The national and provincial prevalence and non-fatal burdens of diabetes in China from 2005 to 2023 with projections of prevalence to 2050

Abstract Background China accounts for one-quarter of the world’s diabetes population, with significant subnational disparities. However, none of the available data have provided comprehensive estimates and projections at both regional and national levels in diabetes prevention and management. This...

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Main Authors: Yu-Chang Zhou, Jiang-Mei Liu, Zhen-Ping Zhao, Mai-Geng Zhou, Marie Ng
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Military Medical Research
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Online Access:https://doi.org/10.1186/s40779-025-00615-1
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author Yu-Chang Zhou
Jiang-Mei Liu
Zhen-Ping Zhao
Mai-Geng Zhou
Marie Ng
author_facet Yu-Chang Zhou
Jiang-Mei Liu
Zhen-Ping Zhao
Mai-Geng Zhou
Marie Ng
author_sort Yu-Chang Zhou
collection DOAJ
description Abstract Background China accounts for one-quarter of the world’s diabetes population, with significant subnational disparities. However, none of the available data have provided comprehensive estimates and projections at both regional and national levels in diabetes prevention and management. This study aimed to explore the temporal trends and geographical variations in the prevalence and non-fatal burden of diabetes by age and sex across China from 2005 to 2023, and to forecast diabetes prevalence through 2050. Methods We conducted a population-based study based on the nationally representative surveys, and literature reviews. Using the DisMod-MR model and Chinese-specific disease disability weights, we estimated the non-fatal burdens of diabetes, including prevalence and years lived with disability (YLDs), across sexes, age groups, and locations. The temporal trend change was measured as the average annual percent change. The effect of the Human Development Index on burdens was assessed by applying Spearman’s rank correlation analysis. We further projected diabetes prevalence to 2050 under two scenarios, the natural trend and the effective intervention on body mass index (BMI). Results In 2023, an estimated 233 million individuals in China were living with diabetes. Compared to 2005, the age-standardized rate (ASR) of prevalence has increased by nearly 50%, from 7.53% (95% CI 7.00–8.10%) to 13.7% (95% CI 12.6–14.8%) in 2023. The ASR of YLDs was estimated at 19.1 per 1000 population (95% CI 18.6–19.5) in 2023, compared to 10.5 per 1000 population in 2005. The ASR of prevalence and YLDs was consistently higher in males than in females. The provinces with the highest diabetes prevalence and disease burden were Beijing, Tianjin, and Shanghai. Our forecast results suggest that if existing trends continue, the prevalence of obesity will reach 29.1% (95% CI 22.2–38.2%) nationally by 2050, with some provinces in the northern region observing a prevalence of over 40%. Conversely, if effective obesity interventions were implemented, the growth in diabetes prevalence could potentially be suppressed by nearly 50%. Conclusions The health burden and economic cost associated with diabetes are profound. There is an urgent need to scale up preventive efforts and improve population awareness to enhance disease management and achieve optimal treatment outcomes.
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spelling doaj-art-3feb19e560b1450f9aba8e58d73d1d332025-08-20T03:10:29ZengBMCMilitary Medical Research2054-93692025-06-0112111510.1186/s40779-025-00615-1The national and provincial prevalence and non-fatal burdens of diabetes in China from 2005 to 2023 with projections of prevalence to 2050Yu-Chang Zhou0Jiang-Mei Liu1Zhen-Ping Zhao2Mai-Geng Zhou3Marie Ng4Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong UniversityNational Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionNational Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionDepartment of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong UniversityYong Loo Lin School of Medicine, National University of SingaporeAbstract Background China accounts for one-quarter of the world’s diabetes population, with significant subnational disparities. However, none of the available data have provided comprehensive estimates and projections at both regional and national levels in diabetes prevention and management. This study aimed to explore the temporal trends and geographical variations in the prevalence and non-fatal burden of diabetes by age and sex across China from 2005 to 2023, and to forecast diabetes prevalence through 2050. Methods We conducted a population-based study based on the nationally representative surveys, and literature reviews. Using the DisMod-MR model and Chinese-specific disease disability weights, we estimated the non-fatal burdens of diabetes, including prevalence and years lived with disability (YLDs), across sexes, age groups, and locations. The temporal trend change was measured as the average annual percent change. The effect of the Human Development Index on burdens was assessed by applying Spearman’s rank correlation analysis. We further projected diabetes prevalence to 2050 under two scenarios, the natural trend and the effective intervention on body mass index (BMI). Results In 2023, an estimated 233 million individuals in China were living with diabetes. Compared to 2005, the age-standardized rate (ASR) of prevalence has increased by nearly 50%, from 7.53% (95% CI 7.00–8.10%) to 13.7% (95% CI 12.6–14.8%) in 2023. The ASR of YLDs was estimated at 19.1 per 1000 population (95% CI 18.6–19.5) in 2023, compared to 10.5 per 1000 population in 2005. The ASR of prevalence and YLDs was consistently higher in males than in females. The provinces with the highest diabetes prevalence and disease burden were Beijing, Tianjin, and Shanghai. Our forecast results suggest that if existing trends continue, the prevalence of obesity will reach 29.1% (95% CI 22.2–38.2%) nationally by 2050, with some provinces in the northern region observing a prevalence of over 40%. Conversely, if effective obesity interventions were implemented, the growth in diabetes prevalence could potentially be suppressed by nearly 50%. Conclusions The health burden and economic cost associated with diabetes are profound. There is an urgent need to scale up preventive efforts and improve population awareness to enhance disease management and achieve optimal treatment outcomes.https://doi.org/10.1186/s40779-025-00615-1DiabetesPrevalenceYears lived with disability (YLDs)ChinaSubnational
spellingShingle Yu-Chang Zhou
Jiang-Mei Liu
Zhen-Ping Zhao
Mai-Geng Zhou
Marie Ng
The national and provincial prevalence and non-fatal burdens of diabetes in China from 2005 to 2023 with projections of prevalence to 2050
Military Medical Research
Diabetes
Prevalence
Years lived with disability (YLDs)
China
Subnational
title The national and provincial prevalence and non-fatal burdens of diabetes in China from 2005 to 2023 with projections of prevalence to 2050
title_full The national and provincial prevalence and non-fatal burdens of diabetes in China from 2005 to 2023 with projections of prevalence to 2050
title_fullStr The national and provincial prevalence and non-fatal burdens of diabetes in China from 2005 to 2023 with projections of prevalence to 2050
title_full_unstemmed The national and provincial prevalence and non-fatal burdens of diabetes in China from 2005 to 2023 with projections of prevalence to 2050
title_short The national and provincial prevalence and non-fatal burdens of diabetes in China from 2005 to 2023 with projections of prevalence to 2050
title_sort national and provincial prevalence and non fatal burdens of diabetes in china from 2005 to 2023 with projections of prevalence to 2050
topic Diabetes
Prevalence
Years lived with disability (YLDs)
China
Subnational
url https://doi.org/10.1186/s40779-025-00615-1
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