Investigating the temporal trends of diabetes disease burden in China during 1990-2019 from a global perspective.

Introduction: Diabetes poses a global public health challenge and our understanding of its temporal evolution in China relative to the rest of the world is limited. Our study aims to comprehensively examine the temporal trend of diabetes DALYs in China from a global perspective. Methods: We analyzed data on diabetes incidence, prevalence, and mortality for individuals aged ≥20 years in China and globally from the Global Burden of Disease (GBD) 2019 study. We assessed trends in age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of diabetes in China and globally by estimating annual percentage changes (EAPCs). We employed decomposition analysis to reveal factors driving the trend of diabetes DALYs in China. Results: During 1990-2019, the number of diabetes patients increased by 160% from 35.14 million to 91.70 million in China. The ASIR of diabetes increased from 249 per 100,000 to 329 per 100,000 in China, which was lower than the global rate (419 per 100,000 in 2019). The EAPC of diabetes incidence was also lower in China compared to the global rate (1.02% vs. 1.57%). Consistently, the age-standardized prevalence rate of diabetes increased from 4788 per 100,000 to 8170 per 100,000 during 1990-2019 in China, which remained lower than the corresponding global rate (8827 per 100,000 in 2019). Further, the ASMR of diabetes increased from 9 per 100,000 to 15 per 100,000 during 1990-2019 in China, which was lower than the corresponding global rate (30 per 100,000 in 2019). However, EAPC of diabetes mortality in China was much higher than the global level (1.75% vs. 1.07%). Globally, the rising diabetes DALYs was predominantly attributed to population growth (55.2%) and epidemiologic changes (24.6%). In comparison, population growth (48.9%) also played an important role in the increasing diabetes DALYs in China, but aging (43.7%) was second major contributor. Conclusion: Our findings show that diabetes DALYs in China followed a global increasing trend during 1990-2019. Notably, aging has a very substantial contribution to the increase in diabetes DALYs in China in addition to population growth. .

Projected rapid growth in diabetes disease burden and economic burden in China: a spatio-temporal study from 2020 to 2030.

Background: This study projects the trend of disease burden and economic burden of diabetes in 33 Chinese provinces and nationally during 2020-2030 and investigates its spatial disparities. Methods: Time series prediction on the prevalence and disability-adjusted life-year (DALY) rates of diabetes was conducted using a Bayesian modelling approach in 2020-2030. The top-down method and the human capital method were used to predict the direct and indirect costs of diabetes for each Chinese province. Global and local spatial autocorrelation analyses were used to identify geographic clusters of low-or high-burden areas. Findings: Diabetes prevalence in Chinese adults aged 20-79 years was projected to increase from 8.2% to 9.7% during 2020-2030. During the same period, the total costs of diabetes would increase from $250.2 billion to $460.4 billion, corresponding to an annual growth rate of 6.32%. The total costs of diabetes as a percentage of GDP would increase from 1.58% to 1.69% in China during 2020-2030, suggesting a faster growth in the economic burden of diabetes than China's economic growth. Consistently, the per-capita economic burden of diabetes would increase from $231 to $414 in China during 2020-2030, with an annual growth rate of 6.02%. High disease and economic burden areas were aggregated in Northeast and/or North China. Interpretation: Our study projects a significant growth of disease and economic burden of diabetes in China during 2020-2030, with strong spatial aggregation in northern Chinese regions. The increase in the economic burden of diabetes will exceed that of GDP. Funding: National Natural Science Foundation of China, Outstanding Young Scholars Funding.

Excess diabetes mellitus-related deaths during the COVID-19 pandemic in the United States.

Background: Diabetes mellitus (DM) is a critical risk factor for severe SARS-CoV-2 infection, and SARS-CoV-2 infection contributes to worsening glycemic control. The COVID-19 pandemic profoundly disrupted the delivery of care for patients with diabetes. We aimed to determine the trend of DM-related deaths during the pandemic. Methods: In this serial population-based study between January 1, 2006 and December 31, 2021, mortality data of decedents aged ≥25 years from the National Vital Statistics System dataset was analyzed. Decedents with DM as the underlying or contributing cause of death on the death certificate were defined as DM-related deaths. Excess deaths were estimated by comparing observed versus expected age-standardized mortality rates derived from mortality during 2006-2019 with linear and polynomial regression models. The trends of mortality were quantified with joinpoint regression analysis. Subgroup analyses were performed by age, sex, race/ethnicity, and state. Findings: Among 4·25 million DM-related deaths during 2006-2021, there was a significant surge of more than 30% in mortality during the pandemic, from 106·8 (per 100,000 persons) in 2019 to 144·1 in 2020 and 148·3 in 2021. Adults aged 25-44 years had the most pronounced rise in mortality. Widened racial/ethnic disparity was observed, with Hispanics demonstrating the highest excess deaths (67·5%; 95% CI 60·9-74·7%), almost three times that of non-Hispanic whites (23·9%; 95% CI 21·2-26·7%). Interpretation: The United States saw an increase in DM-related mortality during the pandemic. The disproportionate rise in young adults and the widened racial/ethnic disparity warrant urgent preventative interventions from diverse stakeholders. Funding: National Natural Science Foundation of China.

