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Background <p>Diabetes mellitus and chronic kidney disease (CKD) are major global public health issues and the leading causes of mortality and morbidity worldwide. Disability-adjusted life years (DALYs) are one of the most commonly used health gap summary measures in public health and have become an important metric for quantifying burden of disease. The primary objective of this study was to quantify the sub-national burden of diabetes mellitus and CKD in France in 2017 using age-standardized DALY rates (ASDRs), and secondary objective was to assess the relationship between these ASDRs and the French Deprivation Index (FDep), as a measure of socioeconomic disparities.</p> Methods <p>We used national French health databases to estimate the burden of diabetes mellitus and chronic kidney disease (CKD) in 2017. Disability-adjusted life years (DALYs) were calculated by summing years of life lost (YLL) and years lived with disability (YLD). We calculated ASDRs by applying the age structure of the 2013 European Standard to the observed age-specific rates in France, which were calculated using French population.</p> Results <p>In 2017, the age-standardized DALY rates per 100 000 population were 685 (95% UI: 552–810) for diabetes mellitus and 251 (95% UI: 205–296) for CKD. ASDRs were lower among females than males (528 vs. 874 for diabetes; 200 vs. 323 for CKD, respectively). The mortality component contributed more to the overall DALYs than the ill-health component, accounting for around 65% for CKD and for diabetes mellitus, the morbidity contributed 55%, in both females and males. Sub-national disparities in DALYs were evident for both diseases, with lower rates observed in metropolitan France compared with the French overseas departments and regions (DROM).</p> Conclusions <p>These results provide a comprehensive understanding of the disease burden due to diabetes mellitus and CKD in France at sub-national level in 2017, providing valuable insights to inform decision-making processes in health policy. Targeted, evidence-based health interventions and prevention strategies tailored to regional needs can significantly enhance public health outcomes for diabetes mellitus and CKD. Future research should take into account the contribution of various risk factors and determinants of health inequalities to these diseases at regional levels.</p>

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Sub-national disparities in disease burden of diabetes mellitus and chronic kidney disease in France: a pre-pandemic analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月10日

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  • Cécile Couchoud,
  • Maxime Raffray,
  • Nour Mahrouseh,
  • Elena von der Lippe,
  • Brecht Devleesschauwer,
  • Grant M A Wyper,
  • Romana Haneef

摘要

Background

Diabetes mellitus and chronic kidney disease (CKD) are major global public health issues and the leading causes of mortality and morbidity worldwide. Disability-adjusted life years (DALYs) are one of the most commonly used health gap summary measures in public health and have become an important metric for quantifying burden of disease. The primary objective of this study was to quantify the sub-national burden of diabetes mellitus and CKD in France in 2017 using age-standardized DALY rates (ASDRs), and secondary objective was to assess the relationship between these ASDRs and the French Deprivation Index (FDep), as a measure of socioeconomic disparities.

Methods

We used national French health databases to estimate the burden of diabetes mellitus and chronic kidney disease (CKD) in 2017. Disability-adjusted life years (DALYs) were calculated by summing years of life lost (YLL) and years lived with disability (YLD). We calculated ASDRs by applying the age structure of the 2013 European Standard to the observed age-specific rates in France, which were calculated using French population.

Results

In 2017, the age-standardized DALY rates per 100 000 population were 685 (95% UI: 552–810) for diabetes mellitus and 251 (95% UI: 205–296) for CKD. ASDRs were lower among females than males (528 vs. 874 for diabetes; 200 vs. 323 for CKD, respectively). The mortality component contributed more to the overall DALYs than the ill-health component, accounting for around 65% for CKD and for diabetes mellitus, the morbidity contributed 55%, in both females and males. Sub-national disparities in DALYs were evident for both diseases, with lower rates observed in metropolitan France compared with the French overseas departments and regions (DROM).

Conclusions

These results provide a comprehensive understanding of the disease burden due to diabetes mellitus and CKD in France at sub-national level in 2017, providing valuable insights to inform decision-making processes in health policy. Targeted, evidence-based health interventions and prevention strategies tailored to regional needs can significantly enhance public health outcomes for diabetes mellitus and CKD. Future research should take into account the contribution of various risk factors and determinants of health inequalities to these diseases at regional levels.