JMIR Publications

ABSTRACT

Background:

Understanding dynamic changes in non-communicable diseases is crucial for informing health policy precisely and improving population-level outcomes.

Objective:

This study analyzed trends in key health metrics to update the care gaps for type 2 diabetes in one high-income country.

Methods:

We conducted a nationwide trend analysis of annual incidence, prevalence, mortality, and life expectancy from 2012 to 2021, the ABC (HbA1c, blood pressure, cholesterol) control metrics from 2015 to 2021, and the complication-specific incidences from 2017 to 2021. The selected health metrics were tested by trend analysis and stratified by age and sex, and standardized to understand disparities in trends.

Results:

The standardized incidence and mortality rates of type 2 diabetes slightly declined by an average of 0.025 and 0.022 per 100 patient-years annually, respectively (p for trend = 0.002 and 0.003). These declines coincided with an average annual increase of 0.51% in the standardized prevalence proportion (p for trend < 0.001). While glycemic and lipid control improved steadily, blood pressure control remained suboptimal, reaching only 35.9% in 2021. All complications examined, except nephropathy, showed heterogeneous decreasing trends between ages. The disparity in life expectancy between people with type 2 diabetes and the general population has narrowed over time, but the gap was still pronounced among younger age groups.

Conclusions:

This nationwide analysis highlights critical care gaps—particularly in blood pressure management, nephropathy prevention, and care for younger individuals with type 2 diabetes. Addressing these deficiencies is urgent for achieving more equitable and effective diabetes care. Clinical Trial: N/A