Diabetes Statistics: Pre-diabetes, Ethnic Stats, Figures,and Financial Costs

Diabetes poses an escalating worldwide challenge, impacting people, families, and nations alike. A comprehensive analysis reveals that diabetes affects a significant portion of the adult population, amounting to 10.5% among individuals aged 20 to 79.

Diabetes extends far beyond mere numbers. This report aims to shed light on the prevalence, demographic variations, and the imperative need for awareness.

Key Diabetes Statistics

1. A staggering 38.4 million individuals, equivalent to 11.6% of the US population, have diabetes.
2. Among these, 29.7 million people, including 29.4 million adults, have received an official diagnosis.
3. About 8.7 million people remain undiagnosed.
4. A concerning trend is the prevalence of prediabetes, affecting 97.6 million adults aged 18 years and older, making up 38.0% of the adult US population.
5. Within the elderly demographic (65 years and older), 27.2 million individuals, accounting for 48.8%, suffer from prediabetes.
6. The trajectory of diabetes is noteworthy; from 1980 to 2014, the number of those afflicted rose dramatically from 108 million to 422 million. Significantly, this surge is more pronounced in low- and middle-income countries compared to their high-income counterparts.
7. Diabetes serves as a major catalyst for various health complications, contributing to blindness, kidney failure, heart attacks, stroke, and lower limb amputations.
8. Between 2000-2019, there was a 3% increase in diabetes mortality rates across different age groups, underscoring the need for ongoing research and improved therapeutic interventions.

Prevalence of Diagnosed Diabetes

1. Approximately 29.7 million individuals, representing 8.9% of the entire US population, have received a diagnosis of diabetes. Within this demographic, 352,000 children and adolescents under the age of 20, equivalent to 35 per 10,000 US youths, are facing the challenges associated with diagnosed diabetes. Specifically, 304,000 among them have been identified with type 1 diabetes.
2. The prevalence of diagnosed diabetes demonstrates significant variations across demographic groups. American Indian and Alaska Native adults exhibit the highest prevalence at 13.6%, followed by 12.1% non-Hispanic Black adults, 11.7% adults of Hispanic origin, 9.1% non-Hispanic Asian adults, and 6.9% non-Hispanic White adults.
3. In the adult population aged 20 years or older with diagnosed diabetes, 1.7 million individuals have reported having type 1 diabetes and utilizing insulin. Furthermore, within this age group, 3.6 million adults, making up 12.3% of all US adults diagnosed with diabetes, have initiated insulin treatment within one year of their diagnosis.
4. Adults with family incomes surpassing 500% of the federal poverty level demonstrate the lowest prevalence, with 6.3% for men and 3.9% for women.

Race and Ethnicity Subgroups in Diabetes Statistics

Understanding the prevalence of health conditions among different race and ethnicity subgroups is crucial for effective healthcare interventions. Here, we present key findings based on recent data:

Non-Hispanic Asian Adults

1. Among non-Hispanic Asian adults, specific subgroups exhibit varying prevalence rates. Notably, Asian Indian adults show a prevalence of 10.8%, while Filipino adults have an even higher prevalence at 12.2%.
2. Chinese, Korean, Japanese, and Vietnamese subgroups demonstrate prevalences ranging from 6.1% to 7.1%. 
3. Additionally, the combined prevalence for other Asian groups is 8.9%.

Adults of Hispanic Origin

1. Within the Hispanic origin category, there are noteworthy variations in prevalence rates. Puerto Rican adults lead with a prevalence of 13.3%, followed closely by Mexican adults at 11.1%. 
2. Dominican adults exhibit a prevalence of 9.4%, and Cuban adults follow closely with a prevalence of 9.0%. 
3. South American, Central American,  and other Hispanic, Spanish  or Latino, adults show prevalence rates ranging from 5.0% to 7.3%.

Native Hawaiian and Pacific Islander Adults

1. The prevalence among Native Hawaiian or Other Pacific Islander adults stands at 11.7%, highlighting a significant representation within this subgroup.

Race and Ethnicity Subgroup	Total Percentage (95% CI)
American Indian or Alaska Native, non-Hispanic	16.0 (12.1–20.6)
Black, non-Hispanic	12.5 (11.6–13.4)
Native Hawaiian or Other Pacific Islander, non-Hispanic	11.7 (7.4–17.2)
Asian, non-Hispanic	9.2 (8.2–10.4)
Asian Indian, non-Hispanic	10.8 (8.3–13.7)
Chinese, non-Hispanic	7.1 (5.2–9.3)
Filipino, non-Hispanic	12.2 (9.4–15.6)
Japanese, non-Hispanic	6.8 (4.1–10.5)
Korean, non-Hispanic	6.1 (3.8–9.1)
Vietnamese, non-Hispanic	6.4 (3.7–10.0)
Other Asian, non-Hispanic	8.9 (5.9–12.8)
Hispanic	10.3 (9.4–11.1)
Mexican or Mexican American	11.1 (9.9–12.3)
Central American	7.3 (5.6–9.4)
South American	5.0 (3.3–7.1)
Puerto Rican	13.3 (11.0–15.9)
Cuban	9.0 (6.5–12.1)
Dominican	9.4 (5.9–14.2)
Other Hispanic, Latino, or Spanish	7.2 (5.5–9.2)
White, non-Hispanic	8.5 (8.2–8.8)

Incidence of Newly Diagnosed Diabetes

In dissecting the incidence of newly diagnosed diabetes, it becomes evident that certain demographic and educational factors play a significant role in shaping the diabetes landscape in the United States.

