{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:39:05Z","timestamp":1792640345830,"version":"4.5.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Clin. Diabetes Healthc."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>This study aims to assess the global burden of type 2 diabetes mellitus (T2DM) attributable to low physical activity from 1990 to 2021 and forecast of its global burden by 2050 using GBD 2021 data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This study uses data from the GBD 2021 to examine the global burden of T2DM attributable to low physical activity, focusing on deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and Years of Life Lost (YLLs). Descriptive analysis was performed across gender, age, region, and country for 1990 and 2021, using age-standardized rates. Trend analysis assessed the average changes in these rates from 1990 to 2021 by calculating the estimated annual percentage change (EAPC). Projections for future burden were made using the exponential smoothing (ES) model and the autoregressive integrated moving average (ARIMA) model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>In 2021, T2DM attributed to low physical activity caused 149,214 deaths and 5,523,050 DALYs, with significant increases since 1990. Both age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALYs) rate (ASDR) rose, especially among females. The highest burden occurred in the 95+ and 70\u201374 age groups. High-SDI regions had the highest rates, with rapid increases in the high-middle SDI regions. Countries like the UAE, Montenegro, and Hungary showed the highest rates. Projections from 2022 to 2050 indicate a steady rise in deaths and DALYs, with a peak in 2050, though the rate of increase is slower according to the exponential smoothing model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The burden of T2DM attributable to low physical activity has steadily increased, with concerning future trends.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcdhc.2025.1606330","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T15:04:12Z","timestamp":1755011052000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Global, regional and national burden of diabetes mellitus type 2 attributable to low physical activity from 1990 to 2021 and projections to 2050: a finding from the global burden of disease study 2021"],"prefix":"10.3389","volume":"6","author":[{"given":"Ning","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01301-6","article-title":"Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021","volume":"402","author":"Collaborators","year":"2023","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1038\/nrendo.2017.151","article-title":"Global aetiology and epidemiology of type 2 diabetes mellitus and its complications","volume":"14","author":"Zheng","year":"2018","journal-title":"Nat. Rev. Endocrinol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2023.02.003","article-title":"The global burden of metabolic disease: Data from 2000 to 2019","volume":"35","author":"Chew","year":"2023","journal-title":"Cell Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2019.08.004","article-title":"Obesity, risk of diabetes and role of physical activity, exercise training and cardiorespiratory fitness","volume":"62","author":"Carbone","year":"2019","journal-title":"Prog. Cardiovasc. Dis"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-020-0381-5","article-title":"Diet and exercise in the prevention and treatment of type 2 diabetes mellitus","volume":"16","author":"Magkos","year":"2020","journal-title":"Nat. Rev. Endocrinol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.964132","article-title":"Physical activity, sedentary behavior, and the risk of type 2 diabetes: A two-sample Mendelian Randomization analysis in the European population","volume":"13","author":"Deng","year":"2022","journal-title":"Front. Endocrinol. (Lausanne)."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2022.101410","article-title":"Physical activity and diabetes mortality in people with type 2 diabetes: a prospective cohort study of 0.5 million US people","volume":"49","author":"Beltran-Valls","year":"2023","journal-title":"Diabetes Metab"},{"key":"B8","doi-asserted-by":"publisher","first-page":"S97","DOI":"10.1016\/S0140-6736(23)02145-1","article-title":"Effectiveness of interventions for improving physical activity level in working-age people (aged 18-60 years) with type 2 diabetes: a systematic review and meta-analysis","volume":"402","author":"Zhao","year":"2023","journal-title":"Lancet"},{"key":"B9","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s12966-018-0703-3","article-title":"Exercise training modalities in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis","volume":"15","author":"Pan","year":"2018","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002495","article-title":"Quantifying the association between physical activity and cardiovascular disease and diabetes: A systematic review and meta-analysis","volume":"5","author":"Wahid","year":"2016","journal-title":"J. Am. Heart Assoc"},{"key":"B11","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.pcd.2019.08.009","article-title":"The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: A systematic review of RCTs","volume":"14","author":"Almutairi","year":"2020","journal-title":"Prim Care Diabetes."},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003054.pub4","article-title":"Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus","volume":"12","author":"Hemmingsen","year":"2017","journal-title":"Cochrane Database Syst. Rev"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnha.2024.100402","article-title":"Spatiotemporal trends of Type 2 diabetes due to low physical activity from 1990 to 2019 and forecasted prevalence in 2050: A Global Burden of Disease Study 2019","volume":"28","author":"Fan","year":"2024","journal-title":"J. Nutr. Health Aging."