1. National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
2. Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
3. Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
zhoumaigeng@ncncd.chinacdc.cn
zhangxiujuan79@163.com
Show less
History+
Received
Accepted
Published Online
2025-03-06
2025-04-25
2025-05-21
PDF
(1060KB)
Abstract
The Healthy China 2030 Plan set the goal of reducing premature deaths from diabetes by 30% by 2030. However, there has been a lack of assessment of premature mortality for diabetes since the action plan was issued. This study used data from the Global Burden of Disease Study 2021, calculated the premature deaths for diabetes by sex, provinces, and subtypes from 1990 to 2021. We explored the temporal trend of premature mortality using the average annual percent change (AAPC) for different sexes, provinces, and subtypes from 1990 to 2021. Furthermore, we predicted premature mortality for diabetes through 2030 for China and its provinces according to the average annual change rate from 2010 to 2021. There was a first slow upward trend in premature mortality for diabetes from 0.5% in 1990 to 0.6% in 2004, and then a decline until 2021 with premature mortality of 0.4%. By 2030, only Fujian (30.3%) will achieve the desired level of reduction, with only seven provinces meeting the target for females and none for males. There is a large range in the degree of decline between inland and coastal regions, showing obvious geographic differences, and there should be a focus on balancing medical resources.
Yang JJ, Yu D, Wen W, Saito E, Rahman S, Shu XO, Chen Y, Gupta PC, Gu D, Tsugane S, Xiang YB, Gao YT, Yuan JM, Tamakoshi A, Irie F, Sadakane A, Tomata Y, Kanemura S, Tsuji I, Matsuo K, Nagata C, Chen CJ, Koh WP, Shin MH, Park SK, Wu PE, Qiao YL, Pednekar MS, He J, Sawada N, Li HL, Gao J, Cai H, Wang R, Sairenchi T, Grant E, Sugawara Y, Zhang S, Ito H, Wada K, Shen CY, Pan WH, Ahn YO, You SL, Fan JH, Yoo KY, Ashan H, Chia KS, Boffetta P, Inoue M, Kang D, Potter JD, Zheng W. Association of diabetes with all-cause and cause-specific mortality in asia: a pooled analysis of more than 1 million participants. JAMA Netw Open2019; 2(4): e192696
[2]
Shen X, Vaidya A, Wu S, Gao X. The diabetes epidemic in china: an integrated review of national surveys. Endocr Pract2016; 22(9): 1119–1129
[3]
Wang L, Peng W, Zhao Z, Zhang M, Shi Z, Song Z, Zhang X, Li C, Huang Z, Sun X, Wang L, Zhou M, Wu J, Wang Y. Prevalence and treatment of diabetes in china, 2013–2018. JAMA2021; 326(24): 2498–2506
[4]
Jia W, Weng J, Zhu D, Ji L, Lu J, Zhou Z, Zou D, Guo L, Ji Q, Chen L, Chen L, Dou J, Guo X, Kuang H, Li L, Li Q, Li X, Liu J, Ran X, Shi L, Song G, Xiao X, Yang L, Zhao Z. Standards of medical care for type 2 diabetes in china 2019. Diabetes Metab Res Rev2019; 35(6): e3158
[5]
Tian Y, Qiu Z, Wang F, Deng S, Wang Y, Wang Z, Yin P, Huo Y, Zhou M, Liu G, Huang K. Associations of diabetes and prediabetes with mortality and life expectancy in china: a national study. Diabetes Care2024; 47(11): 1969–1977
[6]
MaglianoDJBoykoEJDA. IDF diabetes atlas. Brussels: International Diabetes Federation, 2021
[7]
Liu J, Liu M, Chai Z, Li C, Wang Y, Shen M, Zhuang G, Zhang L. Projected rapid growth in diabetes disease burden and economic burden in china: a spatio-temporal study from 2020 to 2030. Lancet Reg Health West Pac2023; 33: 100700
[8]
WorldHealth Organization. Draft comprehensive global monitoring framework and targets for the prevention and control of noncommunicable diseases. Geneva, Switzerland: World Health Organization. 2013
[9]
WorldHealth Organization. Global action plan for the prevention and control of non-communicable diseases 2013–2020. Geneva, Switzerland: World Health Organization. 2013
[10]
CPC Central Committee, State Council. The plan for “healthy china 2030”. 2016
[11]
State Council (PRC). Circular of the general office of the state council on the issuance of the medium- and long-term plan for the prevention and treatment of chronic diseases in china (2017–2025). 2017
[12]
NationalHealth Commission, . Circular on the issuance of the implementation plan for the healthy china initiative—diabetes prevention and control action (2024–2030). 2024
[13]
GBD 2021 Diabetes Collaborators. 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. Lancet2023; 402(10397): 203–234
[14]
Deng LL, Zhao F, Li ZW, Zhang WW, He GX, Ren X. Epidemiological characteristics of tuberculosis incidence and its macro-influence factors in Chinese mainland during 2014–2021. Infect Dis Poverty2024; 13(1): 34
[15]
Liu L, Li Y, Song J, Chen Q, Li S, Mu H, Na J, Zhang R, Yu L, Sun W, Pan G. Current status of premature mortality from four non-communicable diseases and progress towards the sustainable development goal target 3.4: a population-based study in northeast china, 2004–2017. BMC Public Health2021; 21(1): 1608
