EPIDEMIOLOGY

  • An estimated 30.3 million people (or 9.4% of the U.S. population) have diabetes.1
    • Of these, 23.1 million people have a diagnosis of diabetes, while 7.2 million people (or 23.8%) of people with diabetes are undiagnosed.1
race-ethnicity

Reference 1: CDC

Diabetes affects people of all races and ethnicities, but disparities exist.1,2

  • American Indians/Alaskan Natives comprise the largest age-adjusted racial/ethnic group of people diagnosed with diabetes.
  • The proportion of African-American, Hispanic, and Asian American populations who have diabetes is higher than in the white population.

Reference 2.

An estimated 371,000 new cases of diabetes occurred in patients age 20-44 years, 892,000 new cases in patients age 45-64 years, and 400,000 new cases in patients 65 years or older in 2012.2

1.7 million new cases of diabetes are diagnosed in the United States each year.2

Reference 1. (data from 2010–2012 National Health Interview Survey, 2009–2012 National Health and Nutrition Examination Survey, and 2012 U.S. Census data)

Approximately 5,089 people younger than 20 years were diagnosed with type 2 diabetes each year during 2008-2009.2

  • The proportion of newly diagnosed cases in people under 20 years of age was higher among US minority populations than in non-Hispanic whites.1,2
  • Between 2001 and 2009, the overall prevalence of type 2 diabetes increased by 30.5% when adjusted for differences in completeness of ascertainment.3

NHW = non-Hispanic white; AA = African American; HISP = Hispanic; API = Asian Pacific Islander; AI = American Indian.

  • In 2012, 86 million Americans age 20 and older had prediabetes, an increase from 79 million in 2010.3
    • In 2009-2012, based on fasting glucose or A1C levels, 37% of U.S. adults aged 20 years or older, or an estimated 86 million Americans, had prediabetes.2
      • 51% of those adults with prediabetes were aged 65 years or older.
    • On the basis of fasting glucose or A1C levels, and after adjusting for population age differences, the percentage of U.S. adults aged 20 years or older with prediabetes in 2009−2012 was similar for non-Hispanic whites (35%), non-Hispanic blacks (39%), and Hispanics (38%).2
    • Diabetes remains the 7th leading cause of death in the United States.4
      • 79,535 death certificates listed diabetes as the underlying cause of death.4
      • 252,806 death certificates listed diabetes as underlying or contributing cause of death.4

Pathophysiology

Diabetes is characterized by the dysfunction of insulin-producing pancreatic beta cells, insulin hormone resistance in cells of the body, or a combination of both.5,6

  • Genetic predispositions and environmental factors that affect beta-cell function and insulin sensitivity have both been implicated in the development of type 2 diabetes.5,6
  • Type 2 diabetes begins with a resistance to insulin that worsens over time.5
    • When the pancreatic beta-cell can no longer produce enough insulin to compensate for a diminished insulin response, glucose concentrations rise and B cell functions are impaired.5
    • The progressive failure of beta cells is responsible for the transition from impaired glucose tolerance to type 2 diabetes.6
  • The underlying pathophysiology for type 1 diabetes is more developed, and the presence of ≥ 2 autoantibodies is strongly linked to clinical hyperglycemia and diabetes.7
    • Standards of Care: 3 distinct stages of T1DM that serve as the framework for future research and regulatory decision making.

Reference 8.

References

  1. Centers for Disease control and Prevention. National Diabetes Statistics Report. https://www.cdc.gov/diabetes/data/statistics/statistics-report.html. Accessed 3. 2018
  2. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2014. www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf. Accessed March 8, 2017.
  3. Dabelea D, Mayer-Davis EJ, PhD, Saydah S, et al; SEARCH for Diabetes in Youth Study. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA. 2014; 311:1778-1786.
  4. American Diabetes Association (2017). Available at: http://www.diabetes.org/diabetes-basics/statistics/. Diabetes Basics. Site Updated 7/2017. Site Visited: 3/2018
  5. Levin PA. Practical combination therapy based on pathophysiology of type 2 diabetes. Diabetes Metab Syndr Obes. 2016;9:355-369.
  6. Kahn SE, Cooper ME, Del Prato S. Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. Lancet. 2014;383:1068-1083.
  7. American Diabetes Association. Standards of Medical Care in Diabetes – 2018. Diabetes Care. January, 2018. Vol 1, Supp 1. https://doi.org/10.2337/dc18-SPPC01
  8. DeFronzo RA, Bonadonna RC, Ferrannini E. Pathogenesis of NIDDM. A balanced overview. Diabetes Care. 1992;15:318-368.

Additional Reading

Challenges

Treatments

Diagnosis

Epidemiology