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US diabetes rates

US diabetes diagnoses to triple and prevalence to double by 2060

Black women and men will continue to have the highest diabetes percent prevalence and black women and women of other race will have the largest relative increases

The number of US adults with diagnosed diabetes is projected to nearly triple and the percent prevalence double - by 2060 – according to a study by researchers from the Centers for Disease Control and Prevention, Atlanta, and Merck Research Laboratories. They reported that the projected number and percent of adults with diagnosed diabetes would increase from 22.3 million (9.1%) in 2014 to 39.7 million (13.9%) in 2030, and to 60.6 million (17.9%) in 2060. The number of people with diabetes aged 65 years or older would increase from 9.2 million in 2014 to 21.0 million in 2030, and to 35.2 million in 2060.

The paper, ‘Projection of the future diabetes burden in the United States through 2060’, published in BMC Population Health Metrics, also found that the percent prevalence would increase in all race-sex groups, with black women and men continuing to have the highest diabetes percent prevalence, and black women and women of other race having the largest relative increases.

Using a dynamic Markov model to project the number and percent of US adults with diagnosed diabetes through the year 2060, the study used the latest data available to estimate the model parameters, therefore, the researchers claim: “Our projection is based on relatively stable estimates of diabetes incidence over the past 30 years, including the lower incidence rates observed since 2008.”

Interestingly, the study did not consider obesity status or other biomarkers such as blood pressure and lipid level as part of the study – despite obesity being a known cause of type 2 diabetes.

The authors highlighted that diabetes was seventh in the leading causes of death in the US contributing to 76,488 deaths in 2014 with an estimated economic cost of US$245 billion in 2012 and claim their analysis shows that if the diabetes incidence rate was reduced by 20%, the number of people with diabetes would reduce by five million in 2030 and ten million in 2060.

They reported that over time, the overall diabetes percent prevalence is projected to increase on average by 0.3% per year before 2030, and by 0.1% per year after 2030, with the overall diabetes population size will increase by an average of 1.0 million people per year before 2030 and by 0.6 million per year thereafter. The increase would vary by age group (Figure 1) and people aged 65 years or older would have larger increases in both number and percent prevalence than younger adults.

Figure 1: Projection of diagnosed diabetes prevalence in US adults: A) number by age and year B) and percent by age and year (Figure altered from original here)

The number (percent) of people with diagnosed diabetes in the 65 years or older group would increase from 9.18 million (19.8%) in 2014 to 21.0 million (28.1%) in 2030, and 35.2 million (35.0%) in 2060. As a share of the total diabetes population, those aged 65 years or older accounted for 41.1% in 2014. This share would increase to 53.0% in 2030 and to 58.0% in 2060.

With regard to race measured in population size, whites with diabetes outnumbered blacks and people of other races with 16.7 million in 2014 and would continue to do so with 39.1 million in 2060. Among all race-sex groups, black women had the highest percent prevalence in 2014 (12.5%) and would continue to have the highest rate through year 2060 (25.2%), followed by black men with 12.2% in 2014 and 21.2% in 2060.

“We project the number of US adults with diagnosed diabetes would nearly triple from 2014 to 2060 and over one in six adults would be diagnosed with diabetes by year 2060,” the authors conclude. “The future health and economic burden imposed by diabetes on society, health care systems, and the national economy would continue to increase if no actions were taken. Wide implementation of effective prevention strategies could mitigate future increases of the diabetes burden.”

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