[16]
Murthy SS, Trapani D, Cao B, Bray F, Murthy S, Kingham TP, Are C, Ilbawi AM. Premature mortality trends in 183 countries by cancer type, sex, WHO region, and World Bank income level in 2000–19: a retrospective, cross-sectional, population-based study. Lancet Oncol2024; 25(8): 969–978
[17]
Li Y, Zeng X, Liu J, Liu Y, Liu S, Yin P, Qi J, Zhao Z, Yu S, Hu Y, He G, Lopez AD, Gao GF, Wang L, Zhou M. Can China achieve a one-third reduction in premature mortality from non-communicable diseases by 2030. BMC Med2017; 15(1): 132
[18]
Bennett JE, Stevens GA, Mathers CD, Bonita R, Rehm J, Kruk ME, Riley LM, Dain K, Kengne AP, Chalkidou K, Beagley J, Kishore SP, Chen W, Saxena S, Bettcher DW, Grove JT, Beaglehole R, Ezzati M. NCD countdown 2030: worldwide trends in non-communicable disease mortality and progress towards sustainable development goal target 3.4. Lancet2018; 392(10152): 1072–1088
[19]
Wijnen A, Bishop K, Joshy G, Zhang Y, Banks E, Paige E. Observed and predicted premature mortality in Australia due to non-communicable diseases: a population-based study examining progress towards the WHO 25x25 goal. BMC Med2022; 20(1): 57
[20]
Quesada JA, Carratalá-Munuera C, Carbonell-Soliva A, Segura-Aparicio JC, González-Fernández J, Salazar-Sánchez L, Gil-Guillén VF, López-Pineda A, Nouni-García R, Orozco-Beltrán D. Trends in premature mortality from diabetes mellitus in Costa Rica in the period 2000–2020. Postgrad Med2023; 135(2): 128–140
[21]
Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, Li X, Wang L, Wang L, Liu Y, Liu J, Zhang M, Qi J, Yu S, Afshin A, Gakidou E, Glenn S, Krish VS, Miller-Petrie MK, Mountjoy-Venning WC, Mullany EC, Redford SB, Liu H, Naghavi M, Hay SI, Wang L, Murray C, Liang X. Mortality, morbidity, and risk factors in china and its provinces, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet2019; 394(10204): 1145–1158
[22]
Gordon-LarsenPWangHPopkinBM. Overweight dynamics in Chinese children and adults. Obes Rev2014; 15 Suppl 1(1): 37–48
[23]
Ali MK, Pearson-Stuttard J, Selvin E, Gregg EW. Interpreting global trends in type 2 diabetes complications and mortality. Diabetologia2022; 65(1): 3–13
[24]
Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol2018; 14(2): 88–98
[25]
Institutefor Health MetricsEvaluation(IHME). Global burden of disease study 2021 (GBD2021) data resources. 2023
[26]
Pan XF, Wang L, Pan A. Epidemiology and determinants of obesity in China. Lancet Diabetes Endocrinol2021; 9(6): 373–392
[27]
Du W, Wang H, Su C, Jia X, Zhang B. Thirty-year urbanization trajectories and obesity in modernizing China. Int J Environ Res Public Health2022; 19(4): 1943
[28]
Gao L, Wu Y, Chen S, Zhou H, Zhao L, Wang Y. Time trends and disparities in combined overweight and obesity prevalence among children in China. Nutr Bull2022; 47(3): 288–297
[29]
Zhang M, Shi Y, Zhou B, Huang Z, Zhao Z, Li C, Zhang X, Han G, Peng K, Li X, Wang Y, Ezzati M, Wang L, Li Y. Prevalence, awareness, treatment, and control of hypertension in China, 2004–18: findings from six rounds of a national survey. BMJ2023; 380: e071952
[30]
Jakovljevic M, Chang H, Pan J, Guo C, Hui J, Hu H, Grujic D, Li Z, Shi L. Successes and challenges of China’s health care reform: a four-decade perspective spanning 1985–2023. Cost Eff Resour Alloc2023; 21(1): 59
[31]
Papier K, D’Este C, Bain C, Banwell C, Seubsman SA, Sleigh A, Jordan S. Body mass index and type 2 diabetes in Thai adults: defining risk thresholds and population impacts. BMC Public Health2017; 17(1): 707
[32]
Hosseinpanah F, Rambod M, Azizi F. Population attributable risk for diabetes associated with excess weight in Tehranian adults: a population-based cohort study. BMC Public Health2007; 7(1): 328
[33]
Zhang X, Yang S, Zhang X. Analysis of medical expenses of inpatients with diabetes: China’s eastern, central, and western regions (2013–2015). Public Health2020; 185: 167–173
[34]
Zhi H. Research on regional allocation differences of grassroots medical and health resources in China. Adv Soil Sci2024; 5(13): 410–418
[35]
Zhang X, Lu J, Wu C, Cui J, Wu Y, Hu A, Li J, Li X. Healthy lifestyle behaviours and all-cause and cardiovascular mortality among 0.9 million Chinese adults. Int J Behav Nutr Phys Act2021; 18(1): 162
[36]
Mai LX, Liu Y, Wen H, Zeng ZY. The correlation between healthy lifestyle habits and all-cause and cardiovascular mortality in Guangxi. BMC Public Health2024; 24(1): 2226
[37]
Meng J, Mao W, Huang J. Death and probability of premature mortality caused by four major chronic diseases in the death cause monitoring areas of Guangxi, 2008–2017. Applied Prev Med2018; 24(5): 343–348