Trends in Type 2 Diabetes Mortality, Prevalence and Disability-Adjusted Life-Years in the United Kingdom and European Union Countries: 1990–2019

Aims: To compare the trends in prevalence and mortality from type 2 diabetes mellitus (T2DM) in the UK and European Union (EU) countries. Methods: This observational study used data obtained from the Global Burden of Disease (GBD) Study. T2DM age-standardised prevalence rates per 100,000 (ASPRs), age-standardised mortality rates per 100,000 (ASMRs) and disability-adjusted life-year rates per 100,000 (DALYs) were extracted from the GBD online results tool for the UK and each EU country, for the years 1990-2019. Trends were analysed using Joinpoint regression analysis. Results: Between 1990 and 2019, increases in T2DM ASPRs were observed for all EU countries. The highest relative increases in ASPRs were observed in Luxembourg (males +269.1%, females +219.2%), Ireland (males +191.9%, females +165.7%) and the UK (males +128.6%, females +114.6%). The T2DM prevalence increases in the UK have plateaued from 2015/16-2019 for both sexes, with insignificant increases in estimated annual percentage changes of +0.9% and 0% for males and females, respectively. Mortality trends were non-uniform across EU countries, with ASMRs increasing over the 30-year period studied in 11 countries for males and in 4 countries for females. The UK observed the highest relative decrease in ASMRs for males (-46.9%). For females, the largest relative decrease in ASMRs was in Cyprus (-67.6%). Mortality-to-incidence ratios decreased in all countries except for males in Latvia and females in Denmark, with the lowest mortality-to-incidence ratios in 2019 being observed in the UK and Finland. DALYs increased in 25 countries for males and 17 countries for females between 1990 and 2019. Conclusions: T2DM prevalence rates have increased across Europe over the last 30 years, however mortality trends are variable. The prevalence of T2DM has increased more in the UK and Ireland between 1990-2019 than in any EU country, for both males and females, with the exception of Luxembourg. Contrastingly, the UK has observed large relative decreases in T2DM mortality rates. Primary prevention strategies in at risk populations should continue to be a focus for preventing T2DM in at risk groups in the UK and Europe.