Abstract
INTRODUCTION: Type 2 diabetes mellitus (T2DM) poses a global health crisis. Smoking, a key risk factor for T2DM, significantly impacts middle-aged and elderly populations. In China, with the world's largest elderly population and a high prevalence of smoking, the burden of smoking-related T2DM remains underrecognized. METHODS: Using GBD 2021 data, we applied joinpoint regression, age-period-cohort analysis, and the ARIMA model for prediction. This is a secondary dataset analysis. The study population included Chinese adults aged ≥55 years. RESULTS: From 1990 to 2021, deaths and DALYs attributable to smoking-associated T2DM showed a substantial increase, with males experiencing a significant rise in both number of death and DALYs rates, while females exhibited a decrease in death rate though total number of deaths rose. Joinpoint analysis revealed fluctuating trends in mortality and DALYs. The age-period-cohort analysis highlighted the age group of 70-75 years as a high-risk period. Predictive analysis suggested a slight upward trend in mortality for the overall population and males, while the DALYs rate was expected to remain stable but increase among males and decrease among females. CONCLUSIONS: From 1990 to 2021, the impact of smoking on type 2 diabetes mellitus (T2DM) among middle-aged and elderly adults in China continued to rise, with notable gender differences. Strengthening tobacco control and diabetes management, particularly for males and high-risk age groups, is crucial for reducing this burden.