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

Jinli Liu, Min Liu, Zhonglin Chai, Chao Li, Yanan Wang, Mingwang Shen, Guihua Zhuang, Lei Zhang, Jinli Liu, Min Liu, Zhonglin Chai, Chao Li, Yanan Wang, Mingwang Shen, Guihua Zhuang, Lei Zhang

Abstract

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.

Keywords: DALY, Disability-adjusted life-year; Diabetes; Disease burden; Economic burden; GBD, Global Burden of Disease; GDP, Gross domestic product; IDF, International diabetes federation; IMF, International monetary fund; SDI, Sociodemographic index; Spatio-temporal analysis; UNDESA, United Nations Department of Economic and Social Affairs; WHO, World Health Organization.

Conflict of interest statement

All authors declare that they have no competing interests.

© 2023 The Authors.

Figures

Fig. 1
Fig. 1
Spatial distribution (a), local Moran analysis (b) and hot spot analysis (c) of the prevalence of diabetes in China for 2020, 2025 and 2030.
Fig. 2
Fig. 2
Spatial distribution (a), local Moran analysis (b) and hot spot analysis (c) of the cost as a share of GDP of diabetes in China for 2020, 2025 and 2030.
Fig. 3
Fig. 3
Spatial distribution (a), local Moran analysis (b) and hot spot analysis (c) of the per-person economic burden of diabetes in China for 2020, 2025 and 2030.
Fig. 4
Fig. 4
The Pearson correlation between total economic costs of diabetes as a percentage of GDP (a), per capita economic burden of diabetes (b) and prevalence of diabetes in all 33 Chinese provinces and SARs in 2030.

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