Global burden of chronic kidney disease due to type 2 diabetes in adults from 1990 to 2021, with exploratory projections to 2036: a systematic analysis of the Global Burden of Disease Study 2021.

<h4>Aims</h4>To assess the global burden of chronic kidney disease due to type 2 diabetes (CKD-T2D) in adults from 1990 to 2021.<h4>Methods</h4>Data on incidence, mortality, and disability-adjusted life years (DALYs) of CKD-T2D in adults aged ≥ 20 years were extracted from the Global Burden of Disease Study 2021, stratified by age, sex, and year. Analyses included: trend identification, decomposition analysis (aging, population growth, epidemiological transition), risk factor assessment, age-period-cohort modeling, ARIMA forecasting (2022-2036), and frontier analysis.<h4>Results</h4>From 1990 to 2021, global age-standardized rates per 100,000 for incidence, mortality, and DALYs of adult CKD-T2D increased by 56.4%, 88.7%, and 60.1%, respectively. Burden was higher in males. Peak incidence occurred at ages 75-79, while peak mortality and DALYs occurred at ≥ 95 years. Decomposition analysis identified population growth and aging as primary drivers. High BMI, elevated fasting glucose, and hypertension were main metabolic risks. ARIMA projections indicated continued rises in ASR and absolute counts by 2036. Frontier analysis revealed disproportionately high burden in high SDI regions.<h4>Conclusions</h4>Driven by demographic shifts and metabolic risks, global CKD-T2D burden is rising. Enhanced early screening and prevention in adults, particularly in males, adults aged ≥ 75 years, and populations in high SDI regions, is urgently needed.