Diabetes in the United States
Prevalence
The total prevalence of diabetes in the United States in 2010 was 25.8 million people—8.3% of the population, with most of those having type 2 diabetes. It is estimated that approximately 7 million of them are undiagnosed. Diabetes is increasingly common with advancing age but is also becoming more common in younger individuals. Estimates for prevalence of diabetes by age and gender in the U.S. in 2010 are as follows:
- Age 20 years or older: 25.6 million, or 11.3% of all people in this age group have diabetes. Approximately 79 million Americans in this age group have prediabetes.
- Age 65 years or older: 10.9 million, or 26.9% of all people in this age group have diabetes.
- Men: 13.0 million, or 11.8% of all men aged 20 years or older have diabetes.
- Women: 12.6 million, or 10.8% of all women aged 20 years or older have diabetes.
Incidence
1.9 million new cases of diabetes were diagnosed in people aged 20 years or older in 2010.
Deaths
Diabetes was the seventh leading cause of death listed on U.S. death certificates in 2010.
Three hundred and eighty two million people had diabetes worldwide in 2013. Every six seconds there is a death somewhere in the world from diabetes. Without any interventions, the worldwide number of diabetes cases will rise to 592 million by 2035.
According to the IDF Diabetes Atlas 6th edition (http://www.diabetesatlas.org/), in 2013, 80% of people with diabetes in the world live in low- and middle-income countries. The five countries with the largest numbers of persons with diabetes were India (65.1 million), China (98.4 million), the United States, Russia (9.7 million) and Brazil (11.9 milion). Diabetes is the fourth main cause of death in most industrialized countries.
Diabetes increased by one-third during the 1990s, due to the prevalence of obesity and an aging population. By 2035, the number of people with diabetes is expected to approximately double in Africa and the Middle East; and rise by 70% in South-East Asia, by 20% in Europe; by 50% in North America; by 60% in South and Central America; and by 50% in the Western Pacific.
The complications of diabetes, such as heart disease, renal failure, blindness, and amputations are imposing a huge burden on healthcare services world-wide. It is estimated that diabetes accounts for between 5% and 10% of a nation’s health budget.
Significant reductions of economic and human costs of diabetes are possible by investing in prevention, particularly early detection, in order to avoid the onset of diabetic complications. An estimated 25% of the world’s nations have not made any specific provision for diabetes care in national health plans.
Type 1 Diabetes
Type 1 Diabetes is caused by an auto-immune destruction of beta-cells in the pancreas leading to absolute insulin deficiency. It usually affects younger people, but can happen at any age. It affects 1 million people in the United States.
Type 2 Diabetes
Type 2 Diabetes is caused by progressive insulin secretory defect in the setting of increasing insulin resistance. The risk of having type 2 diabetes is higher in those with a family history, suggesting a strong genetic component. The risk of developing type 2 diabetes increases in those with peripheral or central obesity, advancing age, and lack of physical activity. It can also be found more commonly in women with a history of gestational diabetes. Type 2 diabetes can also be part of a cluster of other disorders such as dyslipidemia, hypertension, and obesity (known as “metabolic syndrome”) which can increase the risk of cardiovascular disease. Ninety to 95% of the diabetes in the U.S. is type 2 diabetes.
Gestational Diabetes
Gestational diabetes (GDM) is defined as glucose intolerance during pregnancy. GDM is believed to be caused by increasing insulin requirement during pregnancy, especially during the third trimester. Maternal insulin resistance increases as human placental lactogen levels increase. If a pregnant woman cannot increase insulin secretion, glucose intolerance develops. GDM can lead to perinatal morbidity such as fetal macrosomia and increased cesarean section rates, increased risk of pregnancy-induced hypertension and future development of type 2 diabetes.
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