1. Age Disparities: When examining age groups, adults between 45-64 years and those aged 65 and above exhibit higher incidence rates of diagnosed diabetes compared to their counterparts aged 18 to 44 years. 
2. Residential Factors: Interestingly, incidence rates of diagnosed diabetes show no significant disparity between adults living in nonmetropolitan and metropolitan areas. This finding challenges preconceived notions about the urban-rural divide in diabetes prevalence.
3. Ethnic Variations: Notably, incidence estimates of diagnosed diabetes diverge across ethnic lines. Non-Hispanic Black and Hispanic adults experience higher incidence rates compared to their non-Hispanic White and Asian counterparts. 

Projected prevalence of officially diagnosed diabetes in adults aged 18 and above in the United States

Characteristic	Population Estimates, Number in Thousands (95% CI)	Incidence Estimates, 2019–2021 Rate per 1,000 (95% CI)
Total	1,211 (1,094–1,328)	5.9 (5.1–6.9)b
Age in years
18–44	305 (241–369)	3.0 (2.1–4.2)b
45–64	633 (550–716)	10.1 (8.2–12.4)b
≥65	273 (222–325)	6.8 (5.1–8.9)b
Sex
Men	620 (536–704)	6.4 (5.2–7.9)b
Women	591 (510–672)	5.5 (4.4–6.9)b
Race/ethnicity
White, non-Hispanic	721 (633–809)	5.1 (4.5–5.8)
Black, non-Hispanic	185 (139–232)	6.8 (5.3–8.7)
Asian, non-Hispanic	52 (29–76)	3.8 (2.4–5.9)
Hispanic	233 (178–289)	6.1 (4.8–7.7)

Incidence Prevalence of Prediabetes Among Adults

1. Overall Prevalence: In 2021, a staggering 38.0% of adults in the United States had prediabetes, as determined by their fasting glucose or A1C level. This high prevalence underscores the urgent need for widespread awareness and intervention strategies.
2. Health Professional Awareness: Only 19.0% of adults diagnosed with prediabetes reported being informed by a healthcare professional about their condition. 
3. Dual Diagnosis Criteria: Utilizing both elevated fasting plasma glucose and A1C levels, 10.8% of adults were identified as having prediabetes. 
4. Gender Disparities: Notably, a higher percentage of men (41.0%) than women (32.0%) exhibited prediabetes based on their fasting glucose or A1C level. 
5. Racial and Ethnic Consistency: The prevalence of prediabetes, determined by fasting glucose or A1C levels, was observed to be consistent across all racial and ethnic groups, highlighting the universality of this health concern. This consistency reinforces the need for inclusive and equitable preventive healthcare measures.
6. Educational Level: Interestingly, prevalence rates based on fasting glucose or A1C levels showed no significant variation among different education levels. 

Incidence Among Children and Adolescents

When it comes to diabetes prevalence among children and adolescents, insights gleaned from the SEARCH for Diabetes in Youth study for the year 2017–2018 offer a nuanced perspective. During this period, the United States witnessed a substantial number of new cases, revealing a multifaceted landscape:

1. Type 1 Diabetes Breakdown: An estimated 18,169 cases emerged among children and adolescents under the age of 20 with type 1 diabetes. 
2. A notable subset of 5,293 cases manifested in individuals aged 10 to 19 with type 2 diabetes.
3. Temporal Trends in Type 1 Diabetes: Examining the broader timeline from 2002 to 2018, a statistically significant overall increase in the incidence of type 1 diabetes was observed.
4. Racial Disparities in Type 1 Diabetes: When dissecting the data, it becomes evident that non-Hispanic Asian or Pacific Islander youths experienced the most substantial rise in type 1 diabetes incidence, trailed by Hispanic and non-Hispanic Black counterparts.
5. Intriguingly, non-Hispanic White children and adolescents consistently exhibited the highest incidence of type 1 diabetes across the entire time frame from 2002 to 2018.
6. Type 2 Diabetes Dynamics: The broader lens of 2002–2018 reveals a significant overall increase in the incidence of type 2 diabetes among children and adolescents.
7. Racial Dynamics in Type 2 Diabetes: Diving deeper into racial and ethnic nuances, a pronounced escalation in type 2 diabetes incidence was witnessed across all groups, with heightened prominence among Asian or Pacific Islander, Hispanic, and non-Hispanic Black youths. 
8. Non-Hispanic Black children and adolescents consistently reported the highest incidence of type 2 diabetes throughout the entire time frame.

