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The Diabetes Problem What the new statistics tell us and implications for the future

The Diabetes Problem What the new statistics tell us and implications for the future . Ann Albright, PhD, RD. Director, Division of Diabetes Translation Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion .

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The Diabetes Problem What the new statistics tell us and implications for the future

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  1. The Diabetes ProblemWhat the new statistics tell us and implications for the future Ann Albright, PhD, RD Director, Division of Diabetes Translation Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Diabetes Translation www.cdc.gov/diabetes The findings and conclusions in this presentation are those of the author and do not necessarily represent the views of the CDC.

  2. Household Surveys Hospitals CDC National Diabetes Surveillance System Vital statistics Telephone Surveys Registries

  3. Diabetes Fact Sheet, 2011 Citation: Centers for Disease Control and Prevention, National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011. http://www.cdc.gov/diabetes/pubs/factsheet11.htm www.cdc.gov/diabetes

  4. 26 millionwith Diabetes 79 millionwith Prediabetes

  5. Latest Diabetes Prevalence Data • 25.8 million people in the U.S. have diabetes • 17.8 million are diagnosed • 8.0 million are undiagnosed • 11.3% of those >20 years old • 26.9% of those >65 years old • 79 million people in the U.S. have prediabetes Source: Diabetes Fact Sheet, 2011 http://www.cdc.gov/diabetes/pubs/factsheet11.htm www.cdc.gov/diabetes

  6. Latest diabetes prevalence data www.cdc.gov/diabetes

  7. 1994 2000 1994 2000 No Data <4.5% 4.5-5.9% 6.0-7.4% 7.5-8.9% >9.0% No Data <14.0% 14.0-17.9% 18.0-21.9% 22.0-25.9% >26.0% Age-Adjusted Percentage of U.S. Adults with Diagnosed Diabetes or Obesity Diabetes Prevalence 2009 Obesity (BMI ≥30 kg/m2) 2009 www.cdc.gov/diabetes

  8. County-Level Estimates of Diagnosed Diabetes Among US Adults Aged ≥20 Years: 2004–2008 www.cdc.gov/diabetes

  9. County-Level Estimates of Obesity Among US Adults Aged ≥20 Years: 2004–2008 www.cdc.gov/diabetes

  10. County-Level Est. of Leisure-Time Physical Inactivity Among US Adults Aged ≥20 Years: 2004–2008 www.cdc.gov/diabetes

  11. County-Level Diabetes, Obesity, Leisure-Time Physical Inactivity: Key Trend • Counties with high levels of all three are primarily concentrated in the South and Appalachia • Counties with low levels of all three are primarily concentrated in the West and Northeast www.cdc.gov/diabetes

  12. Diabetes Fact Sheet, 2011Diabetes rates by race and ethnicity • 7.1% of non-Hispanic whites >20 years old have diabetes • Rate is 18% higher for Asian Americans >20 years old • Rate is 66% higher for Hispanics >20 years old overall • Similar to non-Hispanic whites for Cubans and Central and South Americans • 87% higher for Mexican Americans • 94% higher for Puerto Ricans www.cdc.gov/diabetes

  13. Diabetes Fact Sheet, 2011Diabetes rates by race and ethnicity • Rate is 77% higher for non-Hispanic blacks >20 years old • 16.1% of the adult population served by Indian Health Service has diagnosed diabetes • 5.5% among Alaska Native adults • 33.5% among American Indian adults in southern Arizona www.cdc.gov/diabetes

  14. Diabetes Fact Sheet, 2011Diabetes rates by race and ethnicity Non-Hispanic whites Non-Hispanic blacks Asian Americans Alaska Natives/American Indians (overall) Hispanics (overall) www.cdc.gov/diabetes

  15. Diabetes Fact Sheet, 2011Diabetes rates by race and ethnicity Non-Hispanic whites Non-Hispanic blacks Asian Americans Alaska Natives/American Indians (overall) Hispanics (overall) Specific AN/AI groups Specific Hispanic groups www.cdc.gov/diabetes

  16. Diabetes Fact Sheet, 2011Gestational diabetes • 2%–10% of pregnant women will develop gestational diabetes • Likely rate will be higher when using new diagnostic criteria • Women are much more likely to get type 2 diabetes later if they have gestational diabetes • 5%–10% immediately after pregnancy • 35%–60% within 10–20 years http://www.cdc.gov/diabetes/pubs/factsheet11.htm www.cdc.gov/diabetes

  17. Burden of Diabetes in Youth Applied to US Census data, we estimate that • In 2001: 154,000 US youth had physician-dx diabetes • 15,000 youth are diagnosed annually with T1 diabetes • 3600 youth are diagnosed annually with T2 diabetes www.cdc.gov/diabetes

