Diabetes Rates Leveling Off in Adults

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Diabetes Rates Leveling Off in Adults
Diabetes Rates Leveling Off in Adults

The incidence and prevalence of diabetes in the United States doubled during the past few decades, but new data indicate that the rate has stabilized in recent years, according to research published in JAMA.

Unfortunately, however, results also show that incidence continues to increase among Hispanic and black adults.

“Although the prevalence and incidence of diabetes have increased in the United States in recent decades, no studies have systematically examined long-term, national trends in the prevalence and incidence of diagnosed diabetes,” Linda S. Geiss, MA, of the CDC in Atlanta, and colleagues wrote.

To fill this knowledge gap and identify any long-term trends, the researchers analyzed data from 1980 to 2012 for 664,969 adults aged 20 to 79 years from the National Health Interview Survey. They calculated the annual percentage change (APC) in rates of prevalence and incidence in both type 1 and type 2 diabetes combined.

The researchers found no significant change in APC for age-adjusted prevalence and incidence of diabetes (0.2% [95% CI, –0.9 to 1.4] and –0.1% [95% CI, –2.5 to 2.4], respectively) during the 1980s. But results revealed dramatic increases in both prevalence and incidence during 1990 to 2008 (4.5% [95% CI, 4.1-4.9] and 4.7% [95% CI, 3.8-5.6]).

During 2008 to 2012, however, prevalence and incidence of diabetes plateaued with no significant change (0.6% [95% CI, –1.9 to 3.0] and –5.4% [95% CI, –11.3 to 0.9]), according to the data.

Prevalence was 3.5 per 100 persons in 1990, 7.9 in 2008 and 8.3 in 2012. Incidence was 3.2 per 1,000 in 1990, 8.8 in 2008 and 7.1 in 2012, the researchers reported.

The researchers noted that reasons for the stabilization in diabetes prevalence and incidence are difficult to identify from these data, but they highlighted two factors that may play a role.

“Recent studies suggest that the rate of increase in obesity, a major risk factor for type 2 diabetes, may be slowing in the United States, with no change in the prevalence of obesity among US adults since 2003-2004. This slowing in the growth of obesity and diabetes appears to be concurrent with declines in overall caloric intake, food purchases, and energy intake,” they wrote.

“The recent slowing in diabetes prevalence and incidence could also reflect the adoption of hemoglobin A1c (HbA1c) for the diagnosis of diabetes,” the researchers added.

Although analyses of subpopulations suggested trends that were similar to the overall population, data denoted continued increases in incidence rates among black and Hispanic adults (P=.03 and P=.01, respectively) at rates that were significantly greater than for white adults.

Education was also associated with prevalence, with the rate of increase being higher for adults with a high school education or less vs. those with more than a high school education (P=.006 and P<.001, respectively).

These demographic data are indicative of current issues and perhaps hint at problems to come, according to the researchers.

“This threatens to exacerbate racial/ethnic and socioeconomic disparities in diabetes prevalence and incidence. Furthermore, in light of the well-known excess risk of amputation, blindness, end-stage renal disease, disability, mortality, and health care costs associated with diabetes, the doubling of diabetes incidence and prevalence ensures that diabetes will remain a major public health problem that demands effective prevention and management programs,” the researchers wrote.

Reference

  1. Geiss LS et al. JAMA. 2014; 312(12):1218-1226.
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