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1247705","article-title":"The global burden of cardiovascular diseases and type 2 diabetes attributa ble to low physical activity, 1990-2019: an analysis from the global burden of disease study","volume":"10","author":"Zhang","year":"2023","journal-title":"Front. Cardiovasc. Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61031-9","article-title":"Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy","volume":"380","author":"Lee","year":"2012","journal-title":"Lancet."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097385","article-title":"The economic burden of physical inactivity: a systematic review and critical appraisal","volume":"51","author":"Ding","year":"2017","journal-title":"Br. J. Sports Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30383-X","article-title":"The economic burden of physical inactivity: a global analysis of major non-communicable diseases","volume":"388","author":"Ding","year":"2016","journal-title":"Lancet."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br. J. Sports Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"Diseases","year":"2024","journal-title":"Lancet."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00933-4","article-title":"Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","year":"2024","journal-title":"Lancet."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00367-2","article-title":"Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","year":"2024","journal-title":"Lancet"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-025-01709-8","article-title":"The global, regional, and national burden of type 2 diabetes mellitus attributa ble to low physical activity from 1990 to 2021: a systematic analysis of the global burden of disease study 2021","volume":"22","author":"Wei","year":"2025","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-024-16648-0","article-title":"Analysis the burden of breast cancer among adolescents and young adults using the global burden of disease 2021","volume":"32","author":"Zhang","year":"2025","journal-title":"Ann. Surg. Oncol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01821-X","article-title":"Global, regional, and national progress towards the 2030 global nutrition targets and forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2021","volume":"404","year":"2025","journal-title":"Lancet"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/s2352-4642(22)00219-x","article-title":"Global, regional, and national burdens of HIV and other sexually transmitted infections in adolescents and young adults aged 10\u201324 years from 1990 to 2019: a trend analysis based on the Global Burden of Disease Study 2019","volume":"6","author":"Zhang","year":"2022","journal-title":"Lancet Child Adolesc. Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s40779-021-00354-z","article-title":"Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributab le risk factors, 1990-2019","volume":"8","author":"Zi","year":"2021","journal-title":"Mil Med. Res"},{"key":"B27","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1186\/s12889-025-21428-w","article-title":"Global leukemia burden and trends: a comprehensive analysis of temporal and spatial variations from 1990\u20132021 using GBD (Global Burden of Disease) data","volume":"25","author":"Huang","year":"2025","journal-title":"BMC Public Health"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000003300","article-title":"The biological basis of sex differences in athletic performance: consensus statement for the american college of sports medicine","volume":"55","author":"Hunter","year":"2023","journal-title":"Med. Sci. Sports Exerc."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1080\/13557858.2011.603040","article-title":"Selected sociocultural correlates of physical activity among African-American adults","volume":"16","author":"Cogbill","year":"2011","journal-title":"Ethn Health"},{"key":"B30","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1186\/s12966-020-01042-2","article-title":"Advancing the global physical activity agenda: recommendations for future research by the 2020 WHO physical activity and sedentary behavior guidelines development group","volume":"17","author":"DiPietro","year":"2020","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2024.05.013","article-title":"Trajectories of physical activity and chronic conditions among mid-aged women","volume":"67","author":"Nemoto","year":"2024","journal-title":"Am. J. Prev. Med"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2022.12.004","article-title":"Comparison of the ketogenic ratio of macronutrients with the low-carbohydrate diet score and their association with risk of type 2 diabetes in postmenopausal women: A secondary analysis of the women\u2019s health initiative","volume":"123","author":"Titcomb","year":"2023","journal-title":"J. Acad. Nutr. Diet."},{"key":"B33","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.maturitas.2018.08.009","article-title":"Menopause and diabetes: EMAS clinical guide","volume":"117","author":"Slopien","year":"2018","journal-title":"Maturitas."},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3390\/nu16111624","article-title":"Eight weeks of intermittent exercise in hypoxia, with or without a low-carbohydrate diet, improves bone mass and functional and physiological capacity in older adults with type 2 diabetes","volume":"16","author":"Kindlovits","year":"2024","journal-title":"Nutrients."