Trend and Geographical Distribution of Diabetes Mellitus Mortality Attributed to Air Pollution in Iran from 1990 To 2021

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Introduction: The escalating incidence and mortality rates of diabetes, coupled with the growing threat of air pollution, pose a substantial threat to public health in Iran. This study seeks to examine the geographical distribution and temporal trends of diabetes-related deaths specifically linked to air pollution across the country. Methods: Utilizing data from the Global Burden of Disease (GBD) study, we employed Joinpoint regression analysis to identify significant shifts in the mortality trends of type 2 diabetes mellitus (T2DM) linked to air pollution. Furthermore, spatial distribution patterns for the year 2021 were mapped and analyzed using ArcMap GIS v.10. Results: The mortality rate of T2DM attributable to air pollution in Iran exhibited an upward trend between 1990 and 2019, after which a subsequent decline was observed from 2019 to 2021. The highest annual percentage change in females occurred between 2011 and 2016 (5.134, 95% UI: 4.704–5.563), whereas in males, it occurred between 2012 and 2015 (6.275, 95% UI: 4.867–6.934). The highest average annual percentage change in females was observed in Gilan (4.427, 95% UI: 4.305–4.535), and in males, it was observed in Bushehr (4.125, 95% UI: 3.873–4.320). Geographical analysis revealed that in 2021, Tehran and Khuzestan had the highest mortality rates, whereas the lowest rates were recorded in Zanjan, Kohgiluyeh, and Boyer-Ahmad for females and Kohgiluyeh, Boyer-Ahmad, and Hamadan for males. Conclusion: These findings highlight the continued need for stronger environmental control measures, especially in high-risk areas, to further reduce the burden of air pollution-related diabetes mortality in Iran.

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