O-03: Changing patterns of type 1 diabetes in South Asian children and adolescents: trends in deaths, DALYs, and prevalence from GBD 2000–2023
A H Flabe, B Zabeen, K Huda, K U Baset, M R IslamAbstract
Introduction
Type 1 diabetes (T1D) contributes substantially to premature mortality and disability across the life course in South Asia, where access to insulin and structured diabetes care remains constrained. While previous work has emphasized youth, less is known about how the burden is distributed across paediatric, adolescent, and adult age groups over time.
Objectives
To describe age-group–specific trends in type 1 diabetes deaths, DALYs, and prevalence in South Asia from 2000 to 2023.
Methods
We used Global Burden of Disease 2023 estimates for South Asia, extracting type 1 diabetes data (all ages, both sexes) for 2000–2023. We analyzed deaths, DALYs, and prevalence as rates per 100,000, assessing trends in <20 years and specific paediatric/adolescent bands (5–9, 10–14, 5–14, 10–19 years) and using all reported age groups to describe groupwise distribution across the age spectrum.
Results
In 2000, T1D burden in South Asia included DALY and death rates of 24.5 and 0.30 per 100,000 in those <20 years, highest in 10–19 years (35.5; 0.45) and lowest in 5–9 years (20.4; 0.24). By 2023, DALY and death rates declined across all youth groups (e.g., <20 years 15.6; 0.19; 5–14 years 12.4; 0.14), while prevalence rose in every band (<20 years 22.6–26.9; 10–19 years 38.7–42.8 per 100,000), indicating more young people living with T1D but reduced per-capita health loss. Across the full age spectrum, youth still contributed a substantial share of DALYs and deaths, but older groups (20–39 and ≥40 years) had higher absolute rates, consistent with a shift from early mortality to accumulated chronic complications and a persistent concentration of burden in older adolescents and adults.
Conclusions
From 2000 to 2023, T1D mortality and DALY rates declined but prevalence rose across all ages in South Asia, with highest burden in older adolescents and adults, underscoring the need for age-tailored diabetes services.