Objective To analyze the disease burden of type 2 diabetes mellitus (T2DM) attributed to low physical activity in China from 1990 to 2021 predict its future trends and provide references for the improvement of the T2DM prevention and control system, adjustment of health policies, and implementation of precision interventions.

Methods The data of T2DM attributed to low physical activity in China from 1990 to 2021 were collected from the Global Burden of Disease 2021 database. Joinpoint regression model was used for the systematic analysis on the temporal trends in deaths, age-standardized mortality rate (ASMR), disability-adjusted life years (DALYs), and age-standardized DALYs rate (ASDR) of T2DM. An age-period-cohort model was applied to evaluate age, period, and birth cohort effects on low physical activity-related T2DM. Additionally, an autoregressive integrated moving average model was used to predict the disease burden in the following decade.

Results From 1990 to 2021, the deaths attributed to low physical activity-related T2DM increased from 5 500 to 17 100, an increase of 209.22%, the ASMR increased from 0.89/100 000 to 0.90/100 000, an increase of 1.12%, the DALYs increased from 235 000 person-years to 757 400 person-years, an increase of 222.36% and the ASDR increased from 30.12/100 000 to 36.54/100 000, an increase of 21.31% in China. The disease burden level was higher in women than in men indicated by 6 632 deaths caused by low physical activity-related T2DM in men (ASMR: 0.85/100 000) and 10 474 deaths caused by low physical activity-related T2DM in women (ASMR: 0.97/100 000) in 2021.The deaths caused by low physical activity-related T2DM peaked in age group 80-＜85 years (3 356 person-years) and the related DALYs peaked in age group 70-＜75 years (129 600 person-years) in 2021. The mortality increased with age, especially after age 60 years. The APC analysis revealed that the mortality decreased to the lowest at age 55 years, then began to increase, while DALYs rate decreased before age 60 years and fluctuated thereafter. The decomposition analysis revealed that the increase in the mortality was mainly due to population aging. Projections indicated that the deaths caused by low physical activity-related T2DM would continue to increase in the following decade.

Conclusion The disease burden level of T2DM attributed to low physical activity remains high in China, especially in women and old adults. It is necessary to conduct targeted Interventions in these populations.