The Burden of Diabetes
1
Prevalence of Diabetes and
Prediabetes in the United States
Diabetes
8.3% of US population
Prediabetes
35% of US population
2
CDC. National diabetes fact sheet, 2008. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2008.pdf.
CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.
Projected Prevalence of Diabetes in the
United States: 1990 to 2050
Year
3
National Diabetes Surveillance System. http://www.cdc.gov/diabetes/statistics/prev/national/figpersons.htm..
Boyle JP, et al. Popul Health Metr. 2010 Oct 22;8:29.
CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.
Prevalence of Diagnosed Diabetes in
Different Ethnic Groups
US Adults ≥20 Years of Age
4
CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.
4
Annual Incidence of Diabetes
in Children and Adolescents
<10 years
5
10-19 years
NHW, non-Hispanic whites; NHB, non-Hispanic blacks; H, Hispanics;
API, Asians/Pacific Islanders; AI, American Indians.
CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.
Diabetes Morbidity and
Mortality
• Diabetes is the
• Diabetes also
– Seventh leading cause of
death, according to death
certificate data (which may be
an underestimate)
– Leading cause of blindness
among adults
– Leading cause of kidney
failure
• >60% of nontraumatic lower
limb amputations occur in
people with diabetes
– Doubles the risk of periodontal
disease among young adults
– Doubles the risk of developing
depression, and depression
increases the risk of type 2
diabetes by 60%
– Increases patients’ susceptibility
to acute infections and illnesses
(eg, pneumonia and influenza)
– Worsens the prognosis of
patients with acute illnesses
6
CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.
Diabetes and Morbidity and
Mortality
2 times greater
2-4 times greater
2-4 times greater
(relative to individuals without diabetes)
7
CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.
Costs of Diabetes
Indirect
Direct
13% of total
US healthcare
expenditures
8
ADA. Diabetes Care. 2013;36:1033-1046.
Goal Achievement in Diabetes
NHANES 2007-2010
(N=1444)
<7
<8
A1C
(%)
9
>9
<70 <100
<130/80
LDL-C
(mg/dL)
BP
(mm/Hg)
Nonsmoker
All goals met
BP, blood pressure; LDL-C, low-density lipoprotein cholesterol; NHANES, National Health and Nutrition Examination Survey.
Ali MK, et al. N Engl J Med. 2013;368:1613-1624.
A1C Achievement by
Individualized Target
NHANES 2007-2010
(N=1444)
Age (years)
Target A1C (%)
18-44
45-64
≥65
≥65
18-44
45-64
≥65
≤6.5
≤7.0
≤7.0
≤7.5
≤7.0
≤8.0
≤8.0
Without complications
10
With complications
NHANES, National Health and Nutrition Examination Survey.
Ali MK, et al. N Engl J Med. 2013;368:1613-1624.