Tag Archives: diabetes prevalence

Diabetes: Scope of the Problem

97 mg/dl. Yippee!

Type 2 diabetes is arguably the most important public health problem in the U.S. and most of the developed world. The U.S. Centers for Disease Control and Prevention predicts that one of every three Americans born in the year 2000 will develop diabetes.

The most common form of diabetes by far is type 2, which describes about 85% of cases. It’s less serious than type 1 diabetes. Type 1 diabetics have an immune system abnormality that destroys the pancreas’s ability to make insulin. Type 1’s will not last long without insulin injections. On the other hand, many type 2 diabetics live well without insulin shots.

“Prediabetes” is what you’d expect: a precursor that may become full-blown type 2 diabetes over time. Blood sugar levels are above average, but not yet into the diabetic range. One in four people with prediabetes develops type 2 diabetes over the course of three to five years. Researchers estimate that 35% of the adult U.S. population had prediabetes in 2008. That’s one out of every three adults, or 79 million. Only 7% of them (less than one in 10) were aware they had it.

In the U.S. as of 2010, 26 million folks have diabetes. That includes 11% of all adults.

The rise of diabetes parallels the increase in overweight and obesity, which in turn mirrors the prominence of refined sugars and starches throughout our food supply. These trends are intimately related. Public health authorities 40 years ago convinced us to cut down our fat consumption in a mistaken effort to help our hearts. We replaced fats with body-fattening carbohydrates that test the limits of our pancreas to handle them. Diabetics and prediabetics fail that test.

Dr. Richard K. Bernstein, notable diabetologist, wrote that, “Americans are fat largely because of sugar, starches, and other high-carbohydrate foods.”

We’re even starting to see type 2 diabetes in children, which was rare just thirty years ago. It’s undoubtedly related to overweight and obesity. Childhood obesity in the U.S. tripled from the early 1980s to 2000, ending with a 17% obesity rate.  Overweight and obesity together describe 32% of U.S. children.

Diabetes is important because it has the potential to damage many different organ systems, deteriorating quality of life. It can damage nerves (neuropathy), eyes (retinopathy), kidneys (nephropathy),  and stomach function (gastroparesis), just to name a few.

Just as important, diabetes can cut life short. Compared to those who are free of diabetes, having diabetes at age 50 more than doubles the risk of developing cardiovascular disease—heart attacks, strokes, and high blood pressure. Compared to those without diabetes, having both cardiovascular disease and diabetes approximately doubles the risk of dying. Compared to those without diabetes, women and men with diabetes at age 50 die seven or eight years earlier, on average.

Diabetic complications and survival rates will undoubtedly improve over the coming decades as we learn how to better treat this ancient disease.

Steve Parker, M.D.

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U.S. Diabetes Prevalence From 1935 to 2011

From 1935 to 1996, the prevalence of diagnosed type 2 diabetes [in the U.S.] climbed nearly 765%.

This statistic is from the Centers for Disease Control and Prevention as cited in Increased Consumption of Refined Carbohydrates and the Epidemic of Type 2 Diabetes in the United States: an Ecologic Assessment, American Journal of Clinical Nutrition, 2004, vol. 79, no.5, pp: 774-779.

I thought 765% might be a misprint, so I did some digging.  A similar figure is in DHHS Publication No. (PHS) 82-1232 published in 1981:

  • Diabetes prevalence rose from 0.4% of the population in 1935,  to 2.4% in 1979.

This is a six-fold increase.  The major part of the upward trend started in 1960.  Interestingly, that’s when corn syrup started working its way into our food supply.  Coincidence?  The authors of the Department of Human Services paper write:

Preliminary evaluation of these trends suggests that the change in the prevalence of known diabetes has resulted from improvements both in detection of diabetes among high-risk groups and in survivorship among persons with diabetes.

To me, it sounds like they weren’t considering an true increase in the number of new diabetes cases (incidence), but better detection of existing cases and improved longevity of existing patients (prevalence).  Incidence and prevalence are often confusing.  Wikipedia has a clarifying article.  These days, both incidence and prevalence are greatly increased over 1935 levels.

In January of 2011, the U.S. Centers for Disease Control and Prevention released the latest estimates for prevalence of diabetes and prediabetes. The situation is worse than it was in 2008, the last figures available.

  • 8.3% of the total U.S. population has either diagnosed or undiagnosed diabetes (earlier percentages in this post were for diagnosed cases only)
  • 6% of the U.S. adult population has diagnosed diabetes (My calculation: Population in 2011 was 311 million; with 18.8 million diagnosed cases of diabetes, 7 million undiagnosed)
  • Nearly 27% of American adults age 65 or older have diabetes (overwhelmingly type 2)
  • Half of Americans 65 and older have prediabetes
  • 11% of U.S. adults (nearly 26 million) have diabetes (overwhelmingly type 2)
  • 35% of adults (79 million) have prediabetes, and most of those affected don’t know it

Here’s a post about prevention of type 2 diabetes.

Steve Parker, M.D.

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Half of Americans Over 65 Have Prediabetes

Two days ago the U.S. Centers for Disease Control and Prevention released the latest estimates for prevalence of diabetes and prediabetes.  The situation is worse than it was in 2008, the last figures available. 

  • Nearly 27% of American adults age 65 or older have diabetes (overwhelmingly type 2)
  • Half of Americans 65 and older have prediabetes
  • 11% of U.S. adults (nearly 26 million) have diabetes (overwhelmingly type 2)
  • 35% of adults (79 million) have prediabetes, and most of those affected don’t know it

The CDC estimates that one of every three U.S. adults could have diabetes by 2050 if present trends continue.

The press release from the CDC mentions that physical activity and avoidance of overweight will prevent some cases of diabetes.  I believe that  limiting consumption of refined carbohydrates like sugar and flour would also help.

Steve Parker, M.D.

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