Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

This online publication has been corrected. The corrected version first appeared at thelancet.com on September 28, 2023BACKGROUND : Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. METHODS : Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. FINDINGS : In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world’s highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. INTERPRETATION : Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers.Bill & Melinda Gates Foundation.http://www.thelancet.comam2024School of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein

Study of device instability of bottom-gate ZnO transistors with sol-gel derived channel layers

In this paper, the authors report the device instability of solution based ZnO thin film transistors by studying the time-evolution of electrical characteristics during electrical stressing and subsequent relaxation. A systematic comparison between ambient and vacuum conditions was carried out to investigate the effect of adsorption of oxygen and water molecules, which leads to the creation of defects in the channel layer. The observed subthreshold swing and change in field effect mobility under gate bias stressing have supported the fact that oxygen and moisture directly affect the threshold voltage shift. The authors have presented the comprehensive analysis of device relaxation under both ambient and vacuum conditions to further confirm the defect creation and charge trapping/detrapping process since it has not been reported before. It was hypothesized that chemisorbed molecules form acceptorlike traps and can diffuse into the ZnO thin film through the void on the grain boundary, being relocated even near the semiconductor/dielectric interface. The stretched exponential and power law model fitting reinforce the conclusion of defect creation by oxygen and moisture adsorption on the active layerScopu

Time-resolved photocurrent spectroscopic diagnostics of electrically active defects in AlGaN/GaN High Electron Mobility Transistor (HEMT) structure grown on Si wafers

Time-resolved photocurrent (TRPC) spectroscopy with a variable-wavelength sub-bandgap light excitation was used to study the dynamics of the decaying photocurrent generated in the heterostructures of the AlGaN/GaN high electron mobility transistors (HEMTs) layers. In AlGaN/GaN HEMTs, reliability of the device is degraded due to the prevalence of current collapse. It is recognized that electrically active deep level defects at the surface/interfaces and the bulk in the HEMTs layers can contribute to the unwanted current collapse effect. Therefore, it is of great importance to analyze the deep level defects if the reliability of the HEMTs device is to be improved. In this research, TRPC spectroscopy was used to elucidate the origin and nature of the deep level defects by analyzing the time evolution of the photocurrent decay excited at different wavelengths of light. The two devices that show similar characteristics for wavelength-dependency on photocurrent generation were chosen, and TRPC spectroscopy was conducted on these devices. Although the two samples show similar characteristics for the wavelength-dependency on photocurrent generation, they exhibited dissimilar time-dependent photocurrent decay dynamics. This implies that TRPC spectroscopy can be used to distinguish the traps which have different origins but have the same de-trapping energy.Scopu