Global burden of disease attributable to high fasting plasma glucose from 1990 to 2021: a spatiotemporal analysis of global burden of disease 2021

Objective: This study comprehensively assessed the disease burden attributable to high fasting plasma glucose (HFPG) from 1990 to 2021 and projected its future trends over the next 30 years. Research design and methods: The analysis was based on data from the Global Burden of Disease (GBD) 2021 study, including mortality, disability-adjusted life years (DALYs), age-standardized mortality rates (ASMR), and age-standardized DALY rates (ASDR). The DisMod-MR 2.1 model was used to estimate the disease burden attributable to HFPG from 1990 to 2021. In addition, an age-period-cohort model was applied to project the disease burden for 2051. Results: Diabetes mellitus (DM) remained the leading cause of HFPG-attributable burden, with an ASDR of 916.14 (95% UI: 776.14-1,096.55) and an ASMR of 19.61 (95% UI: 18.08-20.82) per 100,000 population. Ischemic heart disease (IHD) and stroke also contributed substantially to global mortality and morbidity. North Africa and the Middle East, along with Oceania, reported the highest regional burdens. China recorded the highest number of deaths (956,264.44) and DALYs (27,655,530.55). Males and individuals aged ≥75 years experienced disproportionately higher burdens. Projections indicated a global decline in ASMR but a continued increase in ASDR, with persistent sex disparities. Conclusions: DM, IHD, and stroke were the primary contributors to the HFPG-attributable disease burden. Although ASMR is projected to decline, the continued rise in ASDR underscores the need for strengthened prevention strategies and health system responses.