Global, regional, and national epidemiology of type 1 diabetes in children from 1990 to 2021: trend and health inequality analyses based on the Global Burden of Disease Study 2021 Original paper
Researched by:
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Dr. Umar
ID
Dr. Umar
Read MoreClinical Pharmacist and Clinical Pharmacy Master’s candidate focused on antibiotic stewardship, AI-driven pharmacy practice, and research that strengthens safe and effective medication use. Experience spans digital health research with Bloomsbury Health (London), pharmacovigilance in patient support programs, and behavioral approaches to mental health care. Published work includes studies on antibiotic use and awareness, AI applications in medicine, postpartum depression management, and patient safety reporting. Developer of an AI-based clinical decision support system designed to enhance antimicrobial stewardship and optimize therapeutic outcomes.
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Dr. Umar
Read More
Researched by:
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Dr. Umar
ID
Dr. Umar
Read More
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Dr. Umar
What was studied?
Global-childhood-type-1-diabetes-epidemiology was quantified using Global Burden of Disease (GBD) 2021 estimates to describe how childhood type 1 diabetes (T1D) incidence, prevalence, disability-adjusted life years (DALYs), and mortality changed from 1990–2021, how those changes differed by sociodemographic index (SDI), and what future patterns might look like through 2050. The investigators combined trend analyses with attribution decomposition (population growth, fertility patterns, and epidemiologic change) and inequality metrics (regression and concentration indices) to distinguish “more T1D exists” from “T1D outcomes are improving,” and to identify where inequities are widening.
Who was studied?
The analysis focused on children aged 0–14 years worldwide, using country-, regional-, and global-level modeled estimates from GBD 2021 rather than enrolling individual patients. Outcomes were stratified across SDI quintiles (low to high SDI) and examined by age bands within childhood and by sex to show where burden is accumulating and where survival and disability outcomes are diverging.
Most important findings
Globally, childhood T1D incident cases rose 32.04% and prevalent cases rose 41.47% from 1990 to 2021, while DALYs and deaths fell by 18.33% and 24.83%, respectively—an epidemiologic “more cases, less harm per case” pattern consistent with improved detection and care. The 2021 burden was geographically split: higher incidence/prevalence in North America and Northern Europe (and parts of the Middle East), but the highest DALYs and mortality in Sub-Saharan Africa, underscoring that where T1D is most common is not where it is most lethal. Inequality worsened over time, with the mortality concentration index shifting from −0.36 (1990) to −0.43 (2021), indicating an increasing concentration of death burden among lower-SDI settings. Decomposition results emphasized population growth and epidemiologic change as dominant drivers of rising incidence/prevalence, while declines in DALYs/deaths were largely linked to epidemiologic improvements (and, in some contexts, fertility change). Importantly for a microbiome signatures database, this paper does not measure microbiome composition or microbial taxa; it provides epidemiologic context rather than microbiome-associated signatures.
| Database-relevant element | Finding |
|---|---|
| Condition and phenotype | Childhood T1D burden rising (incidence/prevalence), severity falling (DALYs/deaths). |
| Geographic/SDI context | High incidence in high-SDI regions; highest DALYs/mortality in Sub-Saharan Africa. |
| Inequality signal | Mortality inequality worsened (concentration index −0.36 to −0.43). |
Key implications
Clinically, the study reframes “rising T1D” as two simultaneous realities: increasing case burden requiring capacity planning (diagnostics, insulin access, workforce) and improving outcomes where health systems can deliver modern care, leaving preventable disability and death concentrated in low-SDI settings. For microbiome-oriented clinicians and researchers, the practical implication is that any future microbiome-based risk stratification or prevention strategy must be designed and validated with equity in mind—otherwise, it risks widening the same SDI-linked gaps this paper documents, especially as incidence and prevalence are projected to keep rising (notably among males) through 2050.
Citation
Xie J, Li W, Li X, Zhang X, Liu J, Liu Z, Jing S, Shao H. Global, regional, and national epidemiology of type 1 diabetes in children from 1990 to 2021: trend and health inequality analyses based on the Global Burden of Disease Study 2021. Diabetology & Metabolic Syndrome. 2025;17:337. doi:10.1186/s13098-025-01905-3