09/09/2015
After years of rapid increase, a
new study published in JAMA
reveals the prevalence of type 2
diabetes in the US has leveled off,
offering some hope that
measures to combat this disease
are beginning to take effect.
However, the study also found
that diabetes and prediabetes
continue to affect almost half of
adults in the country.
While diabetes and prediabetes
affects almost half the US
population, researchers say
prevalence of the condition is
leveling off.
The figures on US prevalence and
trends in diagnosed and
undiagnosed diabetes were
estimated by Andy Menke, PhD,
an epidemiologist at Social &
Scientific Systems Inc. in Silver
Spring, MD, and colleagues.
The team used National Health
and Nutritional Examination
Survey (NHANES) data involving
23,634 adults from 1988-2010
to estimate diabetes trends, with
a further 2,781 from 2011-12 to
estimate the recent prevalence of
the condition.
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The data reveals that in
2011-12, around 12-14% of the
US adult population had
diabetes, while prediabetes
affected approximately 37-38%
of the population.
The cost of diabetes to the US is
enormous, increasing by 41%
between 2007 and 2012, from $
174 billion to $245 billion,
according to the study authors.
The largest part of the cost is
hospital inpatient care, which
accounts for 43%, followed by
prescription medications to treat
complications caused by
diabetes, accounting for 18% of
diabetes costs.
In their study, Menke and
colleagues used a previous
diagnosis of diabetes among
participants to define the
prevalence of diabetes in the US.
Where diabetes had not been
previously diagnosed, the team
identified the condition via the
presence of a hemoglobin A1c
level at 6.5% or greater or a
fasting plasma glucose (FPG) level
of 126 mg/dL or greater.
Alternatively, diabetes was
identified via a 2-hour plasma
glucose (2-hour PG) level of 200
mg/dL or greater.
Study findings 'offer hope'
The study findings revealed that
the unadjusted prevalence for
total diabetes among the US
population was 14.3% between
2011 and 2012. The prevalence
of diagnosed diabetes was 9.1%,
standing at 5.2% for
undiagnosed diabetes and 38%
for prediabetes. Among those
with diabetes, 36.4% were
undiagnosed.
Fast facts about diabetes
•Diabetes is a lifelong
condition characterized by
raised glucose levels
•29.1 million Americans
have diabetes
•86 million Americans have
prediabetes.
Learn more about diabetes
Assessing the prevalence of
diabetes among different ethnic
groups, the team found it was
highest among non-Hispanic
black study participants (21.8%)
and non-Hispanic Asian
participants (22.6%), compared
with non-Hispanic white
participants (11.3%).
In all s*x and racial/ethnic
categories, it was found that
prediabetes prevalence was
greater than 30%. This was
highest among two groups: non-
Hispanic white study participants
and non-Hispanic black
participants.
In both s*xes, all age groups, in
every racial/ethnic group and by
all education levels, diabetes
prevalence rates increased from
9.8% in 1988-1994 to 12.4% in
2011-2012.
The good news this study
reports is that while the
prevalence of diabetes was
seen to increase during the
study periods 1988-1994 and
2011-2012, prevalence levels
for the study periods
2007-2008 and 2011-2012 saw
little change. This suggests,
according to the study authors,
that there has been an
important leveling off in
diabetes prevalence in the US.
"This plateauing of diabetes
prevalence is consistent with
obesity trends in the United
States showing a leveling off
around the same period," note
the study authors.
"These figures offer hope," say
Dr. William Herman and Dr. Amy
Rotheberg - both of the
University of Michigan Health
System in Ann Arbor, MI - in an
editorial linked to the study.
Dr. Herman and Dr. Rotherberg
point to three influencing factors
on this trend: a cultural shift in
attitudes to diabetes, the
American Medical Association
(AMA) recognizing obesity as a
disease, and an increasing focus
on addressing food policy and
even the spaces and places
where we live and work -
referred to collectively as "the
built environment."
Thanks to the AMA and Centers
for Disease Control and
Prevention (CDC), the study says,
people at risk of diabetes are
being identified earlier.
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Dr. Herman and Dr. Rothberg
note:
"Providing insurance
coverage for intensive
behavioral therapies for
obesity and using behavioral
economic approaches to
encourage their uptake are
further removing barriers to
patient engagement and are
providing strong incentives
for individual behavioral
change.
Together, these multifaceted
approaches are addressing
both environmental factors
and individual behaviors
appear to be slowing the
increase in obesity and
diabetes and facilitating the
diagnosis and management
of diabetes. Progress has
been made, but expanded
and sustained efforts will be
required."
Last year, Medical News Today
reported that the rise in the
prevalence of diabetes in the US
was considered "alarming" by
the CDC.
