This observational study aimed to assess trends in type 2 diabetes mellitus (T2DM) disease burden in European Union countries for the years 1990–2019. Sex specific T2DM age-standardised prevalence (ASPRs), mortality (ASMRs) and disability-adjusted life-year rates (DALYs) per 100,000 population were extracted from the Global Burden of Disease (GBD) Study online results tool for each EU country (inclusive of the United Kingdom), for the years 1990–2019. Trends were analysed using Joinpoint regression analysis. Between 1990 and 2019, increases in T2DM ASPRs were observed for all EU countries. The highest relative increases in ASPRs were observed in Luxembourg (males + 269.1%, females + 219.2%), Ireland (males + 191.9%, females + 165.7%) and the UK (males + 128.6%, females + 114.6%). Mortality trends were less uniform across EU countries, however a general trend towards reducing T2DM mortality was observed, with ASMRs decreasing over the 30-year period studied in 16/28 countries for males and in 24/28 countries for females. The UK observed the highest relative decrease in ASMRs for males (− 46.9%). For females, the largest relative decrease in ASMRs was in Cyprus (− 67.6%). DALYs increased in 25/28 countries for males and in 17/28 countries for females between 1990 and 2019. DALYs were higher in males than females in all EU countries in 2019. T2DM prevalence rates have increased across EU countries over the last 30 years. Mortality from T2DM has generally decreased in EU countries, however trends were more variable than those observed for prevalence. Primary prevention strategies should continue to be a focus for preventing T2DM in at risk groups in EU countries.
Aims: To compare the trends in prevalence and mortality from type 2 diabetes mellitus (T2DM) in the UK and European Union (EU) countries. Methods: This observational study used data obtained from the Global Burden of Disease (GBD) Study. T2DM age-standardised prevalence rates per 100,000 (ASPRs), age-standardised mortality rates per 100,000 (ASMRs) and disability-adjusted life-year rates per 100,000 (DALYs) were extracted from the GBD online results tool for the UK and each EU country, for the years 1990-2019. Trends were analysed using Joinpoint regression analysis. Results: Between 1990 and 2019, increases in T2DM ASPRs were observed for all EU countries. The highest relative increases in ASPRs were observed in Luxembourg (males +269.1%, females +219.2%), Ireland (males +191.9%, females +165.7%) and the UK (males +128.6%, females +114.6%). The T2DM prevalence increases in the UK have plateaued from 2015/16-2019 for both sexes, with insignificant increases in estimated annual percentage changes of +0.9% and 0% for males and females, respectively. Mortality trends were non-uniform across EU countries, with ASMRs increasing over the 30-year period studied in 11 countries for males and in 4 countries for females. The UK observed the highest relative decrease in ASMRs for males (-46.9%). For females, the largest relative decrease in ASMRs was in Cyprus (-67.6%). Mortality-to-incidence ratios decreased in all countries except for males in Latvia and females in Denmark, with the lowest mortality-to-incidence ratios in 2019 being observed in the UK and Finland. DALYs increased in 25 countries for males and 17 countries for females between 1990 and 2019. Conclusions: T2DM prevalence rates have increased across Europe over the last 30 years, however mortality trends are variable. The prevalence of T2DM has increased more in the UK and Ireland between 1990-2019 than in any EU country, for both males and females, with the exception of Luxembourg. Contrastingly, the UK has observed large relative decreases in T2DM mortality rates. Primary prevention strategies in at risk populations should continue to be a focus for preventing T2DM in at risk groups in the UK and Europe.
Background: Type 1 diabetes mellitus (T1DM) is a prevalent condition with significant morbidity and financial implications. This study aims to compare the temporal trends in T1DM mortality and morbidity across 27 European Union (EU) countries and the United Kingdom between 1990 and 2017. Methods: The Global Burden of Disease Study database was used to extract T1DM age-standardized mortality rates (ASMR) and disability-adjusted life-years rates (DALYs) per 100,000 for 27 EU countries and the United Kingdom. Joinpoint regression analysis was used to interpret trends. Results: All countries, excluding males from the Czech Republic (+28.5%), had relative reductions in ASMR between 1990 and 2017. The largest relative reductions in ASMR between 1990 and 2017 were observed in Slovenia for both males and females (-75.9% and -87.9%, respectively). The smallest relative reductions in ASMR between 1990 and 2017 were seen in Malta for males (-5.9%) and Czech Republic for females (-12.5%). For all years from 1999 to 2017, males in all countries had higher T1DM ASMRs compared to females. Similarly, T1DM DALYs have decreased across all countries excluding males from the Czech Republic and Malta (+10.4% and +5.3%, respectively). The largest relative reductions in DALYs between 1990 and 2017 were observed in Poland for both males and females (-46.4% and -70.4%, respectively). The smallest relative reductions in DALYs were seen in Greece for both males and females (-4.1% and -17.0%, respectively). From all years from 2006 to 2017, males in all countries had higher T1DM DALYs compared to females. Joinpoint regression analysis demonstrated that over the time period covered by the most recent trends (2013/14–2017), small increases in T1DM ASMRs were observed in Malta, Germany, and Denmark, for males, and in the UK, Netherlands, Germany, and Denmark for females. Furthermore, the UK also observed increases in DALY rates for both males and females between 2013 and 2017 (estimated annual percentage increases: males +0.6%, females +0.5%). Discussion: We identified improvements in both the mortality and morbidity from T1DM in European Union Countries between 1990 and 2017. Both the incidence and prevalence of T1DM is known to be increasing, therefore the observed improvements in mortality and morbidity reflect continent wide improvements in disease management. Our data do suggest, however, that the improvements in mortality and DALYs appear to be plateauing in the UK over the time periods covered by the most recent trends.
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