Trends in type 2 diabetes incidence and BMI at diagnosis by age, sex, and ethnicity, 2011–2024: a population-based analysis of the English National Diabetes Audit

Background: Early-onset type 2 diabetes is associated with aggressive disease progression, long-term health burden and reduced life expectancy. Trends in incidence have not been comprehensively described. Methods: Using data from the English National Diabetes Audit, age-standardised incidence rates for adults with type 2 diabetes were calculated by age, sex, and ethnicity between 2011 and 2024. Poisson regression models were created to study incidence over time. Annual change in median BMI within 26 weeks of diagnosis were calculated. Findings: /year [0.08-0.26] and females +0.17 [0.09-0.26]; 30-39-year-old males +0.21 [0.18-0.24] and females +0.20 [0.16-0.24]; 40-59 year-old-males +0.06 [0.04-0.07] and females +0.09 [0.06-0.12]; 60-79 year old males +0.08 [0.06-0.09] and females +0.11 [0.08-0.13]). Interpretation: Since 2011, incidence of type 2 diabetes has risen significantly in young adults across most ethnicity and sex subgroups (especially females) despite minimal changes or declining rates at older ages. This trend parallels greater increases in BMI-at-diagnosis in young people, highlighting a shift in disease burden and the urgent need for earlier prevention, and focused obesity interventions in early-life. Funding: Wellcome Trust.