ObjectiveTo analyze the disease burden and its changing trends of lung cancer attributable to high fasting plasma glucose (HFPG) in China from 1990 to 2021, and to provide key strategic evidence for the prevention and treatment of tracheal, bronchial, and lung cancer (hereinafter referred to as lung cancer). MethodsData related to lung cancer attributable to HFPG in China from 1990 to 2021 were collected from the Global Burden of Disease Study 2021 database, including mortality rate, disability-adjusted life years (DALYs), age-standardized rates, and other indicators. The Joinpoint regression model was applied to analyze the temporal trends of these indicators. Furthermore, the grey prediction model GM (1,1) was used to forecast the disease burden of lung cancer attributable to HFPG in China from 2022 to 2031. ResultsFrom 1990 to 2021, the overall disease burden of lung cancer attributable to HFPG in China showed an upward trend. The total number of deaths, DALYs, crude mortality rate, age-standardized mortality rate, crude DALYs rate, and age-standardized DALYs rate increased from 0.47/10000, 12.13/10000, 0.40/100000, 0.61/100000, 10.31/100000, and 14.10/100000 in 1990 to 1.74/10000, 38.65/10000, 1.22/100000, 0.82/100000, 27.16/100000, and 17.72/100000 in 2021, with growth rates of 270.21%, 218.63%, 205.00%, 34.42%, 163.43%, and 25.67%, respectively. The increase rates among females were higher than those among males. Analysis using the Joinpoint regression model indicated that both the age-standardized mortality rate and age-standardized DALYs rate exhibited a significant upward trend, with average annual percentage changes (AAPC) of 1.01% and 0.82%, respectively, during 1990-2021 (P<0.05). The disease burden across different age and gender groups generally increased from 1990 to 2021. Mortality and DALYs rates for both males and females rose with advancing age, with elderly individuals and males constituting the primary affected populations. The GM (1,1) grey prediction model projected continued increases in mortality rate, age-standardized mortality rate, DALYs rate, and age-standardized DALYs rate of lung cancer attributable to HFPG in China from 2022 to 2031, reaching 1.64/100000, 1.06/100000, 36.45/100000, and 21.81/100000, respectively, by 2031. ConclusionThe disease burden of lung cancer attributable to HFPG remained substantial in China from 1990 to 2021, with males and elderly populations bearing the highest burden. However, the growth rate of disease burden was faster among females compared to males. It is predicted that the disease burden will continue to rise over the next decade, necessitating enhanced focus on early diagnosis and treatment for women and older adults.