Secular trends in type 2 diabetes mellitus attributable to PM_2.5 exposure in China from 1990 to 2019: an age-period-cohort analysis

Secular trends of mortality and disability-adjusted life years (DALY) in type 2 diabetes mellitus (T2DM) attributable to PM_2.5 exposure in China remain unclear. This study applied the joinpoint regression analysis and age-period-cohort model to assess the secular trends. There was a slight alternation in age-standardized rate of mortality and DALY in the total population, while the changes were increased in males and decreased in females from 1990 to 2019. Meanwhile, the changes attributable to ambient particular matter pollution exposure (APE) increased significantly and reduced household air pollution from solid fuels exposure (HPE). Longitudinal age curves showed that T2DM mortality and DALY increased with age. Period rate ratios (RR) attributable to APE increased but fell to HPE. Similar trends were observed in the cohort RR. PM_2.5 exposure is more harmful to males and older people. The type of air pollution responsible for T2DM has changed from HPE to APE.