Global epidemiology and burden of type 2 diabetes in adults aged 55 and older: insights from 1990 to 2021

Background: Type 2 diabetes mellitus (T2DM) poses a growing global health challenge, particularly among individuals aged 55 years and above, placing significant pressure on healthcare systems. Objectives: This study aims to assess long-term trends in T2DM burden and its risk factors in this demographic from 1990 to 2021. Design: We conducted a retrospective analysis of T2DM based on the latest 2021 Global Burden of Disease (GBD) database. Methods: Utilizing data from the 2021 GBD Study, we analyzed T2DM incidence, prevalence, and disability-adjusted life years (DALYs) among individuals aged ⩾55 years, stratified by sex and age group. An autoregressive integrated moving average model was applied to forecast trends for 2022–2036. Results: In 2021, there were 9,179,347 (95% uncertainty interval (UI), 7,905,452–10,626,325) T2DM cases among those aged 55 years and above. From 1990 to 2021, global incidence increased from 409.06 (95% UI, 349.86–477.48) to 617.73 (95% UI, 532.00–715.10) per 100,000 population; diabetes-related mortality rose from 81.55 (95% UI, 76.57–85.44) to 96.19 (95% UI, 88.62–102.11) per 100,000, and DALYs climbed from 2562.71 (95% UI, 2293.81–2926.77) to 3552.41 (95% UI, 3041.94–4200.97) per 100,000. The highest mortality increase was in low-middle sociodemographic index (SDI) regions, while high SDI regions saw declines. Eastern Europe reported the highest incidence rate among 21 regions, at 1218.43 per 100,000 (95% UI, 1083.02–1370.82). Environmental, occupational, and behavioral risks were major contributors to diabetes-related mortality in this age group. Projections estimate T2DM cases will rise from 9.3 million in 2022 to 12.3 million by 2036. Conclusion: The global burden of diabetes in adults aged ⩾55 years has risen substantially from 1990 to 2021. As the population continues to age, urgent action is needed to address this growing disease burden.