The Global Burden of Type 2 Diabetes Attributable to Dietary Risks Among Women: A 1990-2021 Analysis and Forecasting Through 2050

Type 2 diabetes (T2D) is one of the major contributors to global mortality and disability. Diet and gender are key aspects of T2D, yet limited attention has been given to how their intersection contributes to the T2D disease burden. This study aims to assess the global burden of type 2 diabetes (T2D) attributable to dietary risks among women, using data from the Global Burden of Disease (GBD) 2021 study, and to explore regional and age-specific disparities over time. Method: We conducted a retrospective analysis using GBD 2021 data from 1990 to 2021 across 204 countries and territories. Outcomes included female deaths and disability-adjusted life years (DALYs) due to dietary risk-attributable T2D, stratified by age, region, and socio-demographic index (SDI). Future trends were projected using ARIMA and exponential smoothing models. Result: In 2021, 197,699 deaths and 9.4 million DALYs in women were attributed to dietary risks for T2D. The highest age-standardized mortality rate (ASMR) was observed in low SDI regions (8.26 per 100,000), while the highest age-standardized DALY rate (ASDR) occurred in Oceania (800.83 per 100,000). From 1990 to 2021, female deaths increased by 118.5% and DALYs by 183.4%, with a 4.9% decline in ASMR but a 34.0% rise in ASDR. Decomposition analysis showed that epidemiological changes (56.36%) were the main contributor to DALY increases. Projections suggest further DALY growth through 2050, especially in low-income regions. Discussion: These findings show that dietary risk-related T2D imposes a heavy burden on women globally, with significant differences across regions. Low SDI regions face higher mortality rates, while disability remains considerable in high-income regions, reflecting gaps in long-term care. These patterns suggest that nutrition transitions and healthcare inequalities contribute to the growing burden, indicating the need for dietary interventions adapted to local needs. Conclusion: The burden of dietary risk-attributable T2D among women has increased substantially, with marked regional and socio-economic differences. The results underscore the need for targeted, context-specific dietary interventions, particularly in settings facing limited healthcare access and rising nutrition-related risks.