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Healthy People 2010 Focus Area 5: Diabetes Progress Review October 20, 2006

Healthy People 2010 Focus Area 5: Diabetes Progress Review October 20, 2006. Diabetes. Affects 20.6 million or nearly 10% of the U.S. adult population, with 1.5 million new cases (2005) Non-Hispanic white: 13.1 million (8.7%) Non-Hispanic black: 3.2 million (13.3%)

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Healthy People 2010 Focus Area 5: Diabetes Progress Review October 20, 2006

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  1. Healthy People 2010 Focus Area 5:DiabetesProgress ReviewOctober 20, 2006

  2. Diabetes • Affects 20.6 million or nearly 10% of the U.S. adult population, with 1.5 million new cases (2005) • Non-Hispanic white: 13.1 million (8.7%) • Non-Hispanic black: 3.2 million (13.3%) • 6th leading underlying cause of death (2002) • The total cost of diabetes in the U.S. (2002): $132 billion • $92 billion in direct medical costs • $40 billion in indirect costs including disability, work loss, premature mortality • Lifestyle changes can prevent or delay the onset of diabetes among high-risk adults • Complications can be prevented by control of blood glucose, blood pressure, and blood lipids, and by regular preventive care practices/exams

  3. Highlighted Objectives Target met or exceeded 5-6. Diabetes-related deaths among persons with diabetes 5-12. A1C test at least 2 times a year 5-17. Self blood-glucose monitoring Improving 5-10. Lower extremity amputations 5-13. Annual dilated eye examination 5-15. Annual dental examinations Getting worse 5-2. New cases of diabetes 5-3. Prevalence of diabetes Little or no change 5-4. Diagnosed diabetes 5-5. Diabetes related deaths

  4. 1995 2000 2004 Diabetes Prevalence Among U.S. Adults HP2010 Target: 2.5 4% to 6% Above 6% Less than 4% No Data NOTE: Data are age-adjusted to the 2000 standard population. SOURCE: Behavioral Risk Factor Surveillance System (BRFSS), CDC.

  5. New Cases of Diabetes, Among Adults Decrease desired Age-adjusted rate per 1,000 population 1997-99 2000-02 2003-05 20 15 10 2010 Target: 3.8 5 0 Less than HS At least some college High school 75-84 18-44 45-64 65-74 Total* Education* Age† I = 95% confidence interval. *Data are for adults aged 18-84 years and are age adjusted to the 2000 standard population. Education estimates exclude persons <25 years of age. †Age-specific estimates are not age adjusted. SOURCE: National Health Interview Survey (NHIS), CDC, NCHS. Obj. 5-2

  6. New Cases of Diabetes, Among Adults Decrease desired Age-adjusted rate per 1,000 population 1997-99 2000-02 2003-05 20 15 10 5 2010 Target: 3.8 * * 0 Total Am. Indian/Alaska Native White Hispanic Black Native Hawaiian/Pacific Islander Asian I = 95% confidence interval. *Data are statistically unreliable and are suppressed. NOTE: Data are for adults aged 18-84 years and are age-adjusted to the 2000 standard population. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. For data prior to 1999, respondents reported one or more races and identified one race as best representing their race. For 1999 and later years, respondents were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. SOURCE: National Health Interview Survey (NHIS), NCHS, CDC. Obj. 5-2

  7. Prevalence of Diabetes Decrease desired Age-adjusted rate per 1,000 population 120 100 80 60 40 20 0 American Indian/ Alaska Native Black not Hispanic Hispanic Total White not Hispanic Asian 2010 Target: 25 1999 2000 2001 2002 2003 2004 2005 NOTE: 1999 data for the American Indian/Alaska Native group and all data for the Native Hawaiian/Pacific Islander group are statistically unreliable and are suppressed. Data are age adjusted to the 2000 standard population. Persons of Hispanic origin may be any race. Persons were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. SOURCE: National Health Interview Survey (NHIS), NCHS, CDC. Obj. 5-3

