The occurrence of diabetes has leveled off among U.S. adults in general, but has continued to rise among non-Hispanic blacks, Hispanics, and adults who did not study past high school, researchers from the Centers for Disease Control and Prevention reported Sept. 23 in JAMA.
In 2012, the estimated diabetes incidence was 7.1 cases per 1,000 adults (95% confidence interval, 6.1-8.2), and the prevalence was 8.3% (95% CI, 7.9%-8.7%), with no significant changes in either rate since 2008, said Linda Geiss and her associates at the CDC. The plateau could reflect stabilizations in U.S. obesity rates since 2003, and “appears to be concurrent with declines in overall caloric intake, food purchases, and energy intake,” the researchers said.
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The leveling off of diabetes among U.S. adults could reflect stabilizations in U.S. obesity rates since 2003.
The study included National Health Interview Survey data collected between 1980 and 2012 from 664,969 U.S. adults aged 20-79 years old. Rates of type 1 and 2 diabetes rose by about 4.5% per year between 1990 and 2008, the researchers said. During that period, the estimated incidence of diabetes more than doubled from 3.1 to 8.8 cases per 1,000 persons, while prevalence climbed from 3.5% to 7.9%.
Changes in diagnostic practices could have fueled the increase, but were unlikely to fully explain the “strong and steady 15- to 20-year increase in diabetes prevalence and incidence,” Ms. Geiss and her associates added (JAMA 2014 Sept. 23;312:1218-26).
Despite the recent overall plateau, diabetes incidence continued to climb among Hispanics and non-Hispanic blacks between 2008 and 2012, while prevalence rose among adult Americans who had a high school education or less, said the investigators. “This threatens to exacerbate racial/ethnic and socioeconomic disparities in diabetes prevalence and incidence,” the researchers wrote. “Furthermore, in light of the well-known excess risk of amputation, blindness, end-stage renal disease, disability, mortality, and health care costs associated with diabetes, the doubling of diabetes incidence and prevalence ensures that diabetes will remain a major public health problem that demands effective prevention and management programs.”
The Centers for Disease Control National Center for Health Statistics collected the data. The authors reported having no relevant financial conflicts.