CDC Says US Diabetes Population Tops 30 Million

The number of Americans diagnosed with diabetes has topped 30 million and the total living with diabetes or prediabetes exceeds 100 million, according to a new CDC report that shows how this growing health emergency is hitting hardest on those least able manage the disease or its effects.

Diabetes, especially type 2 diabetes (T2D), and prediabetes are seen more among the poor, among minorities, among those with less education, and among those living in the South and Appalachia, where several states did not expand Medicaid under the Affordable Care Act.

CDC updates diabetes data approximately every 2 years. This report includes data as of 2015 and finds that 30.3 million Americans, or 9.4% of the population, had diabetes, including both T2D and type 1 diabetes (T1D).

If there’s good news, it’s that the rate of increase seems to be slowing, according to Ann Albright, PhD, RD, director of CDC’s Division of Diabetes Translation. “Diabetes is a contributing factor to so many other serious health conditions,” said Albright, who has made it a priority to find people with prediabetes, a condition that leads to T2D if left untreated.

While CDC found that 84.1 million people have prediabetes, that figure is down from previous estimates of 86 million. Working with the American Medical Association, Albright has made prediabetes the focus of a massive public health campaign; CDC created the curriculum and recognition process for the Diabetes Prevention Program, which Medicare will offer seniors with prediabetes in April 2018. Medicare has estimated that diabetes accounts for $1 of every $3 it spends; thus, reversing trends in diabetes is crucial if Medicare is to stay solvent in the decades ahead.

Key findings from the CDC report include:

• In 2015, approximately 1.5 adults receive a new diagnosis of diabetes (aged 18 or older).
• Nearly 1 in 4 adults with diabetes, or 7.2 million people, didn’t know they had the disease. Only 11.6 adults with prediabetes knew they had it.
• The odds of being diagnosed with diabetes increases with age. Only 4% of adults aged 18-44 years had diabetes, but that number jumps to 17% for those aged 45-65 years and leaps again to 25% for those 65 years or older.
• This means 1 out of 4 Americans eligible for Medicare has been diagnosed with diabetes; the actual number is believed to be higher.

The report highlights significant disparities among those with diabetes and prediabetes, including:

• Native Americans and Alaska Natives had the highest rates of diabetes at 15.1% of the population, followed by African Americans at 12.7% and Hispanics at 12.1%. By comparison, 8% of Asians and 7.4% of whites had diabetes.
• Adults with less education are more likely to have diabetes. Rates by level of education were: less than a high school diploma, 12.6%; high school education, 9.5%; some post-secondary education, 7.2%.
• Rates of prediabetes were higher among men (36.6%) than women (29.3%); this split held up across education levels and ethnic groups. The higher rate among men has frustrated those offering the DPP because thus far, the vast majority of those enrolled in the program have been women. Virtual programs, seen as a way to engage more men, were not fully included in the Medicare DPP under a rule proposed last week.

Besides the complications associated with diabetes itself, such as retinopathy and amputations, there is growing evidence of links between diabetes and Alzheimer’s disease—one of the costliest burdens in Medicare and Medicaid. The common thread of insulin resistance runs through both conditions, and preventing T2D is now seen as a way of stopping as least some cases of Alzheimer’s. Right now, 5.5 million people have Alzheimer’s disease, and that number is projected to grow to 13.8 million by 2050.