Global spatial distribution and risk factor profiles of Co-occurring type 2 diabetes and ischemic heart disease across 204 countries and territories.

Authors

Qingying Tian, Fengting Yang, Bo Chen, Jingjing Zeng, Menglin Fan, Qiqi You, Chenyue Wang, Aaron M Lett, Shaoyong Xu

Published in

Diabetes research and clinical practice. Pages 113651. Nov 09, 2026. Epub Nov 09, 2026.

Abstract

Type 2 diabetes (T2D) and ischemic heart disease (IHD) interact reciprocally and contribute to massive global multimorbidity burden. This study aimed to map global T2D-IHD co-occurrence patterns and quantify key risk factors to support targeted integrated prevention.
We extracted incidence data of T2D and IHD and exposure data of 58 risk factors for adults aged ≥ 25 years across 204 countries and territories in 2021 GBD. SHAP machine learning and negative binomial regression were applied to screen independent risk factors, and population-attributable fractions (PAFs) and a composite risk index were calculated to evaluate attributable disease burden.
Among 204 countries and territories, 36.27% were consistent, 32.84% T2D-dominant and 30.88% IHD-dominant. Six key risk factors were identified, including two shared metabolic risks (high body mass index, kidney dysfunction), one T2D-specific (high fasting plasma glucose), and three IHD-specific risks (low temperature, high systolic blood pressure, diet low in whole grains). Collectively, cumulative exposure to the three T2D-related factors explained 22.98% of global T2D cases, while the five IHD-related factors explained 56.22% of global IHD cases. The combined PAF of these six risk factors exceeded 70% T2D and IHD cases in consistent regions. In addition, high-risk exposure areas of these factors spatially overlapped greatly with T2D and IHD hotspots.
Global T2D-IHD co-occurrence showed obvious spatial heterogeneity driven by modifiable shared and disease-specific risks. Combined interventions for common risks plus regionally targeted strategies for unique hazards are essential to alleviate their combined global health burden.

PMID:
43003289
Bibliographic data and abstract were imported from PubMed on 10 Nov 2026.

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