Presentation of Diabetes

Slide 1Diabetes: The Numbers
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What is Diabetes?
Diabetes is a group of diseases characterized by high levels of blood glucose (blood sugar)
Diabetes can lead to serious health problems and premature death
NIDDK, National Diabetes Statistics fact sheet. HHS, NIH, 2005.
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Diabetes is a group of diseases characterized by high levels of blood glucose (or blood sugar) which results from problems with insulin production, insulin action, or both.
Diabetes can lead to serious problems and complications, such as heart disease, blindness, kidney failure, lower-limb amputations, and premature death.
Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics fact sheet: general information and national estimates on diabetes in the United States, 2005. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2005.
Diabetes: The Numbers
January 2007
Diabetes Complications
2 in 3 people with diabetes die of heart disease or stroke
Diabetes is the #1 cause of adult blindness
Diabetes is the #1 cause of kidney failure
Diabetes causes more than 60% of non-traumatic lower-limb amputations each year
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About 2 in 3 people with diabetes die from heart disease or stroke. The risk for heart disease and stroke is 2 to 4 times higher in people with diabetes.
Diabetes is the leading cause of new cases of blindness among adults aged 20 to 74 years.
Diabetes is the leading cause of kidney failure, accounting for 44 percent of new cases in 2002. In 2002, close to 154,000 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant in the United States and Puerto Rico.
Diabetes causes more than 60 percent of nontraumatic lower-limb amputations each year. In 2002, about 82,000 nontraumatic lower-limb amputations were performed in people with diabetes.
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Type 2 diabetes
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Type 1 diabetes is an auto-immune disease that develops when the body’s immune system destroys pancreatic beta cells—the only cells in the body that make the hormone insulin that regulates blood glucose. People with type 1 diabetes must take insulin every day either by injection or pump. Inhalable insulin is also available.
Type 1 diabetes accounts for 5% to 10% of all diagnosed cases of diabetes and usually affects children and young adults, although the disease can occur at any age. There is no known way to prevent type 1 diabetes.
Type 2 diabetes usually begins as insulin resistance—a disorder in which cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce it. Insulin resistance and abnormal beta cell function may occur long before type 2 diabetes is diagnosed.
Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes. It is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians and other Pacific Islanders are at particularly high risk for type 2 diabetes and its complications. Although still rare, type 2 diabetes is being diagnosed more frequently in children and adolescents.
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7% of all U.S. pregnancies, or about 200,000 cases annually
Increased lifelong risk for mother and child for developing type 2 diabetes
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Gestational diabetes mellitus is a form of glucose intolerance diagnosed in some women during pregnancy.
Gestational diabetes affects 7%, or about 200,000 U.S. pregnancies each year.
After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have an increased lifelong risk—up to a 50% chance—of developing diabetes in the next 5 to 10 years after pregnancy. Their offspring are also at higher risk for obesity and type 2 diabetes compared to other children.
Gestational diabetes is more common among African Americans, Hispanic/Latino Americans, and American Indians and Alaska Natives. It is also more common among obese women and women with a family history of diabetes.
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These maps show the dramatic increase in obesity and diabetes in the United States from 1990 to 2001.
This increase is important because obesity is a major risk factor for type 2 diabetes and because about 55% of adults in the U.S. who have diabetes are also obese (CDC).
Reference
Centers for Disease Control and Prevention. Prevalence of overweight and obesity among adults with diagnosed diabetes--United States, 1988-1994 and 1999-2002. MMWR. 2004;53:1066-1068.
Diagnosed: 14.6 million people
Undiagnosed: 6.2 million people
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In 2005, at least 15 million Americans had been diagnosed with diabetes and another 6 million were undiagnosed—for a total of about 21 million Americans with diabetes.
Of diagnosed cases, type 1 diabetes accounts for 5 to 10 percent and type 2 diabetes accounts for 90 to 95 percent.
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About 20.6 million or 9.6 percent of all people 20 years or older have diabetes.
About 10.3 million or 20.9 percent of all people 60 years or older have diabetes.
