A new global analysis has revealed that the burden of type 1 diabetes (T1DM) among children and adolescents has increased substantially over the past three decades, while health inequalities between high- and low-income countries continue to widen.
The study analysed data from the Type 1 Diabetes Index, the Global Burden of Disease Study, and International Diabetes Federation datasets to assess trends in T1DM incidence, prevalence, mortality, and years of life lost (YLLs) among individuals aged 0–19 years between 1990 and 2021.
Researchers found that the global incidence of T1DM nearly tripled during the study period, increasing from 2.71 to 7.42 cases per 100,000 population. Prevalence also rose sharply, from 20.75 to 56.59 cases per 100,000 population. In 2021, North America and Europe reported the highest incidence and prevalence rates, while African regions experienced the highest burden of years of life lost.
The researchers observed that inequalities in T1DM outcomes worsened over time. Lower-income countries carried a disproportionately large share of T1DM-related deaths and YLLs, reflecting major disparities in access to insulin treatment, glucose monitoring, healthcare resources, and diabetes management systems. In 2021, countries in the lower half of the global income distribution accounted for approximately 80% of the T1DM mortality burden and 86% of the T1DM YLL burden.
The researchers noted that although disease burden estimates varied somewhat across international databases, the overall trends were highly consistent, particularly with respect to the increasing incidence and prevalence of T1DM and the widening disparities in mortality and YLLs between richer and poorer countries. These findings highlight the urgent need for globally coordinated efforts to improve diabetes care in resource-limited settings. Expanding insulin accessibility, strengthening disease registries, improving glucose monitoring, and supporting long-term care for children and adolescents with T1DM may help reduce growing global inequalities.
The study was conducted by researchers from Xi’an Jiaotong University, Monash University, the Chinese Center for Disease Control and Prevention, and collaborating institutions.
Science Bulletin
Data/statistical analysis