Global burden of type 2 diabetes attributable to dietary risks in working-age adults aged 25-64 years: insights from the GBD 2023 study.
OBJECTIVE To estimate the global burden of type 2 diabetes mellitus (T2DM) attributable to dietary risks among working-age adults from 1990 to 2023, stratified by sex, age, region, and Socio-Demographic Index (SDI). Because Global Burden of Disease (GBD) 2023 data are not disaggregated for ages 15-24, analyses were restricted to adults aged 25-64 years, the core working-age group. STUDY DESIGN GBD 2023 data from 204 countries and territories were analyzed. Age-standardized mortality (ASMR) and disability-adjusted life-year rates (ASDR) attributable to seven dietary risks were estimated using population-attributable fractions and joinpoint regression. RESULTS During 1990-2023, global ASMR rose from 17.1 to 21.5 per 100,000 (average annual percentage change [AAPC] 0.69%), accelerating after 2010, and ASDR rose from 695.9 to over 800 per 100,000 (AAPC 0.50%). Sugar-sweetened beverages and processed meat were the fastest-growing risks; the low-fiber burden declined slightly. Males bore higher and faster-growing burdens. Pacific Island nations had the highest rates; Eastern Europe and the Middle East grew fastest. Crude DALYs rose most among 25-29-year-olds, largely reflecting demographic change. CONCLUSION Diet-related T2DM burden is rising among working-age adults, with sugar-sweetened beverages and processed meats growing fastest. Targeted interventions are urgently needed in high-burden regions, particularly for males and younger adults.