About 11 million or 10.5 percent of all men aged 20 years or older have diabetes.
About 10 million or 8.8 percent of all women aged 20 years or older have diabetes.
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1.5 million new cases of diabetes diagnosed in 2005
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1.5 million new cases of diabetes were diagnosed in people age 20 or older in 2005.
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American Indians, African Americans, Hispanic/Latino Americans, and some Asian Americans and Native Hawaiians or other Pacific Islanders are at particularly high risk for type 2 diabetes and its complications.
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American Indians and Alaska Natives and Diabetes
12.8 percent of American Indians and Alaska Natives had diabetes in 2003
2.2 times as likely to have diabetes as non-Hispanic whites
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About 99,500 or 12.8 percent of American Indians and Alaska Natives aged 20 years or older who received care from the Indian Health Service (IHS) in 2003 had diabetes.
American Indians and Alaska Natives are 2.2 times as likely to have diabetes as non-Hispanic whites.
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13.3 percent of all African Americans have diabetes
African Americans are 1.8 times as likely to have diabetes as non-Hispanic whites
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3.2 million or 13.3 percent of all non-Hispanic blacks aged 20 years or older have diabetes.
African Americans are 1.8 times as likely to have diabetes as non-Hispanic whites.
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9.5 percent of all Hispanic/Latino Americans have diabetes
Mexican Americans are 1.7 times as likely to have diabetes as non-Hispanic whites
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It is estimated that 2.5 million or 9.5 percent of all Hispanic/Latino Americans aged 20 years or older have diabetes.
Mexican Americans are 1.7 times as likely to have diabetes as non-Hispanic whites. Most data are available for Mexican Americans. More data are needed to derive estimates for other Hispanic/Latino Americans.
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Asian Americans and Pacific Islanders and Diabetes
Hawaii: Asians, Native Hawaiians, and other Pacific Islanders are more than 2 times as likely to have diabetes as non-Hispanic whites
California: Asians are 1.5 times as likely to have diabetes as non-Hispanic whites
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The total prevalence of diabetes is not available for Asian Americans or Pacific Islanders. It is important to note that the absence of data for Asian Americans and Pacific Islanders does not mean they are not affected by diabetes.
However, in Hawaii, Asians, Native Hawaiians, and other Pacific Islanders aged 20 years or older are more than 2 times as likely to have diagnosed diabetes as non-Hispanic whites.
In California, Asians are 1.5 times as likely to have diagnosed diabetes as non-Hispanic whites. Other groups within these populations also have an increased risk for diabetes.
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Young people under age 20
154,369 or 0.18% of young people under age 20 have diabetes, OR 1 in 523
Type 1 diabetes is more common than type 2, except in American Indian youth
Diabetes in youth is more common in young females and in young people ages
10-19
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Close to 155,000 people under the age of 20—or .18 percent of young people under age 20 have diabetes.
That’s one in 523.
Type 1 diabetes is more common than type 1 diabetes, except in American Indian youth.
Diabetes is more common in young females than males, and in young people ages 10-19.
Reference
The Burden of Diabetes Mellitus Among US Youth: Prevalence Estimates From the SEARCH for Diabetes in Youth Study Group Pediatrics. 2006; 118: 1510-1518.
Young people ages 0 -9
Diabetes occurs in less than 1 in 1,000 young people ages 0 – 9
Type 1 diabetes accounts for 97% of diagnosed cases in this age group
Diabetes is more common in non-Hispanic white young people ages 0-9 than in any other ethnic group
(SEARCH) Pediatrics.2006; 118: 1510-1518.
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Diabetes occurs in less than 1 in 1,000 young people ages 0 to 9.
Type 1 diabetes accounts for 97% of diagnosed cases in this age group.
Diabetes is more common in non-Hispanic white young people ages 0 – 9 than in any other ethic group.
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10 – 19
Type 1 diabetes accounts for 81% of diagnosed cases in this age group
Type 2 diabetes accounts for 6% (non-Hispanic white youth) to 76% (American Indian youth) of diagnosed diabetes in this age group
(SEARCH) Pediatrics.2006; 118: 1510-1518.