Does digital inclusive finance promote industrial transformation? New evidence from 115 resource-based cities in China.

Industrial transformation (IT) is the inevitable course for the sustainable development of resource-based cities, while digital inclusive finance (DIF) provides essential capital elements for industrial transformation. Based on the panel data of 115 resource-based cities in China from 2011 to 2019, this paper discusses the influence mechanism of digital inclusive finance on industrial transformation from the perspectives of the optimization of industrial structure (OIS) and the rationalization of industrial structure (RIS). The empirical results show that digital inclusive finance has a positive effect on both the optimization of industrial structure and the rationalization of industrial structure. Digital inclusive finance influences industrial transformation through residents' income and technological innovation. In addition, in the analysis of income gap and innovation gap, low-income regions have a better effect on the industrial transformation of industrial structure optimization, while high-income regions have a better effect in manufacturing upgrading, thus resulting in a more significant effect of industrial transformation on the rationalization of industrial structure. Obviously, the development of high-innovation regions has relative advantages with more channels for industrial transformation, which have significant effect of industrial transformation. Therefore, it is necessary to provide differentiated reform on the basis of unified development reform.

Does green innovation suppress carbon emission intensity? New evidence from China.

The sustainable development of human beings is facing severe challenges in the context of a new era. The effective reduction of carbon emission intensity is essential to achieve the goal of sustainable development. Obviously, green innovation is an important factor in mitigating carbon emission intensity. It is important to measure the effect of green innovation on carbon emission intensity for accelerating industrial transformation and building a circular economy system. Therefore, this paper uses the data of 30 provinces in China from 2000 to 2019, obtained by the State Intellectual Property Office, using fixed effects model quantile regression model and Spatial Durbin Model to empirically verify the theoretical hypothesis. The conclusions are as follows: (1) Green innovation inhibits carbon emission intensity. Instrumental variable model and robustness test support this conclusion. (2) For carbon emission intensity under different quantiles, green innovation has a more significant effect on provinces with high carbon emission intensity through "target accountability system" and "reverse coercive system." (3) There is a significant spatial correlation between green innovation in China's provinces. The reduction of carbon emission intensity in the region will benefit from the improvement of green innovation in surrounding cities.

Low- and middle-income countries demonstrate rapid growth of type 2 diabetes: an analysis based on Global Burden of Disease 1990-2019 data.

AIMS/HYPOTHESIS: The study aims to quantify the global trend of the disease burden of type 2 diabetes caused by various risks factors by country income tiers. METHODS: Data on type 2 diabetes, including mortality and disability-adjusted life years (DALYs) during 1990-2019, were obtained from the Global Burden of Disease Study 2019. We analysed mortality and DALY rates and the population attributable fraction (PAF) in various risk factors of type 2 diabetes by country income tiers. RESULTS: Globally, the age-standardised death rate (ASDR) attributable to type 2 diabetes increased from 16.7 (15.7, 17.5)/100,000 person-years in 1990 to 18.5 (17.2, 19.7)/100,000 person-years in 2019. Similarly, age-standardised DALY rates increased from 628.3 (537.2, 730.9)/100,000 person-years to 801.5 (670.6, 954.4)/100,000 person-years during 1990-2019. Lower-middle-income countries reported the largest increase in the average annual growth of ASDR (1.3%) and an age-standardised DALY rate (1.6%) of type 2 diabetes. The key PAF attributing to type 2 diabetes deaths/DALYs was high BMI in countries of all income tiers. With the exception of BMI, while in low- and lower-middle-income countries, risk factors attributable to type 2 diabetes-related deaths and DALYs are mostly environment-related, the risk factors in high-income countries are mostly lifestyle-related. CONCLUSIONS/INTERPRETATION: Type 2 diabetes disease burden increased globally, but low- and middle-income countries showed the highest growth rate. A high BMI level remained the key contributing factor in all income tiers, but environmental and lifestyle-related factors contributed differently across income tiers. DATA AVAILABILITY: To download the data used in these analyses, please visit the Global Health Data Exchange at http://ghdx.healthdata.org/gbd-2019 .

Trends in Under-5 Mortality Rates and Their Associations with Socioeconomic Factors Among Countries Participating in the Belt and Road Initiative: A Panel Data Analysis.

