Anticipating years lived with vision loss attributable to diabetic retinopathy in Mexico: a quantitative simulation for 2040.

AIMS: To model the projected burden of years lived with disability (YLDs) attributable to visual impairment (VI) secondary to diabetic retinopathy (DR) in people living with diabetes mellitus (DM) in Mexico through 2040, using Global Burden of Disease (GBD) data and national demographic projections. METHODS: This population-based ecological study used secondary aggregated data from GBD 2021 (1990-2021). Age-standardized rates of moderate visual impairment (MVI), severe visual impairment (SVI), and blindness attributable to DR were analyzed. ARIMA models were applied to each time series. Model selection was based on AIC and BIC criteria, with validation through residual diagnostics, Ljung-Box tests, and out-of-sample forecasting (1990-2016 training; 2017-2021 validation). Forecasts were generated for 2021-2040 with 95% confidence intervals. RESULTS: DM prevalence is projected to increase from 9.36% in 2021 to 10.84% in 2040. Total YLDs attributable to DR rose from 15,222 in 1990 to 25,495 in 2021 and are projected to reach 31,332 by 2040, representing a 22.9% increase compared with 2021. Blindness is expected to account for 64.3% of total YLDs by 2040 and to represent the main driver of the projected burden. CONCLUSIONS: Visual disability attributable to DR will continue to increase in Mexico, primarily driven by DR-related blindness. These findings underscore the urgency of strengthening preventive strategies, early detection programs, and equitable access to ophthalmologic care to mitigate the future public health burden. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.