},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.exger.2021.111449","article-title":"Regular physical activity reduces the proinflammatory response in older women with diabetes and hypertension in the postmenopausal phase","volume":"152","author":"Lopes","year":"2021","journal-title":"Exp. Gerontol."},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2023.155585","article-title":"Diet, exercise, and pharmacotherapy for sarcopenia in people with diabetes","volume":"144","author":"Hashimoto","year":"2023","journal-title":"Metabolism."},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1089\/met.2021.0024","article-title":"Exploring the association of a total physical activity energy expenditure and diabetes mellitus in adults: A cross-sectional analysis of the canadian health measures survey","volume":"19","author":"Colpitts","year":"2021","journal-title":"Metab. Syndr. Relat. Disord"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.5888\/pcd15.180070","article-title":"Patterns of screen time among rural mexican-american children on the new Mexico-Mexico border","volume":"15","author":"McDonald","year":"2018","journal-title":"Prev. Chronic Dis"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.2196\/49150","article-title":"Digital rights and mobile health in low- and middle-income countries: protocol for a scoping review","volume":"12","author":"Poulsen","year":"2023","journal-title":"JMIR Res. Protoc"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1111\/jopy.12569","article-title":"Country-level correlates of the Dark Triad traits in 49 countries","volume":"88","author":"Jonason","year":"2020","journal-title":"J. Pers."},{"key":"B41","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1186\/s12916-019-1449-8","article-title":"The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action","volume":"17","author":"Di Cesare","year":"2019","journal-title":"BMC Med"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31992-5","article-title":"NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4","volume":"392","author":"Collaborators","year":"2018","journal-title":"Lancet"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01210-8","article-title":"Obesity in adults","volume":"404","author":"Lingvay","year":"2024","journal-title":"Lancet."},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)00355-1","article-title":"Global, regional, and national prevalence of adult overweight and obesity, 1990-2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021","volume":"405","author":"Collaborators","year":"2025","journal-title":"Lancet"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01548-4","article-title":"National-level and state-level prevalence of overweight and obesity among children, adolescents, and adults in the USA, 1990-2021, and forecasts up to 2050","volume":"404","author":"Collaborators","year":"2024","journal-title":"Lancet."},{"key":"B46","doi-asserted-by":"publisher","first-page":"5164","DOI":"10.1038\/s41467-024-49542-0","article-title":"Accelerometer-derived physical activity and mortality in individuals with type 2 diabetes","volume":"15","author":"Cao","year":"2024","journal-title":"Nat. Commun"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2023.110819","article-title":"Association of physical activity with total and cause-specific mortality in patients with diabetes: A nationwide population-based cohort study","volume":"202","author":"Jung","year":"2023","journal-title":"Diabetes Res. Clin. Pract"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2020.100171","article-title":"Contribution of sarcopenia and physical inactivity to mortality in people with non-alcoholic fatty liver disease","volume":"2","author":"Golabi","year":"2020","journal-title":"JHEP Rep"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3390\/nu11071652","article-title":"Physical activity, cardiorespiratory fitness, and the metabolic syndrome","volume":"11","author":"Myers","year":"2019","journal-title":"Nutrients."},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13273","article-title":"Exercise training in the management of overweight and obesity in adults: Synthesis of the evidence and recommendations from the European Association for the Study of Obesity Physical Activity Working Group","author":"Oppert","year":"2021","journal-title":"Obes. Rev"},{"key":"B51","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.diabres.2018.03.010","article-title":"Sleep duration, obesity and insulin resistance in a multi-ethnic UK population at high risk of diabetes","volume":"139","author":"Brady","year":"2018","journal-title":"Diabetes Res. Clin. Pract"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.01.016","article-title":"Diabetes and disability in older Australians: The Australian Diabetes, Obesity and Lifestyle (AusDiab) study","volume":"126","author":"Koye","year":"2017","journal-title":"Diabetes Res. Clin. Pract"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.969022","article-title":"Role of built environments in physical activity, obesity, and cardiovascular disease","volume":"125","author":"Sallis","year":"2012","journal-title":"Circulation."}],"container-title":["Frontiers in Clinical Diabetes and Healthcare"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcdhc.2025.1606330\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T15:04:15Z","timestamp":1755011055000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcdhc.2025.1606330\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,12]]},"references-count":53,"alternative-id":["10.3389\/fcdhc.2025.1606330"],"URL":"https:\/\/doi.org\/10.3389\/fcdhc.2025.1606330","relation":{},"ISSN":["2673-6616"],"issn-type":[{"value":"2673-6616","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,12]]},"article-number":"1606330"}}