Bridget Dillon and Rachel Pryor
EPID 691
January 28, 2013
 Incidence
of Diabetes Type 2 remained
relatively steady during the 1980’s, but
has steadily increased since 1990
 Incidence in 2010 was 1,735,000 people
in the United States
 Incidence in 1980 was 493,000
Source: 2007–2009 National Health Interview Survey estimates projected to the year 2010.

“From 1980 to 2011, the crude incidence of diagnosed diabetes increased
133% from 3.3 to 7.7 per 1,000 population. Similarly, the age–adjusted
incidence increased 117% from 3.5 to 7.6 per 1,000 population,
suggesting that the majority of the change was not due to the aging of the
population. ”
http://www.cdc.gov/diabetes/statistics/incidence/fig3.htm
http://www.cdc.gov/diabetes/statistics/incidence/fig4.htm
http://www.cdc.gov/diabetes/statistics/incidence/fig6.htm
<10 years
10–19 years
Source: SEARCH for Diabetes in Youth Study
NHW=non-Hispanic whites; NHB=non-Hispanic blacks; H=Hispanics; API=Asians/Pacific Islanders; AI=American
Indians
 20.9
million Americans currently have
Diabetes
(http://www.cdc.gov/diabetes/statistics/prev/national/figpersons.htm)
 20.7
million of the population who have
Diabetes are adults aged 18 and older
(http://www.cdc.gov/diabetes/statistics/prev/national/figadults.htm)
 8.3%
of the US population

http://www.cdc.gov/diabetes/statistics/prev/national/figbyage.htm
 http://www.cdc.gov/diabetes/statistics/p
revalence_national.htm


http://apps.nccd.cdc.gov/DDTSTRS/Index.aspx?stateId=51&state=Virgini
a&cat=prevalence&Data=data&view=TO&trend=prevalence&id=1
508,000 Virginians were living with Diabetes in 2010
 People
with diabetes are 2-4 times more
likely to die from heart disease or suffer
a stroke.
 70% of people with diabetes have high
blood pressure.
 Diabetes can also lead to kidney disease,
blindness, and nerve damage in
extremities.
 On
average, people with diabetes spend
$6,000 annually to treat their condition.
 As of 2008, the estimate cost of diabetes
in the United States was $218 billion.
• This included costs for those with diagnosed
diabetes ($174.4 billion), undiagnosed ($18
billion), gestational diabetes ($636 million) and
pre-diabetes ($25 million).
 Diabetes Type
2 used to be unheard of in
children. Now that the incidence is everincreasing, when is it appropriate to
screen at risk (ie, obese) children?
(Zeitler, Phil. Type 2 Diabetes Mellitus
Challenges in Diagnoses and Treatment.
Contemporary Pediatrics, 2012 Jul; 29(7):
16-23)
 Diabetes
and Self-Management Education
(DSME). There is an association between
women who have had DSME and better
health outcomes related to Diabetes.
(Gumbs, Jean Maydalyne. Relationship
between diabetes self-management and
education and self-care behaviors among
African-American women with Type 2
Diabetes. Journal of Cultural Diversity, 2012
Spring; 19(1): 18-22.
 There
is an increased risk of mortality for
post-MI patients with diabetes and
depression. (Bot, M; Pouwer,
F; Zuidersma, M; van Melle, JP; de Jonge,
P. Association of coexisting diabetes and
depression with mortality after
myocardial infarction. Diabetes Care.
2012 March; 35(3): 503-9)
Research continued
 The
FDA is currently considering the
approval of a new class of drugs to treat
diabetes. The SGLT2 inhibitors target
glucose uptake in the kidneys to prevent
the absorption of glucose.
• This treatment takes a new approach from insulin
injections.
• There are concerns about its efficacy in patients
with renal impairment.
 Islet transplantation
• No need for insulin a year after surgery.
• Episodes of low blood sugar reduced for five
years.
• Effects are not permanent.
 DCCT/EDIC
• Large scale study conducted from 1983 to 1993.
• Demonstrated that keeping blood glucose close
to normal slowed progression of eye, kidney and
nerve damage.