Risk Factors for Diabetes-Related Complications

This report dives into the prevalent trends among adults aged 18 years and older:

Overweight and Obesity

An overwhelming 89.8% of individuals with diabetes were either overweight or suffering with obesity, characterized by a body mass index (BMI) of 25 kg/m² or higher:

1. 26.9% fell into the overweight category.
2. 47.1% were classified as obese.
3. 15.7% carried the burden of extreme obesity.

High Cholesterol

The lipid profile of this population depicted the following breakdown:

1. 39.5% recorded a non-HDL level of 130 mg/dL or above.
2. 19.9% fell within the range of 130-159 mg/dL.
3. 11.5% had a non-HDL level ranging from 160-189 mg/dL.
4. 8.0% faced the challenge of a non-HDL level of 190 mg/dL or above.

High Blood Pressure

The prevalence of high blood pressure was pronounced, with:

1. 80.6% having a systolic blood pressure of 130 mmHg or higher, diastolic blood pressure of 80 mmHg or higher, or receiving prescription medication.
2. 70.8% registering a systolic blood pressure of 140 mmHg or higher, diastolic blood pressure of 90 mmHg or higher, or receiving prescription medication.

Smoking

In this cohort of US adults aged 18 years or older diagnosed with diabetes:

1. 22.1% were identified as tobacco users, gauged through self-reporting or serum cotinine levels.
2. 14.6% acknowledged current cigarette smoking.
3. 36.0% had quit smoking but boasted a history of at least 100 cigarettes in their lifetime.

Emergency Department Visits

In 2020, a staggering 16.8 million emergency department (ED) visits were recorded for adults aged 18 years and older, where diabetes was identified as any listed diagnosis. This encompassed:

Hyperglycemic Crisis

1. There were 267,000 ED visits for hyperglycemic crisis, translating to 11.4 visits per 1,000 adults with diabetes.
2. Approximately 66.8% were treated and subsequently released.
3. Around 25.1% necessitated admission to the hospital.
4. An extremely low percentage, less than 0.1%, resulted in mortality.

Hypoglycemia

1. A notable 202,000 ED visits were reported for hypoglycemia, equating to 8.6 visits per 1,000 adults with diabetes.
2. A mere 8.4% were treated and released.
3. A substantial 84.4% required hospital admission.
4. The mortality rate remained less than 0.1%.

Hospitalizations

In the year 2020, more than 7.8 million hospital discharges were recorded in the United States among adults aged 18 years or older, where diabetes was listed as a diagnosis. This equates to 335.4 hospitalizations per 1,000 adults with diabetes.

The diverse nature of these hospitalizations encompassed various complications associated with diabetes, including:

Cardiovascular Challenges

1. 1.68 million hospitalizations were attributed to major cardiovascular diseases, indicating a prevalence of 71.6 hospitalizations per 1,000 adults with diabetes.
2. Specifically, 368,000 cases were related to ischemic heart disease, with a corresponding rate of 15.7 hospitalizations per 1,000 adults with diabetes.
3. 321,000 cases were associated with stroke, reflecting a rate of 13.7 hospitalizations per 1,000 adults with diabetes.

Peripheral Complications

1. A concerning 160,000 hospitalizations occurred due to lower-extremity amputation, translating to 6.8 hospitalizations per 1,000 adults with diabetes.

Metabolic Emergencies

1. 232,000 hospitalizations were reported for hyperglycemic crises, with an incidence of 9.9 hospitalizations per 1,000 adults with diabetes.
2. Additionally, 51,000 hospitalizations were recorded for hypoglycemia, indicating a rate of 2.2 hospitalizations per 1,000 adults with diabetes.

The Economic Impact of Diabetes

In 2022, the total economic impact of diagnosed diabetes in the United States was a staggering $412.9 billion. To comprehend the scale of this financial burden, it is essential to dissect this amount into two main components: direct medical costs and indirect costs.

Direct Medical Costs

Out of the $412.9 billion, a substantial $306.6 billion was attributed to direct medical costs. These encompass expenses related to medical services, treatments, and medications directly associated with managing diabetes. Individuals with diagnosed diabetes incur, on average, medical expenditures that are 2.6 times higher than those without diabetes, after adjusting for age and sex differences within the population.

Indirect Costs

Further contributing to the economic impact, $106.3 billion was allocated to indirect costs associated with diabetes. Indirect costs encapsulate the financial repercussions of lost productivity, absenteeism, and disability stemming from the condition. These costs not only affect individuals but also have broader implications for the economy as a whole.

References 

• https://www.cdc.gov/diabetes/php/data-research/data-statistics/index.html
• https://diabetes.org/about-diabetes/statistics/about-diabetes
• https://www.niddk.nih.gov/health-information/health-statistics/diabetes-statistics
• https://diabetesresearch.org/diabetes-statistics/
• https://dph.illinois.gov/topics-services/diseases-and-conditions/diabetes.html