Trends in type 2 diabetes incidence and BMI at diagnosis by age, sex, and ethnicity, 2011-24: a population-based analysis of the English National Diabetes Audit
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Author(s)
Type
Journal Article
Abstract
Background: Early-onset type 2 diabetes is associated with aggressive disease progression, long-term health burden and reduced life expectancy. Trends in incidence have not been comprehensively described.
Methods: Using data from the English National Diabetes Audit, age-standardised incidence rates for adults with type 2 diabetes were calculated by age, sex, and ethnicity between 2011-2024. Poisson regression models were created to study incidence over time. Annual change in median BMI within 26 weeks of diagnosis were calculated.
Findings Age-standardised incidence increased among adults aged 20–29 years (RR 1.021 [95% CI 1.017-1.026] per year in males, 1.030 [1.026-1.034] in females) and 30–39 years (1.013[1.012-1.015] in males, 1.03 [1.028-1.032] in females). Incidence increased minimally in males aged 40–59 years (1.006 [1.005-1.006]), was rising in females (1.018 [1.017-1.019]) and declined in males and females aged 60–79 years (0.983 [0.983-0.984] in males, 0.985 in females 0.985 [0.984-0.985]). Increasing incidence in young adults were observed in all sex and ethnicity subgroups except Asian males (20-39-years) but highest rates were in White females (30-39-years) and Black females (20-29). BMI at diagnosis increased in all subgroups over time but was highest in younger adults and higher in females than males. The annual change in younger adults was double that of older (20-29 year-old-males +0.17 kg/m2/year [0.08-0.26] and females +0.17[0.09-0.26]; 30-39-year-old males +0.21[0.18-0.24] and females +0.20 [0.16-0.24]; 40-59 year-old-males +0.06 [0.04-0.07] and females +0.09 [0.06-0.12]; 60-79 year old males +0.08 [0.06-0.09] and females +0.11 [0.08-0.13].
Interpretation: Since 2011, incidence of type 2 diabetes has risen significantly in young adults across most ethnicity and sex subgroups (especially females) despite minimal changes or declining rates at older ages. This trend parallels greater increases in BMI-at-diagnosis in young people, highlighting a shift in disease burden and the urgent need for earlier prevention, and focused obesity interventions in early-life.
Funding: Wellcome Trust
Methods: Using data from the English National Diabetes Audit, age-standardised incidence rates for adults with type 2 diabetes were calculated by age, sex, and ethnicity between 2011-2024. Poisson regression models were created to study incidence over time. Annual change in median BMI within 26 weeks of diagnosis were calculated.
Findings Age-standardised incidence increased among adults aged 20–29 years (RR 1.021 [95% CI 1.017-1.026] per year in males, 1.030 [1.026-1.034] in females) and 30–39 years (1.013[1.012-1.015] in males, 1.03 [1.028-1.032] in females). Incidence increased minimally in males aged 40–59 years (1.006 [1.005-1.006]), was rising in females (1.018 [1.017-1.019]) and declined in males and females aged 60–79 years (0.983 [0.983-0.984] in males, 0.985 in females 0.985 [0.984-0.985]). Increasing incidence in young adults were observed in all sex and ethnicity subgroups except Asian males (20-39-years) but highest rates were in White females (30-39-years) and Black females (20-29). BMI at diagnosis increased in all subgroups over time but was highest in younger adults and higher in females than males. The annual change in younger adults was double that of older (20-29 year-old-males +0.17 kg/m2/year [0.08-0.26] and females +0.17[0.09-0.26]; 30-39-year-old males +0.21[0.18-0.24] and females +0.20 [0.16-0.24]; 40-59 year-old-males +0.06 [0.04-0.07] and females +0.09 [0.06-0.12]; 60-79 year old males +0.08 [0.06-0.09] and females +0.11 [0.08-0.13].
Interpretation: Since 2011, incidence of type 2 diabetes has risen significantly in young adults across most ethnicity and sex subgroups (especially females) despite minimal changes or declining rates at older ages. This trend parallels greater increases in BMI-at-diagnosis in young people, highlighting a shift in disease burden and the urgent need for earlier prevention, and focused obesity interventions in early-life.
Funding: Wellcome Trust
Date Issued
2026-08-01
Date Acceptance
2026-06-19
Citation
The Lancet Regional Health. Europe, 2026, 67 (1)
ISSN
2666-7762
Publisher
Elsevier
Journal / Book Title
The Lancet Regional Health. Europe
Volume
67
Issue
1
Copyright Statement
© 2026 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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Subjects
Early-onset type 2 diabetes
Incidence
Epidemiology
Ethnicity
Type 2 diabetes
Young type 2 diabetes
Publication Status
Published
Article Number
101764
Date Publish Online
2026-07-22