  18. Prevalence of DM in Youth 0-9 Years 10-19 Years Source: Pediatrics 2006; based on 6379 cases, from surveillance denominator of 3,499,846 www.cdc.gov/diabetes

  19. Annual Incidence per 100,000 people by Race/Ethnicity & Clinical DM Type Source: SEARCH for Diabetes in Youth Study (2002-2005 data) www.cdc.gov/diabetes

  20. Beyond Type: Characteristics of Youth with Diabetes Type 1 Type 2 www.cdc.gov/diabetes

  21. What about Overweight and Obesity? Type 1 Type 2 www.cdc.gov/diabetes

  22. Prevalence of Selected Health Behaviors Type 2 Type 1 www.cdc.gov/diabetes

  23. Minority Youth with Poor Glycemic Control www.cdc.gov/diabetes

  24. Incidence of diagnosed diabetes (1980–2007) and projected incidence (2008–2050) Source: http: //www.pophealthmetrics.com/content/8/1/29 www.cdc.gov/diabetes

  25. Number of People with Diabetes (20-79 years), 2010 and 2030

  26. Diabetes Fact Sheet, 2011 Health burden • The 7th leading cause of death in the U.S. • Underlying cause on 71,382 death certificates • Contributing cause on 231,404 death certificates • The leading cause of kidney disease • The leading cause of nontraumatic lower-limb amputations • The leading cause of new cases of blindness • Significant contributor to heart disease and stroke http://www.cdc.gov/diabetes/pubs/factsheet11.htm www.cdc.gov/diabetes

  27. Diabetes Fact Sheet, 2011Health burden • Heart disease and stroke • 2 to 4 times more likely in people with diabetes • Hypertension • 67% of adults with diabetes have hypertension • Eye Problems • 28.5% of people with diabetes >40 years old had diabetic retinopathy • Kidney disease • Over 200,000 people with diabetes-related ESRD on chronic dialysis or had a transplant (2008) www.cdc.gov/diabetes

  28. Diabetes Fact Sheet, 2011Health burden • Nervous system disease • 60% to 70% of people with diabetes >40 years old have mild to severe nervous system damage • Other examples of possible health complications • Dental disease • Pregnancy complications • Greater susceptibility to diseases such as influenza and pneumonia • Depression www.cdc.gov/diabetes

  29. Death rates (age adjusted) with hyperglycemic crises as underlying cause per 100,000 with diabetes, U.S., 1980–2005 Source: www.cdc.gov/diabetes/statistics/mortalitydka/fRateDKADiabTotals.htm www.cdc.gov/diabetes

  30. Age-Adjusted Percentage of US Adults with Diabetes Reporting Visual Impairment, 1997–2009 Source: www.cdc.gov/diabetes/statistics/visual/fig2.htm www.cdc.gov/diabetes

  31. Diabetes Fact Sheet, 2011Treatment of diabetes: U.S., 2007–2009 www.cdc.gov/diabetes

  32. Diabetes Fact Sheet, 2011Economic cost of diabetes Medical expenses for people with diabetes are more than two times higher than for people without diabetes Indirect costs $ 58 billion Direct costs $116 billion Total $174 billion (2007 figures) http://www.cdc.gov/diabetes/pubs/factsheet11.htm www.cdc.gov/diabetes

  33. Strategy Prevent diabetes Prevent diabetes complications and disabilities Eliminate diabetes-related health disparities www.cdc.gov/diabetes

  34. Ecological Model Community and policy System, group, culture Family, friends, small group Individual The health of individuals is inseparable from the health of communities (Healthy People 2010)

  35. The Community – Clinic Partnership Model Community Clinic Insurers Partnership Zone } Employers Proactive Practice Team Reimbursement Screening for High Risk Informed Population Diagnosis of Prediabetes and Diabetes Decision Support Strong Community Organizations Structured Lifestyle Programs Information Systems Healthy Public Policy Informed, Activated Patients Regular Glucose Monitoring Supportive Environments Total Population Complications Pre-diabetes Diabetes

  36. Summary • More people have diabetes and more are developing it • Future projections underscore prevention is critical • Diabetes management remains a priority • Eliminating disparities is key • There are effective diabetes prevention and management interventions that must be scaled-up and sustained

  37. Resources and Media Contacts • Division of Diabetes Translation • www.cdc.gov/diabetes • National Diabetes Education Program • www.yourdiabetesinfo.org • Media Contacts • Email: media@cdc.gov • Phone: 404-639-3286

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