Global spatiotemporal Dynamics of Type 2 Diabetes Mellitus (T2DM) burden and projections: focusing on the impact of non-optimal temperature on adults aged 55.

The study aims to evaluate the global trends in Type 2 Diabetes Mellitus (T2DM) burden from 1990 to 2021 across different Socio-Demographic Index (SDI) levels, which is essential for developing effective strategies for prevention and management. We analyzed mortality and Disability-Adjusted Life Years (DALYs) related to T2DM from the Global Burden of Disease (GBD) study for 1990-2021. We employed Joinpoint Regression Analysis to track trend changes, Age-Period-Cohort Modeling to dissect the effects of age, period, and cohort, and Decomposition Analysis to identify key contributors to the DALYs trends. A projection model was applied to predict T2DM burden through 2044. The global T2DM burden, measured by DALYs, increased modestly at an annual average percent change (AAPC) of 0.17 %. There was a notable upward trend in low SDI regions, with an AAPC of 1.36 %, while high SDI regions experienced a decrease, especially after 2005. Decomposition analysis revealed that population growth was the primary driver of the T2DM burden, with lifestyle changes such as obesity and sedentariness also contributing significantly. Our projections indicate a substantial rise in T2DM cases and DALY rates across all age groups over 70, with the most significant increase expected in the 70-74 age group. These findings highlight the growing disparities in T2DM burden across SDI levels and underscore the urgent need for targeted prevention strategies and adaptive public health policies to mitigate the impact of non-optimal temperature on elderly populations worldwide.