Global, Regional, and National Burden of Chronic Kidney Disease Due to Type 2 Diabetes Mellitus from 1990 to 2017: Results from GBD 2017

Background: Type 2 diabetes mellitus (T2DM) has been a leading cause of chronic kidney disease (CKD) with a heterogeneous distribution worldwide. Optimal health-care planning requires an understanding how the burden of CKD due to T2DM has changed over time and geographic location, as well as the potential roles of sociodemographic, clinical, and behavioral factors in these changes. Methods: We used the Global Burden of Disease data from 1990 to 2017 at the global, regional, and national levels to investigate changes in the incidence, death, and disability-adjusted life years (DALYs) of CKD due to T2DM, incorporating both epidemiological research and risk-factor monitoring. Findings: The incident cases of CKD due to T2DM worldwide in 2017 had increased by 74% compared to 1990, and DALYs had increased by 113%. The SDI was significantly and negatively correlated with ASIR, ASDR, and the age-standardized DALY rate. However, in 82 countries and territories the burden was not alleviated in parallel with socioeconomic development. High systolic blood pressure was the leading risk factor for CKD due to T2DM, while high body mass index represented a growing threat globally across the entire SDI spectrum. Interpretation: We suggest a more-pragmatic approach focusing on early diagnosis and primary care to reduce the risk of death in low-SDI regions. Our findings indicate that sociodemographic prosperity is far from a decisive factor. Interventions for the increasing burden should address high systolic blood pressure as well as overweight and obesity problems, especially in high-income regions. Funding: National Social Science Foundation of China. Declaration of Interest: The authors declare no conflicts of interest that pertain to this work. Ethical Approval: Not required.