{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:38:18Z","timestamp":1785411498527,"version":"3.56.0"},"reference-count":44,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"JSPS KAKENHI","doi-asserted-by":"publisher","award":["26K02613"],"award-info":[{"award-number":["26K02613"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012330","name":"Okayama university","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012330","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/02pc6pc55","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The Middle East and North Africa (MENA) region has one of the highest age-standardized diabetes prevalence rates globally, yet all-age, diabetes-specific evidence incorporating GBD 2023 estimates through 2023 remains limited. Materials and Methods: Using Global Burden of Disease (GBD) 2023 estimates for 21 MENA countries from 1990 to 2023, this ecological time-trend analysis quantified 33-year trends in incidence, prevalence, mortality, and disability-adjusted life-years (DALYs); compared pre-2019 and post-2019 trajectories using joinpoint regression; characterized age- and sex-specific burden patterns; and quantified contributions of modifiable risk factors. Results: Age-standardized incidence increased 92%, from 251.7 (95% uncertainty interval [UI]: 231.5 to 272.4) to 482.5 (95% UI: 451.5 to 516.4) per 100,000, and prevalence more than doubled, from 5564 (95% UI: 5088 to 6024) to 11,247 (95% UI: 10,382 to 12,132) per 100,000. In 2023, males exhibited higher DALY rates than females in most adult age groups from age 15 years onward, shifting away from the female-predominant pattern seen in 1990; female rates remained higher at several of the oldest age groups. Children aged 0 to 14 years were the only group with declining DALY rates (\u221252% to \u221257%). Post-2019 incidence was higher in 15 of 21 countries, and six countries had higher DALY trends with non-overlapping confidence intervals. Because we only have four to five years of data, these short trends are preliminary and require care when evaluating. High body-mass index was the leading modifiable risk factor. Conclusions: These data support country-specific prevention and chronic-care strategies across the MENA region.<\/jats:p>","DOI":"10.3390\/medicina62071352","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:55:21Z","timestamp":1783990521000},"page":"1352","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diabetes Burden in the Middle East and North Africa Region, 1990\u20132023: An Ecological Time-Trend Analysis of GBD Estimates"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2535-4122","authenticated-orcid":false,"given":"Hanane","family":"Ouddoud","sequence":"first","affiliation":[{"name":"Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 7008558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8871-5654","authenticated-orcid":false,"given":"Judah Israel Ong","family":"Lescano","sequence":"additional","affiliation":[{"name":"Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 7008558, Japan"},{"name":"Department of Pharmacy, School of Health Care Professions, University of San Carlos, Cebu City 6000, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4293-9708","authenticated-orcid":false,"given":"Keith Pardillada","family":"Belangoy","sequence":"additional","affiliation":[{"name":"Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 7008558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0224-7501","authenticated-orcid":false,"given":"Yoshito","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Mayo Clinic, Rochester, MN 55901, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko","family":"Harada","sequence":"additional","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5086-1891","authenticated-orcid":false,"given":"Hideharu","family":"Hagiya","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Okayama University Hospital, Okayama 7008558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quynh Thi","family":"Vu","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Haiphong University of Medicine and Pharmacy, Haiphong 180000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7891-3006","authenticated-orcid":false,"given":"Naohiro","family":"Iwata","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Okayama University Hospital, Okayama 7008558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4671-1409","authenticated-orcid":false,"given":"Tsukasa","family":"Higashionna","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Okayama University Hospital, Okayama 7008558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuaki","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Education and Research Center for Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Okayama University, Okayama 7008558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Zamami","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Okayama University Hospital, Okayama 7008558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7755-1754","authenticated-orcid":false,"given":"Toshihiro","family":"Koyama","sequence":"additional","affiliation":[{"name":"Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 7008558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref_1","unstructured":"International Diabetes Federation (2025). 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