Type 2 diabetes and prediabetes

Definitions

Individuals with prediabetes have blood glucose levels that are higher than normal but not high enough to be considered type 2 diabetes. Those with prediabetes are more likely to develop type 2 diabetes—and may already have some symptoms of diabetes—as well as heart disease and stroke.

Type 2 diabetes is the most common form of diabetes. In patients with type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to use glucose for energy.

Source: American Diabetes Association

Incidence and projected growth in the U.S. population (including how diabetes impacts minority populations)

• Prediabetes

— About 33 percent of U.S. adults (approximately 79 million) have prediabetes but awareness of this high risk condition is very low; about 50 percent of U.S. adults aged 65 years or older have prediabetes
— People with prediabetes can prevent or delay the onset of type 2 diabetes by losing 5–7 percent of their body weight and getting at least 150 minutes per week of moderate physical activity

• African Americans are from 1.4 to 2.2 times more likely to have diabetes than whites

— Hispanic Americans have a higher prevalence of diabetes than non-Hispanic people, with the highest rates for type 2 diabetes among Puerto Ricans and Hispanics living in the Southwest

— The prevalence of diabetes among American Indians is 2.8 times the overall rate
— The rate of diabetic kidney failure is 2.6 times higher among African Americans than whites

• Diabetes affects 25.8 million people, 8.3 percent of the U.S. population (all ages, 2010 data; 95 percent is type 2 diabetes)

— Diagnosed 18.8 million people
— Undiagnosed 7 million people

• From 1990 through 2010 the annual number of new cases of diagnosed diabetes almost tripled

— As many as one in three U.S. adults could have diabetes by 2050 if current trends continue
— This rise is associated with increases in obesity, decreases in leisure-time physical activity and the aging of the U.S. population

Sources (accessed April 11, 2013): CDC National Diabetes Fact Sheet 2011 www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf; CDC Diabetes Report Card 2012 www.cdc.gov/diabetes/pubs/pdf/DiabetesReportCard.pdf; AHRQ Diabetes Disparities Fact Sheet www.ahrq.gov/research/findings/factsheets/diabetes/ diabdisp/index.html

Human toll and costs

• More than 230,000 American deaths in 2010 included diabetes as a primary or contributing cause Source:
National Center for Health Statistics, November 2012

• The American Diabetes Association released new research on March 6, 2013, estimating that the total costs of diagnosed diabetes have risen from $174 billion in 2007 when the cost was last examined to $245 billion in 2012

— $176 billion in direct medical expenses
— $69 billion in lost productivity
— This figure represents a 41 percent increase over a five year period

Potential complications if not managed properly

• Diabetes is the leading cause of kidney failure, nontraumatic lower limb amputations and new cases of blindness among adults in the United States

• Diabetes is a major cause of heart disease and stroke and the seventh leading cause of death in the United States

Source (accessed April 11, 2013): CDC National Diabetes Fact Sheet 2011 www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf

Reasons why diabetes may be uncontrolled

• Gaps in availability of, access to, use of, or continuity of health care
• Poor adherence to medication regimens:

— Medication costs
— Complicated regimens
— Medication adverse effects
— Insufficient physician-patient communication

• Limited access to or use of healthful foods and physical activity
• Suboptimal clinical care