ArticleEndocrine2026
Global burden of deaths and DALYs attributable to smoking in Middle-Aged and elderly patients with type 2 Diabetes, 1990-2021: A systematic analysis of the GBD 2021 study.
Article in Endocrine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundType 2 diabetes mellitus (T2DM) represents a global health crisis, with smoking being a key risk factor, especially in middle-aged and elderly populations. However, comprehensive insights into the global burden of smoking-attributable mortality and disability-adjusted life years (DALYs) in these patients remain scarce.
objectiveThis study aims to quantify the global burden of smoking-related deaths and DALYs in middle-aged and elderly T2DM patients from 1990 to 2021, analyzing regional, gender, and age disparities, SDI associations, and future trends.
methodUsing GBD 2021 data across 204 countries/territories, we assessed numbers and rates, estimated annual percentage changes, and employed age-period-cohort modeling, frontier analysis, and ARIMA forecasting.
resultsGlobal deaths from T2DM attributable to smoking rose by 89.16%, with DALYs increasing 133.30%, though death rate declined 14.53%. Middle- and low-middle SDI regions faced the highest burden. High-SDI regions showed the steepest rate declines, while low-middle SDI regions showed the largest relative increases. Males had higher mortality and DALYs than females, with greater rate declines in females. Age-period-cohort analysis linked older age (≥ 75 years) to higher risks, while younger cohorts showed lower risks. Frontier analysis identified middle-SDI countries (e.g., Kiribati) as deviating most from optimal performance, versus high-SDI nations (e.g., Netherlands). Projections to 2036 suggest stable rates, with potential female mortality declines.
conclusionsSmoking-related T2DM burden varies significantly by region, gender, and age, urging targeted interventions in low-middle SDI regions. High-SDI tobacco control strategies offer scalable models to reduce this preventable burden.
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