Trends in incidence and prevalence of diabetes along with mortality attributed to its risk factors and high fasting plasma glucose in United States from 1990 to 2019: a joinpoint regression analysis

Abstract

Abstract Purpose: Diabetes is a major public health crisis in the U.S. This study aimed to investigate the temporal trends in the incidence and prevalence of diabetes, as well as mortality attributed to its risk factors and the causes of death resulting from high fasting plasma glucose (HFPG) in the U.S. Methods: From 1990 to 2019, the estimates of incidence, prevalence, and mortality were retrieved from the Global Health Data Exchange. Joinpoint regression analysis was used to produce the average annual percent change (AAPC), annual percentage change (APC), and the 95% confidence intervals (CI). Results: From 1990 to 2019, the incidence of diabetes among both sexes in all-age and age-standardized age groups increased by 132.3% and 47.1%, respectively, and the prevalence of diabetes raised by 148.8% and 48.1%, respectively. AAPC estimates of diabetes incidence and prevalence for both sexes increased by 1.3% (CI: 1.2% to 1.5%) and 1.4% (CI: 1.2% to 1.6%), respectively. The age-standardized death rate attributable to HFPG decreased by 8% among both sexes. Excluding cancer subtypes, the greatest increase was noted in chronic kidney disease (CKD), peripheral artery disease (PAD), and Alzheimer's disease (AD) by 184%, 82.6%, and 47.9%, respectively. Among cancer subtypes, the highest increase was seen in liver and pancreatic cancers, at 209.2% and 68.8%, respectively. Conclusion: We witnessed that the incidence and prevalence of diabetes continued to rise in adults accompanied by a shift from conventional HFPG causes of death toward cancers (primarily liver and pancreas) and aging-related diseases (such as CKD, PAD, and AD).