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The most significant decrease in DALYs was observed among those aged &lt;79 years: 65-69 (\u22120.44% per year (95% CI \u22120.53% to \u22120.34%)), 70-74 (\u22120.34% per year (\u22120.41% to \u22120.27%)), and 75-79 years (\u22120.42% per year (\u22120.58% to \u22120.26%)). Mortality fell 13 times faster in countries with a high sociodemographic index versus countries with a low-middle sociodemographic index (\u22122.17% per year (95% CI \u22122.31% to \u22122.02%)\n                      <jats:italic>v<\/jats:italic>\n                      \u22120.16% per year (\u22120.45% to 0.12%)). While the highest prevalence remained in high income North America, Australasia, and western Europe, the highest DALY rates were found in southern sub-Saharan Africa, Oceania, and the Caribbean. A high fasting plasma glucose level remained the highest risk factor for DALYs among older adults during 1990-2019.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The life expectancy of older people with T1DM has increased since the 1990s along with a considerable decrease in associated mortality and DALYs. T1DM related mortality and DALYs were lower in women aged \u226565 years, those living in regions with a high sociodemographic index, and those aged &lt;79 years. Management of high fasting plasma glucose remains a major challenge for older people with T1DM, and targeted clinical guidelines are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2023-078432","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T20:05:13Z","timestamp":1718222713000},"page":"e078432","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":169,"title":["Global burden of type 1 diabetes in adults aged 65 years and older, 1990-2019: population based study"],"prefix":"10.1136","volume":"385","author":[{"given":"Kaijie","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism and the Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, First Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism and the Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, First Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenye","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, First Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuangning","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism and the Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, First Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism and the Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, First Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Evidence-based Medicine, First Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Evidence-based Medicine, First Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health, Shenzhen University Medical School, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8782-3314","authenticated-orcid":false,"given":"Yongze","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism and the Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, First Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"2025110102395385000_385.jun12_7.e078432.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.16425"},{"key":"2025110102395385000_385.jun12_7.e078432.2","unstructured":"World Health Organization (WHO) Diabetes . 2023. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/diabetes."},{"key":"2025110102395385000_385.jun12_7.e078432.3","doi-asserted-by":"publisher","DOI":"10.2337\/db11-1625"},{"key":"2025110102395385000_385.jun12_7.e078432.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2022.10.006"},{"key":"2025110102395385000_385.jun12_7.e078432.5","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1193403"},{"key":"2025110102395385000_385.jun12_7.e078432.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05571-8"},{"key":"2025110102395385000_385.jun12_7.e078432.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2017.10.021"},{"key":"2025110102395385000_385.jun12_7.e078432.8","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00218-2"},{"key":"2025110102395385000_385.jun12_7.e078432.9","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-S016"},{"key":"2025110102395385000_385.jun12_7.e078432.10","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2019-00198"},{"key":"2025110102395385000_385.jun12_7.e078432.11","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2019-00198"},{"key":"2025110102395385000_385.jun12_7.e078432.12","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-S013"},{"key":"2025110102395385000_385.jun12_7.e078432.13","unstructured":"Diabetes Atlas IDF. 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