Regional burden, trends, and future projections of chronic kidney disease due to type 2 diabetes mellitus in South Asia: insights from the global burden of disease study (1990–2021) and ARIMA forecasting

Chronic kidney disease (CKD) due to Type 2Diabetes Mellitus (T2DM) is an increasing health burden in South Asia. This study evaluates the burden, trends, and future projections of CKD from 1990–2021 using Global Burden of Disease (GBD) data and ARIMA modeling. We analyzed age-standardized rates (ASR) for prevalence, incidence, mortality, and DALYs of CKD due to T2DM in South Asia(India, Pakistan, Bangladesh, Bhutan, Nepal). Join point regression and ARIMAmodels were applied for trend analysis and projections. From 1990 to 2021, prevalence decreased slightly (e.g. India: 5.4% to 5.2%), while mortality increased (e.g.Pakistan: 33.7 to 42.1 per 100,000). Incidence increased across all countries, with Nepal (1.3% increase) and Bhutan (1.7% increase) showing the highest growth. Projections indicate a continued rise in CKD burden, especially inNepal and India. CKD due to T2DM is increasing, emphasizing the need for targeted interventions.

由2型糖尿病（Type 2 Diabetes Mellitus, T2DM）引发的慢性肾脏病（Chronic Kidney Disease, CKD）在南亚地区的健康负担日益加重。本研究依托全球疾病负担（Global Burden of Disease, GBD）数据集与自回归积分滑动平均（ARIMA）建模方法，对1990年至2021年间由T2DM导致的CKD的健康负担、变化趋势及未来预测情况展开评估。研究分析了南亚地区（包括印度、巴基斯坦、孟加拉国、不丹、尼泊尔）该类CKD的患病率、发病率、死亡率及伤残调整寿命年（Disability-Adjusted Life Years, DALYs）的年龄标准化率（Age-Standardized Rates, ASR）。本研究采用连接点回归（Join Point Regression）与ARIMA模型分别开展趋势分析与预测工作。1990年至2021年间，该类CKD的患病率略有下降（如印度：从5.4%降至5.2%），而死亡率则呈上升趋势（如巴基斯坦：每10万人中从33.7例升至42.1例）。所有受访国家的CKD发病率均有所上升，其中尼泊尔（增幅1.3%）与不丹（增幅1.7%）的增长幅度最为显著。预测结果显示，该类CKD的健康负担将持续攀升，尤以尼泊尔与印度最为突出。由T2DM引发的CKD健康负担仍在持续增加，这凸显了开展针对性公共卫生干预措施的必要性。