  8. Prevalence of Diabetes, 2005 = 95% confidence interval. NOTE: Data are age adjusted to the 2000 standard population. Age-specific estimates are not age-adjusted. Education estimates exclude persons <25 years of age. SOURCE: National Health Interview Survey (NHIS), CDC, NCHS. 54 per 1,000 Total Persons with disabilities Persons w/o disabilities <18 years 18-44 years 45-64 years 65-74 years 75+ years Female Male Less than high school High school At least some college 2010 Target: 25 0 25 50 75 100 125 150 175 200 225 Age-adjusted rate per 1,000 population Obj. 5-3

  9. Proportion of Diabetes Diagnosed Increase desired Age-adjusted percent 1988-1994 2001-04 100 2010 Target: 78 80 60 40 20 0 Mexican American Male White Black Female Total Race/ethnicity Gender NOTE: Data are for adults aged 20 years and over and are age adjusted to the 2000 standard population. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Prior to 1999, respondents were asked to select one race category; selection of more than one race was not an option. For 1999 and later years, respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. SOURCE: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS. Obj. 5-4

  10. Diabetes-Related Deaths, 2004 Decrease desired 76 per 100,000 Total Cuban Asian or Pacific Islander White not Hispanic American Indian Mexican American Puerto Rican Black not Hispanic Female Male Less than high school High school At least some college 2010 Target: 46 0 40 80 120 160 Age-adjusted rate per 100,000 population = 95% confidence interval. NOTE: Data are preliminary. Includes any mention of diabetes as underlying or multiple cause of death. Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Persons of Hispanic origin may be any race. Only one race category could be recorded. Recording more than one race was not an option. Education estimates are based on persons aged 25-64 years. SOURCE: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC. Obj. 5-5

  11. Diabetes Mortality* by Health Service Area: U.S., 2001-2003 HP2010 Target: 46 Age-adjusted rate per 100,000 NOTE: Includes any mention of diabetes as underlying or multiple cause of death. Data are age-adjusted to the 2000 standard population. SOURCE: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC. Obj. 5-5

  12. Diabetes-Related Deaths Among Persons With Diabetes Decrease desired Age-adjusted rate per 1,000 11 10 9 8 7 6 5 0 2010 Target: 7.8 Male Total Female 1999 2000 2001 2002 2003 2004* 2004 data are preliminary. NOTE: Data are age adjusted to the 2000 standard population. SOURCE: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC. Obj. 5-6

  13. Lower Extremity Amputations Among Persons With Diabetes Decrease desired Age-adjusted rate per 1,000 1997-99 2001-03 20 15 10 2010 Target: 2.9 5 0 Female White Black 75+ Male <65 65-74 Total* Race* Gender* Age† I = 95% confidence interval. *Age adjusted to the 2000 standard population. †Age-specific rates are not age-adjusted. NOTE: Includes any amputation of lower limb. For NHDS data prior to 2000, only one race category was recorded; reporting more than one race was not an option. For NHIS data prior to 1999, respondents reported one or more races and identified one race as best representing their race. Respondents were asked to select one or more races starting in 1999 (NHIS) or 2000 (NHDS), although more than one race selection was not used for 1999 NHIS data in order to be consistent with 1997-1998 data. Data for the single race categories shown are for persons who reported only one racial group. SOURCE: National Hospital Discharge Survey (NHDS) and National Health Interview Survey (NHIS), CDC, NCHS. Obj. 5-10

  14. A1C Test at Least Two Times a Year Among Adults With Diabetes, 2004 Increase desired Total Hispanic Black not Hispanic White not Hispanic American Indian Asian Female Male Less than high school High school At least some college 2010 Target: 65 0 50 60 70 80 90 100 Age-adjusted percent = 95% confidence interval. NOTE: Data for the Native Hawaiian or Pacific Islander group are statistically unreliable and are suppressed. Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races and identify one race as best representing their race. Education estimates exclude persons <25 years of age. SOURCE: Behavioral Risk Factor Surveillance System (BRFSS), CDC. Obj. 5-12

