Trends in type 2 diabetes-related deaths and disability-adjusted life years among smoking middle-aged and elderly adults in China, 1990-2021.

INTRODUCTION

Type 2 diabetes mellitus (T2DM) poses a global health crisis. Smoking, a key risk factor for T2DM, significantly impacts middle-aged and elderly populations. In China, with the world's largest elderly population and a high prevalence of smoking, the burden of smoking-related T2DM remains underrecognized.

METHODS

Using GBD 2021 data, we applied joinpoint regression, age-period-cohort analysis, and the ARIMA model for prediction. This is a secondary dataset analysis. The study population included Chinese adults aged ≥55 years.

RESULTS

From 1990 to 2021, deaths and DALYs attributable to smoking-associated T2DM showed a substantial increase, with males experiencing a significant rise in both number of death and DALYs rates, while females exhibited a decrease in death rate though total number of deaths rose. Joinpoint analysis revealed fluctuating trends in mortality and DALYs. The age-period-cohort analysis highlighted the age group of 70-75 years as a high-risk period. Predictive analysis suggested a slight upward trend in mortality for the overall population and males, while the DALYs rate was expected to remain stable but increase among males and decrease among females.

CONCLUSIONS

From 1990 to 2021, the impact of smoking on type 2 diabetes mellitus (T2DM) among middle-aged and elderly adults in China continued to rise, with notable gender differences. Strengthening tobacco control and diabetes management, particularly for males and high-risk age groups, is crucial for reducing this burden.