Global Disease Burden of Hyperglycemia-Related Pancreatic Cancer: An Analysis Based on GBD Data from 1990 to 2021

Background: Due to its high aggressiveness and limited prognosis, pancreatic cancer has become one of the leading causes of cancer-related deaths worldwide. Existing research data reveal a significant association between abnormal glucose metabolism (particularly as characterized by type 2 diabetes) and this malignancy, indicating that it may serve both as a predictive indicator for disease onset and an early clinical marker of disease progression. Systematic evaluation of the global epidemiological distribution and disease burden of abnormal glucose metabolism is of substantial scientific significance for constructing precise risk intervention systems. Methods: Utilizing data from the 2021 Global Burden of Disease (GBD) study, this research quantified the burden of pancreatic cancer attributable to hyperglycemia from 1990 to 2021. Indicators such as age-standardized mortality rate (ASR) and disability-adjusted life years (DALYs) were assessed at global, regional, and national levels, stratified by sex, age, and sociodemographic index (SDI). Advanced analytical methods were employed, including autoregressive integrated moving average (ARIMA) modeling, Bayesian age-period-cohort (BAPC) analysis, and decomposition techniques to identify key drivers of observed trends. Frontier analysis evaluated the efficiency of healthcare systems, while Joinpoint regression identified inflection points and calculated average annual percentage change (AAPC). Results: In 2021, deaths and disease burden (DALYs) due to hyperglycemia accounted for 26% and 24%, respectively, of the global total for pancreatic cancer. That year, there were 132,753 deaths from pancreatic cancer attributable to hyperglycemia worldwide (95% UI: 15,076–252,345), with males comprising 53.9% and bearing a higher disease burden than females. Additionally, the burden of disease was more pronounced in high-income regions or densely populated areas. East Asia had the highest death and DALY burden from hyperglycemia-induced pancreatic cancer. Over the past thirty years, the Caribbean region exhibited the fastest annual growth rate in age-standardized mortality (AAPC = 3.849, 95% CI 3.310 to 4.391). In 2021, China recorded the highest number of pancreatic cancer deaths globally, followed by the United States and Japan. As the sociodemographic index (SDI) increased, the age-standardized mortality rate (ASR) also showed an upward trend. Conclusion: This study highlights the escalating global impact of hyperglycemia on pancreatic cancer, emphasizing the necessity of robust public health interventions, glycemic control, and early detection strategies. Identifying and controlling hyperglycemia as a modifiable metabolic risk factor provides a crucial intervention target for significantly reducing the global burden of diabetes-related complications and optimizing outcomes for patients with chronic diseases. These findings offer important guidance for the formulation of public health prevention and control strategies.