{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:49:20Z","timestamp":1785232160027,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To explore the geographical and risk factor trends associated with type 2 diabetes mellitus using Global Burden of Disease (GBD) data (1990\u20132021).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Age\u2010standardized T2DM incidence, prevalence, mortality and disability\u2010adjusted life years (DALYs) were extracted from the GBD for 204 countries stratified by sociodemographic index (SDI). Trends were analysed using joinpoint regression to compute average annual percentage changes (AAPCs) and mapping. Age\u2010standardized burden estimates were calculated across 5\u2010year age groups. Risk factor attribution was performed using Bayesian meta\u2010regression and spatiotemporal analysis, illustrating the relative importance of each risk factor by bubble plots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 1990 to 2021, the global age\u2010standardized incidence rate of T2DM increased (AAPC\u2009=\u20091.83%), with the most pronounced rises in low\u2010middle SDI regions. Mortality slightly increased globally (AAPC\u2009=\u20090.30%) but declined in high\u2010SDI regions. The burden was highest in middle\u2010aged and elderly populations, with a concerning increase in adolescent cases. High body mass index (BMI) was the leading risk factor, estimated to account for 44.5% (95% UI: 19.0%\u201365.2%) of deaths and 51.9% (95% UI: 24.7%\u201371.5%) of DALYs in 2021, followed by ambient particulate matter pollution and physical inactivity. The contribution of dietary risks and air pollution varied significantly across SDI regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our analysis identifies high BMI, ambient air pollution and physical inactivity as the primary risk drivers of the global T2DM burden. All indicators increased most markedly in low\u2010middle SDI regions, with substantial disparities across age and sex groups. These findings underscore the need for risk\u2010specific and region\u2010tailored preventive strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70217","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T06:39:28Z","timestamp":1771223968000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trends in global risk factors for the development of type 2 diabetes mellitus: Evidence from the global burden of disease study, 1990\u20132021"],"prefix":"10.1111","volume":"43","author":[{"given":"Qianying","family":"Xiang","sequence":"first","affiliation":[{"name":"MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention Shanxi Medical University  Taiyuan China"},{"name":"Department of Public Health Laboratory Sciences, School of Public Health Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhan","family":"Wang","sequence":"additional","affiliation":[{"name":"MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention Shanxi Medical University  Taiyuan China"},{"name":"Department of Public Health Laboratory Sciences, School of Public Health Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yurong","family":"Miao","sequence":"additional","affiliation":[{"name":"MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention Shanxi Medical University  Taiyuan China"},{"name":"Department of Public Health Laboratory Sciences, School of Public Health Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixuan","family":"Fu","sequence":"additional","affiliation":[{"name":"MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention Shanxi Medical University  Taiyuan China"},{"name":"School of Management Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huirong","family":"Duan","sequence":"additional","affiliation":[{"name":"MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention Shanxi Medical University  Taiyuan China"},{"name":"Department of Public Health Laboratory Sciences, School of Public Health Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofang","family":"Xu","sequence":"additional","affiliation":[{"name":"MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention Shanxi Medical University  Taiyuan China"},{"name":"School of Management Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Cao","sequence":"additional","affiliation":[{"name":"MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention Shanxi Medical University  Taiyuan China"},{"name":"Department of Public Health Laboratory Sciences, School of Public Health Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianjun","family":"Ren","sequence":"additional","affiliation":[{"name":"MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention Shanxi Medical University  Taiyuan China"},{"name":"School of Management Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqing","family":"Yan","sequence":"additional","affiliation":[{"name":"MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention Shanxi Medical University  Taiyuan China"},{"name":"Department of Public Health Laboratory Sciences, School of Public Health Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1923-0629","authenticated-orcid":false,"given":"Xiujuan","family":"Yang","sequence":"additional","affiliation":[{"name":"MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention Shanxi Medical University  Taiyuan China"},{"name":"Department of Public Health Laboratory Sciences, School of Public Health Shanxi Medical University  Taiyuan China"},{"name":"Academic Affairs Office Shanxi Medical University  Taiyuan China"},{"name":"Shanxi Key Laboratory of Functional Proteins Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,15]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"International Diabetes Federation.IDF Diabetes Atlas 11th Edition. 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