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Background <p>Type 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.</p> Objective <p>This 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.</p> Method <p>Using 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.</p> Results <p>Global 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.</p> Conclusions <p>Smoking-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.</p>

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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

  • 期刊论文

  • 发表日期：

    2026年1月21日

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  • Yujun He,
  • Yuping Ye,
  • Minhui Liu,
  • Bowen Xing,
  • Hui Xu,
  • Jiujie He,
  • Wei Mai,
  • Simin Qin,
  • Zhenyi Luo,
  • Yi Xu,
  • Xiaoyi Wang

摘要

Background

Type 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.

Objective

This 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.

Method

Using 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.

Results

Global 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.

Conclusions

Smoking-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.