[Forecasting the burden of disease from diabetes under the scenarios of specific risk factors control in China in 2030].

Objective: To forecast mortality, age-standardized mortality, and probability of premature mortality from diabetes, and to simulate the impact of controlling risk factors by 2030 in China. Methods: We simulated the burden of disease from diabetes in six scenarios according to the development goals of risk factors control by the WHO and Chinese government. Based on the theory of comparative risk assessment and the estimates of the burden of disease for China from the Global Burden of Disease Study 2015, we used the proportional change model to project the number of deaths, age-standardized mortality, and probability of premature mortality from diabetes under different scenarios of risk factors control in 2030. Results: If the trends in exposures to risk factors from 1990 to 2015 continued. Mortality, age-standardized mortality, and probability of premature mortality from diabetes would increase to 32.57/100 000, 17.32/100 000, and 0.84% by 2030, respectively. During that time, mortality, age-standardized mortality and probability of premature mortality for males would all be higher than for females. If the goals of controlling risk factors were all achieved, the number of deaths from diabetes in 2030 would decrease by 62.10% compared to the predicted numbers based on the historical trends in exposure to risk factors, and the probability of premature mortality would drop to 0.29%. If only the exposure to a single risk factor were achieved by 2030, high fasting plasma glucose control would have the greatest impact on diabetes, resulting in a 56.00% reduction in deaths compared to the predicted numbers based on the historical trends, followed by high BMI (4.92%), smoking (0.65%), and low physical activity (0.53%). Conclusions: Risk factors control plays an important role in reducing the number of deaths, age-standardized mortality rate, and probability of premature mortality from diabetes. We suggest taking comprehensive measures to control relevant risk factors for certain populations and regions, to achieve the goal of reducing the burden of disease from diabetes as expected.

[Progress in research of burden of disease attributed to population ageing].

Objective: To summarize recent progress in research of burden of disease attributed to population ageing and provide reference for relevant research in the future. Methods: We conducted a systematic literature review of quantitative studies about the impact of population ageing on burden of disease published from 2009 to 2019 according to the inclusion and exclusion criteria through PubMed, Web of Science, Embase, Cochrane Library, Wangfang database and China National Knowledge Infrastructure (CNKI) databases and extracted basic information and key results of the searched literature. Results: A total of 65 studies were included in the analysis, in which 29 (44.6%) studies used death number or mortality rate as outcome measures, 43 (66.2%) studies focused on a single country, such as China, United Kingdom and United States, 39 (60.0%) studies quantified the impact of population ageing on single disease, such as diabetes, lung cancer and coronary heart disease, 44 (67.7%) studies used decomposition methods to quantify the impact of population ageing, and 10 (15.4%) studies evaluated the effect of interventions on alleviating the impact of population ageing. Most studies found that population ageing increased the burden of some diseases, such as cancer, cardiovascular disease and dementia, while a few studies reported that population ageing decreased the burden of some diseases, such as neonatal disease and malaria. Various decomposition methods were adopted in 65 included studies, but several common methods were sensitive to the preconditions that were assumed, the decomposition order of three factors (population size, age structure, and age-specific rate) and the choice of control group, resulting incomparable and unstable results. Conclusions: The published decomposition studies adopted various methods and only evaluated the impact of population ageing in very limited countries and for several diseases. Therefore, a systematic evaluation using robust decomposition method is very necessary to evaluate the impact of population aging on disease burden across countries and diseases.