PURPOSE: The Belt and Road Initiative (BRI) provided a platform to promote trade and economic collaboration, with health promotion also being an important component. This study examined the burden of the under-5 mortality rate (U5MR) among BRI countries and studied the impact of socioeconomic development on the U5MR. PATIENTS AND METHODS: Data were collected from 137 BRI countries for the period 2000-2018. The temporal changes in the U5MR and the estimated annual percentage change (EAPC) were used to assess the U5MR burden. A quantile fixed-effects model was used to access the associations between socioeconomic factors and the U5MR. RESULTS: The U5MR varied widely among the 137 analyzed countries in 2018, being highest in Somalia (121.5 per 1000) and lowest in Slovenia (2.1 per 1000). The decreasing trend in U5MR was largest in Montenegro (EAPC = -9.6, 95% confidence interval [CI] = -10.2 to -9.0), while the increasing trend was largest in Dominica (EAPC = 6.0, 95% CI = 5.3 to 6.7). Countries with higher U5MRs in 2000 experienced more rapid decreases in the U5MR from 2000 to 2018. The influence of socioeconomic factors on U5MR was related to the distribution of U5MR. CONCLUSION: The U5MR remains a major public-health issue in some BRI countries. Improving the economic situation will benefit child health in BRI countries in the long run.

Trends in the incidence of diabetes mellitus: results from the Global Burden of Disease Study 2017 and implications for diabetes mellitus prevention.

BACKGROUD: Diabetes mellitus is a common chronic disease and a severe public health issue. The incidence trends for type 1 diabetes (TIDM) and type 2 diabetes (T2DM) have rarely been studied on a global scale. We aimed to determine the temporal and geographical trends of diabetes globally. METHODS: Data on diabetes mellitus, including incidence, prevalence from 1990 to 2017 were obtained from the 2017 Global Burden of Disease study. We calculated the estimated annual percentage changes (EAPCs) in age-standardized incidence rate (ASIR) of diabetes mellitus according to sex, region, and disease type. RESULTS: The worldwide incident cases of diabetes mellitus has increased by 102.9% from 11,303,084 cases in 1990 to 22,935,630 cases in 2017 worldwide, while the ASIR increased from 234 /100,000 persons (95% UI, 219-249) to 285/100,000 persons (95% UI, 262-310) in this period [EAPC = 0.87, 95% confidence interval (CI):0.79-0.96]. The global ASIRs of T1DM and T2DM both demonstrated significant increase during 1990-2017, with EAPCs of 0.34 (95% CI,0.30-0.39) and 0.89 (95% CI,0.80-0.97), respectively. The ASIR trends also varied considerably by regions and countries. The increase in ASIR was greatest in high sociodemographic index regions (EAPC = 1.05, 95% CI:0.92-1.17) and lowest in low-SDI regions (EAPC = 0.79, 95% CI:0.71-0.88). CONCLUSIONS: Both the number of incident cases and ASIR of diabetes mellitus increased significantly during 1990-2017 worldwide, but the temporal trends varied markedly across regions and countries.

Comparison of different methods for nutrition assessment in patients with tumors.

Nutrition screening to identify patients at risk of malnutrition is vital for cancer patients because of the high prevalence of malnutrition in this population. The aim of the present study was to compare different methods of nutrition assessment in patients with tumors. From June 2013 to June 2014, we conducted an observational multicenter study to compare the assessment of nutritional status in patients with tumors by anthropometry, biochemical indicators, nutritional risk screening (NRS-2002) and patient-generated subjective global assessment (PG-SGA). Mann-Whitney test and Kruskal-Wallis H non-parametric test were used for intergroup comparisons. Spearmans rank correlation coefficients were calculated to evaluate the association between different methods of nutritional assessment. The κ statistic was used to evaluate the agreement between two assessment methods. A total of 927 oncology inpatients underwent full nutritional assessment and nutrition screening. The PG-SGA tool determined that 13.7% of patients were well-nourished (PG-SGA from 0-1) and the rest (86.3%) were malnourished. Among the malnourished patients, 57.8% were moderately malnourished (PG-SGA from 2-8) and 28.5% were severely malnourished (PG-SGA ≥9). According to NRS-2002, 30.7% of patients were at nutritional risk (NRS-2002 ≥3). There was a significant positive correlation between PG-SGA scores and NRS-2002 scores in both men and women. Compared to albumin, the PG-SGA had a sensitivity of 93.78% and specificity of 21.80%. In comparison, NRS-2002 had a low sensitivity of 43.13% and relatively higher specificity of 82.16%. In conclusion, the relationship between PG-SGA, NRS-2002 and nutritional status is statistically significant. Compared with NRS-2002, PG-SGA is a suitable screening tool for detecting the risk of malnutrition in patients with cancer.