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Number of Americans With Diabetes Nears 21 Million

Elizabeth Thompson Beckley

The prevalence of type 2 diabetes in the U.S. "is bad, it's beengetting bad, and it's going to get worse before it gets better," saysFrank Vinicor, MD, MPH, director of the division of diabetes translation atthe Centers for Disease Control and Prevention (CDC) inAtlanta.

His dire prediction reflects the CDC's latest diabetes prevalence data,released October 26. Seven percent of the U.S. population, or 20.8 millionAmericans, have diabetes. That's an increase of 2.6 million cases from thelast estimates reported in 2003. Type 2 diabetes represents 95% of all cases.About 6 million of those currently affected do not know they have the disease,and an additional 41 million people are estimated to have pre-diabetes.

The toll of the disease in the course of a day is even more startling.According to Vinicor, every 24 hours, 4,100 new diabetes cases are diagnosedin the U.S., at least 810 people die, 230 undergo amputation, 120 learn theyneed kidney dialysis or transplant, and 55 go blind.

"I don't think I'd be exaggerating to say that diabetes is ournation's most costly disease, both in human terms and in economicterms," says Nathaniel Clark, MD, MS, RD, national vice president forclinical affairs for the American Diabetes Association (ADA). "We mayactually see a generation of Americans that will not outlive their parents ifchanges are not made."

Clark and Vinicor made their remarks at a diabetes news briefing hosted bythe American Medical Association on October 27 in New York.

The burden of diabetes prevalence weighs more heavily on the elderly and onminority populations. As has been the case in past years, the majority ofpeople with diabetes are either working age or older. About 21% of Americans60 years of age have diabetes, compared with 10% of people aged40–59 and 2% of those aged 20–39.

Compared with the non-Hispanic white population, where roughly 8.7% havediabetes, diabetes is 1.7–2.2 times more common in Hispanic, black,Native American, Alaska Native, and Asian-American populations.

"This is not a fair, equitable diabetes," Vinicor says.

If the current trends don't change, a person born in 2000 will have a1-in-3 chance of developing diabetes.

WHAT TO DO
The growing diabetes problem has spurred ADA to collaborate with theAmerican College of Cardiology and the National Diabetes Education Program topublicize the link between diabetes and related cardiovascular complications.These groups are encouraging patients to talk with their health care providersabout the "ABCs" of diabetes: A is for the A1C (glycatedhemoglobin) test, B is for blood pressure, and C is for cholesterol. Thepatient should ask the clinician what the patient's numbers are and what stepsto take to reach healthier targets.

"Primary prevention can stop the inflow of people developing diabetesand stop the outflow of complications that can be mortal," Vinicor says."We must engage in primary prevention."

Recent studies show that people with pre-diabetes can successfully preventor delay the onset of diabetes by losing 5–7% of their body weight, hesays. "This can be accomplished through 30 minutes or more of physicalactivity most days of the week and by following a low-calorie, low-fat eatingplan, including a diet rich in whole grains and fruits and vegetables."

Footnotes

FYI

The 2005 National Diabetes Fact Sheet is available on the CDC's Web site atwww.cdc.gov/diabetes.

Recommended ABC targets for patients with diabetes:

• A1C <7%. Check at least twice a year.

• Blood pressure <130/80 mmHg. Check at every patientvisit.

• Cholesterol (LDL) <100 mg/dl. Check at least once ayear.

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