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Diabetes occurs in one in 357 young people ages 10 – 19.
Type 1 diabetes accounts for 81% of diagnosed cases in this age group.
Type 2 diabetes accounts for 6% (non Hispanic white youth) to 76% (American Indian youth) of diagnosed diabetes in this age group.
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Blindness - 55
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The following are rough approximations to help emphasize what diabetes prevalence numbers mean to people with diabetes each and every day.
Approximately,
810 people die from the complications of diabetes;
230 people with diabetes will have an amputation;
120 people with diabetes will suffer from kidney failure; and
55 people with diabetes will go blind.
Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics fact sheet: general information and national estimates on diabetes in the United States, 2005.Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2005.
Preventive care practices for eyes, kidneys, feet, teeth and gums
Aspirin as directed by physician
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People with diabetes and their health care providers can reduce the occurrence of diabetes complications by controlling the levels of blood glucose, blood pressure, and blood lipids, and by receiving other preventive care practices in a timely manner.
Studies have found that improved glycemic control benefits people with either type 1 or type 2 diabetes. In general, every percentage point drop in A1C blood test results (i.e., from 8.0% to 7.0%) reduces the risk of microvascular complications—like eye, kidney, and nerve diseases—by 40%.
Blood pressure control reduces the risk of heart disease or stroke among persons with diabetes by 33% to 50%, and the risk of microvascular complications by about 33%.
Improved cholesterol or blood lipids control (for example, HDL, LDL, and triglycerides) can reduce cardiovascular complications by 20% to 50%.
Detecting and treating diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50% to 60%.
Comprehensive foot care programs can reduce amputation rates by 45% to 85%.
Treating early diabetic kidney disease by lowering blood pressure can reduce the decline in kidney function by 30% to 70%.
Studies have shown that an aspirin a day can help prevent diabetes complications.
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Indirect Cost: $40 billion
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The total estimated cost of diabetes in the United States is $132 billion.
The estimated direct medical cost of diabetes is $92 billion. This includes medical care and services.
The estimated indirect cost of diabetes is $40 billion. This includes disability, work loss, and premature mortality.
Medicines and supplies and outpatient services are responsible for a minority of these costs.
Reference
Lewin Group, Inc., for the American Diabetes Association, 2002. Estimated diabetes costs in the United States in 2002.
What is Pre-diabetes?
People with pre-diabetes have blood glucose levels higher than normal but not high enough to be diagnosed with diabetes
People with pre-diabetes can prevent or delay the onset of type 2 diabetes through lifestyle change and/or medication - though none are approved for diabetes prevention
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Pre-diabetes is a condition that raises the risk of developing type 2 diabetes, heart disease, and stroke.
People with pre-diabetes have high blood glucose levels higher than normal, but not yet high enough to be diagnosed with diabetes.
People with pre-diabetes can prevent or delay the onset of type 2 diabetes through lifestyle change and/or medication - though no medications are approved for diabetes prevention.
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Pre-Diabetes
At least 54 million U.S. adults age 20 and older have pre-diabetes—which raises their risk for type 2 diabetes and cardiovascular disease
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At least 54 million U.S. adults age 20 and older have pre-diabetes, which independently raises the risk of developing type 2 diabetes and cardiovascular disease.
It is important to note that progression to diabetes among people with pre-diabetes is not inevitable.
The NIDDK-funded Diabetes Prevention Program (DPP) clinical trial showed us that people who lost 5 to 7 percent of their body weight by making healthy food choices and being physically active 30 minutes a day, 5 days a week reduced the onset of type 2 diabetes by 58%. This powerful reduction in risk was found in all subgroups, including men and women, ethnic groups at high risk, women with a history of GDM, and people age 60 and older.
In fact, participants over the age of 60—who as a group have a nearly 20 percent prevalence of diabetes—reduced their development of diabetes by 71%.
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Presentation of Diabetes

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