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

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.