Epidemiology 

• 34.2 million Americans, or 10.5% of the US population, have diabetes.¹
• 7.3 million people with diabetes have not had a diagnosis.¹

Source: CDC. Diabetes Info Cards. https://www.cdc.gov/diabetes/library/socialmedia/infocards.html.

Diabetes affects people of all races and ethnicities, but disparities exist.³

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

Source: CDC. Addressing Health Disparities in Diabetes. https://www.cdc.gov/diabetes/disparities.html.

1.5 million new cases of diabetes were diagnosed in adults in the United States in 2018. An estimated 452,000 new cases of diabetes occurred in patients age 18-44 years, 706,000 new cases in patients age 45-64 years, and 326,000 new cases in patients 65 years or older.¹

Source: Centers for Disease Control and Prevention (CDC). National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2020.https://www.cdc.gov/diabetes/data/statistics/statistics-report.html.

Annually, 5,758 people younger than 20 years had diagnoses of type 2 diabetes annually during 2014-2015.¹

• 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
• Between 2001 and 2009, the overall prevalence of type 2 diabetes among children and adolescents increased by 30.5% when adjusted for differences in completeness of ascertainment.⁴

Trends in type 2 diabetes prevalence among children and adolescents, 2001-2009, by sex and age and race/ethnicity ⁴

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

• In 2018, 88 million Americans age 20 and older had prediabetes.¹

• From 2013-2016, based on fasting glucose or A1C levels, 34.5% of U.S. adults aged 18 years or older had prediabetes.¹
  • 6% of those adults 65 years or older had prediabetes.
• On the basis of fasting glucose or A1C levels, and after adjusting for population age differences, the percentage of US adults aged 20 years or older with prediabetes 2013−2016 was similar for non-Hispanic whites (33.9%), non-Hispanic blacks (36.9%), non-Hispanic Asians (32.8%), and Hispanics (35.4%).¹

• Diabetes was the seventh leading cause of death in the United States in 2018.⁵
  • The death rate from diabetes may be underreported.⁶
  • Studies have reported that only about 35% to 40% of people with diabetes who died had diabetes listed anywhere on the death certificate.⁶
  • Approximately 10% to 15% of death certificates had diabetes listed as the underlying cause of death.⁶

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.^8,9

• Genetic predispositions and environmental factors that affect beta-cell function and insulin sensitivity have both been implicated in the development of type 2 diabetes.^8,9
• Type 2 diabetes begins with a resistance to insulin that worsens over time.⁷
• When the pancreatic beta cell can no longer produce enough insulin to compensate for a diminished insulin response, glucose concentrations rise and ß cell functions are impaired.⁸
• The progressive failure of beta cells is responsible for the transition from impaired glucose tolerance to type 2 diabetes.⁹

Source: DeFronzo RA, et al. Pathogenesis of NIDDM. A balanced overview. Diabetes Care. 1992;15:318-368.

References

1. Centers for Disease Control and Prevention (CDC). National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2020. https://www.cdc.gov/diabetes/data/statistics/statistics-report.html.
2. CDC. Diabetes Info Cards. https://www.cdc.gov/diabetes/library/socialmedia/infocards.html.
3. CDC. Addressing Health Disparities in Diabetes. https://www.cdc.gov/diabetes/disparities.html.
4. Dabelea D, 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.
5. Xu JQ, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2018. NCHS Data Brief, 355. Hyattsville, MD: National Center for Health Statistics.2020. https://www.cdc.gov/nchs/products/databriefs/db355.htm#section_2.
6. American Diabetes Association. Statistics about diabetes. https://www.diabetes.org/resources/statistics/statistics-about-diabetes?loc=db-slabnav.
7. Levin PA. Practical combination therapy based on pathophysiology of type 2 diabetes. Diabetes Metab Syndr Obes. 2016;9:355-369.
8. Kahn SE, et al. Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. Lancet. 2014;383:1068-1083.
9. DeFronzo RA, et al. Pathogenesis of NIDDM. A balanced overview. Diabetes Care. 1992;15:318-368.