie-dense, a possible surrogate for obesogenic food environment, and associated with cardiometabolic diseases. The burden of type 2 diabetes mellitus (T2DM) associated with a diet high in SSBs on a global scale remain unclear. In this study, we examined global trends of disability adjusted life years (DALYs) and mortality of T2DM associated with diet high in SSBs, and explored their associations with age, period, and birth cohort.MethodsUsing data from Global Burden of Disease (GBD) 2021, we estimated the global trends and average annual percentage changes (AAPCs) in age-standardized DALYs and age-standardized mortality of T2DM attributable to diet high in SSBs from 1990 to 2021. Diet high in SSBs was defined as daily consumption of beverages with ≥ 50 kcal per 226.8 g serving on average. Age-period-cohort analyses were conducted to assess the individual contribution of age, period and cohort effects on DALYs and mortality. We used the Nordpred age-period-cohort analysis to forecast global DALYs and mortality for the next 25 years.ResultsFrom 1990 to 2021, there was a continuous annual increase of 2.23% in global age-standardized T2DM DALYs attributable to diet high in SSBs, and a fluctuating increasing trend in mortality with an annual increase of 0.86%. People aged < 60 years experienced a larger increase (AAPC in DALYs and mortality: 2.69% and 1.35%;) in disease burden when compared with adults aged ≥ 60 years (AAPC in DALYs and mortality: 1.86% and 0.74%). The temporal rates were higher in more recent periods (rate ratios for DALYs and mortality: 1.37 and 1.13) and more recently born cohorts (rate ratios for DALYs and mortality: 3.72 and 1.71). The largest DALYs was observed in high socio-demographic index (SDI) countries (56.12 per 100,000 population in 2021). The T2DM burden attributable to diet high in SSBs was projected to increase further, with 22.00% increase in DALYs and 3.02% increase in mortality by 2046.ConclusionThe disease burden of T2DM associated with diet high in SSBs remains a growing health problem globally, especially in younger people. High SDI countries with highest DALYs and elevated mortality require special attention for public health and policy interventions targeting SSBs.