  15. Annual Dilated Eye Exams Among Adults With Diabetes Increase desired Age-adjusted percent 1998 2003 80 2010 Target: 76 70 60 50 40 30 0 White At least some college Hispanic Black Total Less than High School High school Race/ethnicity Education Level* I = 95% confidence interval. * Excludes persons <25 years old. NOTE: Data are age adjusted to the 2000 standard population. Data for the American Indian or Alaska Native, Asian, and Native Hawaiian or Pacific Islander groups are statistically unreliable and are suppressed. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Prior to 1999, respondents were asked to select one or more races and identify one race as best representing their race. For 1999 and later years, respondents were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. SOURCE: National Health Interview Survey (NHIS), CDC, NCHS. Obj. 5-13

  16. Annual Dental Exams Among Persons With Diabetes Increase desired Age-adjusted percent 1997 2005 80 2010 Target: 71 70 60 50 40 30 0 White Hispanic Black 75-84 18-44 45-64 65-74 Total* Race/ethnicity* Age† *Age adjusted to the 2000 standard population. †Age-specific estimates are not age adjusted. NOTE: Data are for persons aged 2 years and over. Data for the American Indian or Alaska Native, Asian, and Native Hawaiian or Pacific Islander groups are statistically unreliable and are suppressed. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Prior to 1999, respondents were asked to select one or more races and identify one race as best representing their race. For 1999 and later years, respondents were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. SOURCE: National Health Interview Survey (NHIS), CDC, NCHS. Obj. 5-15

  17. Self Blood-Glucose Monitoring† Among Adults With Diabetes Increase desired 1998 2002 2004 Age-adjusted percent 80 70 2010 Target: 61 60 50 40 30 20 10 * 0 Total American Indian/Alaska Native Asian Hispanic Black White I = 95% confidence interval. †At least once daily. *Data are statistically unreliable and are suppressed. NOTE: Data for the Native Hawaiian or Pacific Islander group are statistically unreliable and are suppressed. Data are age adjusted to the 2000 standard population. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Prior to 2001, respondents were asked to select one race category; selection of more than one race was not an option. For 2001 and later years, respondents were asked to select one or more races and identify one race as best representing their race. Data for the single race categories shown are for persons who reported only one racial group. SOURCE: Behavioral Risk Factor Surveillance System (BRFSS), CDC. Obj. 5-17

  18. Status of Diabetes Objectives Dropped at the Midcourse * 5-1. Diabetes Education 5-2. New cases of diabetes 5-3. Prevalence of diabetes 5-4. Diagnosis of diabetes 5-5. Diabetes deaths 5-6. Diabetes related deaths among persons with diabetes 5-7. Cardiovascular disease deaths among persons with diabetes 5-8. Gestational diabetes* 5-9. Foot ulcers* 5-10. Lower extremity amputations 5-11. Annual urinary microalbumin measurement 5-12. A1C test at least 2 times a year 5-13. Annual dilated eye examinations 5-14. Annual foot examinations 5-15. Annual dental examinations 5-16. Aspirin therapy 5-17. Self blood-glucose monitoring Target met Improving Little or no change Getting worse Baseline only

  19. Summary • Incidence and prevalence of diabetes are increasing • Rates higher in older, lower educated, and some racial/ethnic minorities • Diabetes-related and cardiovascular disease deaths among those with diabetes have met targets, but large disparities persist by race/ethnicity and gender • Lower extremity amputations are decreasing • Rates of preventive services to avoid complications have improved and/or met the target, with high rates in some racial/ethnic minority groups • For some objectives, smaller racial/ethnic groups lack reliable data

  20. Progress review data and slides are available on the web at: http://www.cdc.gov/nchs/hphome.htm

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