The Burden of Diabetes.

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The Impact of Diabetes Mellitus in the United States

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Presentation transcript:

The Burden of Diabetes

Worldwide Prevalence of Diabetes Current estimated prevalence: 415 million worldwide By 2040, 642 million people worldwide are expected to have diabetes IDF. Diabetes Atlas Update 2015. Available at: http://www.idf.org/sites/default/files/Atlas7e-poster.pdf.

Prevalence of Diabetes and Prediabetes in the United States 9.4% of US population Prediabetes 33.9% of US population 20081 20112 20143 20174 1. CDC. National diabetes fact sheet, 2008. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2008.pdf. 2. CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf. 3. CDC. National diabetes statistics report, 2014. http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf. 4. CDC. National diabetes statistics report. 2017. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf.

Projected Prevalence of Diabetes in the United States: 1990 to 2050 3 3 3 3 Year 1. National Diabetes Surveillance System. http://www.cdc.gov/diabetes/statistics/prev/national/figpersons.htm. 2. CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf. 3. Boyle JP, et al. Popul Health Metr. 2010 Oct 22;8:29.

Prevalence of Diagnosed Diabetes in Different US Ethnic and Racial Groups US Adults ≥18 Years of Age CDC. National diabetes statistics report, 2017. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

Annual Incidence of Diabetes in US Children and Adolescents US Population, 0-19 Years of Age Race and Ethnicity Age of Onset Rate (per 100,000 per year) Years *Incidence of type 2 diabetes not reported for children 0-9 years. API, Asians/Pacific Islanders; H, Hispanics; non-Hispanic blacks; NA, Native American; NHW, non-Hispanic whites; NHB. Mayer-Davis EJ, et al. N Engl J Med. 2017;376:1419-1429.

T2D Prevalence Parallels Prevalence of Obesity Obese NHANES Data, U.S. Adults ≥20 Years1-5 Diagnosed Diabetes CDC Data, U.S. Population6,7 Population (%) BMI, body mass index (in kg/m2); CDC, Centers for Disease Control and Prevention; NHANES, National Health and Nutrition Examination Survey (x-axis lists last year of each survey). *NHANES 1994 data. 1. Flegal KM, et al. Int J Obes Relat Metab Disord. 1998;22:39-47. 2. Flegal KM, et al. JAMA. 2002 ;288:1723-1727. 3. Flegal KM, et al. JAMA. 2010;303:235-241. 4. Flegal KM, et al. JAMA. 2012;307:491-497. 5. Ogden CL, et al. JAMA. 2014;311:806-814. 6. Harris MI, et al. Diabetes Care. 1998;21:518-524. 7. CDC. Diabetes data & trends. Available at: https://www.cdc.gov/diabetes/statistics/prev/national/figraceethsex.htm and http://www.cdc.gov/diabetes/statistics/prev/national/fighispanicthsex.htm.

Increase in Diabetes Parallels the Increase in Obesity in the United States Population (%) 111% increase *BMI ≥30 kg/m2. CDC. National diabetes statistics report, 2014. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, 2014. Mokdad AH, et al. JAMA. 1999;282:1519-1522; Mokdad AH, et al. Diabetes Care. 2000;23:1278-1283; Flegal KM, et al. JAMA. 2016;315:2284-2291.

Diabetes Morbidity and Mortality 7th leading cause of death in US Leading cause of blindness Most frequent cause of kidney failure ~60% of nontraumatic lower limb amputations occur in people with diabetes Diabetes also Doubles the risk of periodontal disease Doubles the risk of developing depression Depression increases T2D risk by 60% Increases patients’ susceptibility to acute illness (eg, pneumonia and influenza) Worsens the prognosis of patients with acute illnesses CDC. National diabetes statistics report, 2017. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf. CDC. National diabetes statistics report, 2014. http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf. CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.

Diabetes and Morbidity and Mortality (relative to individuals without diabetes) CDC. National diabetes statistics report, 2014. http://www.cdc.gov/diabetes/pubs/statsreport14/national- diabetes-report-web.pdf

Costs of Diabetes 2012 Burden Estimate *Includes $1.3 billion in costs from gestational diabetes. Dall TM, et al. Diabetes Care. 2014;37:3172-3179.

Goal Achievement in Diabetes NHANES 2007-2010* N=1444 N=1342 <7 <8 >9 <70 <100 <130/80 <140/90 A1C (%) LDL-C (mg/dL) BP (mm/Hg) Nonsmoker All goals met BP (mm/Hg) Taking a statin *Data from separate studies. BP, blood pressure; LDL-C, low-density lipoprotein cholesterol; NHANES, National Health and Nutrition Examination Survey. Ali MK, et al. N Engl J Med. 2013;368:1613-1624. Stark Casagrande S, et al. Diabetes Care. 2013;36:2271-2279.

A1C Achievement by Individualized Target NHANES 2007-2010 (N=1444) Age (years) 18-44 45-64 ≥65 Target A1C (%) ≤6.5 ≤7.0 ≤7.5 ≤8.0 Without complications With complications NHANES, National Health and Nutrition Examination Survey. Ali MK, et al. N Engl J Med. 2013;368:1613-1624.