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A new study from the federal Centers for Disease Control and Prevention (CDC) shows diabetes rates continue to rise unabated at a rate of about 5% annually, and have been climbing steeply since 1990.
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"The diabetes epidemic is like a runaway freight train that shows no sign of slowing down," says Desmond Williams, MD, PhD, a medical epidemiologist at CDC.
However, public health experts did find a few positive trends amid the gloomy statistics they presented at the American Diabetes Association's (ADA's) 67th Scientific Sessions, held June 22–26 in Chicago. For example, more patients are reaching treatment goals for glycemic control, and a reduced incidence of some diabetes-related conditions and consequences, such as kidney disease and amputations, has been observed.
The bad news about rising diabetes rates comes from an analysis of 1963–2005 data from the National Health Interview Survey, presented by Linda S. Geiss, MA, chief of diabetes surveillance for CDC's Diabetes Program in the Division of Diabetes Translation.
The CDC data show that during 1963–1975 the prevalence of type 2 diabetes increased 5.1% per year, from 13.6 to 25.8 per 1,000 people, then stayed level during the years 1975–1990. Then, during 1990–2005, according to Geiss, the prevalence of diabetes again increased sharply: 4.6% per year, from 26.4 to 54.5 per 1,000 people.
Still unexplained is the leveling of diabetes incidence and prevalence during the years 1975–1990, says Geiss, noting the first standard diagnostic criteria for type 2 diabetes were released in 1975.
Public health experts don't dispute that diabetes rates turned sharply upward in 1990, shortly after studies showed obesity beginning to increase at a more rapid rate in 1986, Geiss says.
The diabetes news isn't all bad, though, according to other presentations
at the Scientific Sessions. Quest Diagnostics, one of the nation's largest
clinical laboratory companies, reported an analysis of 
22.7 million
glycated hemoglobin (A1C) tests performed during 2001–2006 showing that
more than half of patients, or 54.6%, reached the American Diabetes
Association-recommended treatment goal of 
7% A1C, compared with 37.8% of
patients in 2001.
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However, about 44.4% of patients still fall short of the A1C treatment goal.
"There are a number of promising trends," says Geiss. "We're beginning to see improvements in the rates of complications." Data suggest a reduction in diabetes risk factors, such as blood pressure and lipids, which reflect improved primary care.
In addition, says Geiss, the rates of amputations and kidney disease linked to diabetes have decreased.
Nonetheless, the trend for diabetes incidence and prevalence continues upward. "The best explanation is that our society has become more toxic," Geiss says. "We have become too sedentary, eat bad food, and have poor lifestyle habits."
Halting the diabetes epidemic will require teamwork among endocrinologists, primary care providers, public health authorities, and other members of the health care team, says Ann Albright, PhD, RD, director of CDC's Division of Diabetes Translation and president-elect of health care and education for ADA.
"It's going to take a coordinated effort to slow the [diabetes]
freight train down," says Albright. "The challenge is finding the
resources to do that." 
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| DOC News | Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |
