Skip to main content

Advertisement

Log in

Impact of the population at risk of diabetes on projections of diabetes burden in the United States: an epidemic on the way

  • Article
  • Published:
Diabetologia Aims and scope Submit manuscript

Abstract

Aims/hypothesis

The aim of this study was to make projections of the future diabetes burden for the adult US population based in part on the prevalence of individuals at high risk of developing diabetes.

Materials and methods

Models were created from data in the nationally representative National Health and Nutrition Examination Survey (NHANES) II mortality survey (1976–1992), the NHANES III (1988–1994) and the NHANES 1999–2002. Population models for adults (>20 years of age) from NHANES III data were fitted to known diabetes prevalence in the NHANES 1999–2002 before making future projections. We used a multivariable diabetes risk score to estimate the likelihood of diabetes incidence in 10 years. Estimates of future diabetes (diagnosed and undiagnosed) prevalence in 2011, 2021, and 2031 were made under several assumptions.

Results

Based on the multivariable diabetes risk score, the number of adults at high risk of diabetes was 38.4 million in 1991 and 49.9 million in 2001. The total diabetes burden is anticipated to be 11.5% (25.4 million) in 2011, 13.5% (32.6 million) in 2021, and 14.5% (37.7 million) in 2031. Among individuals aged 30 to 39 years old who are not currently targeted for screening according to age, the prevalence of diabetes is expected to rise from 3.7% in 2001 to 5.2% in 2031. By 2031, 20.2% of adult Hispanic individuals are expected to have diabetes.

Conclusions/interpretation

The prevalence of diabetes is projected to rise to substantially greater levels than previously estimated. Diabetes prevalence within the Hispanic community is projected to be potentially overwhelming.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ARIC:

Atherosclerosis Risk in Communities study

ESM:

Electronic supplementary material

FPG:

fasting plasma glucose

NHANES:

National Health and Nutrition Examination Survey

References

  1. Englegau MM, Geiss LS, Saaddine JB et al (2004) The evolving diabetes burden in the United States. Ann Intern Med 140:945–950

    Google Scholar 

  2. Newnham A, Ryan R, Khunti K, Majeed A (2002) Prevalence of diagnosed diabetes mellitus in general practice in England and Wales, 1994 to 1998. Health Stat Q 14:5–13

    Google Scholar 

  3. Steinbrook R (2006) Facing the diabetes epidemic—mandatory reporting of glycosylated hemoglobin values in New York City. N Engl J Med 345:545–548

    Article  Google Scholar 

  4. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP (2001) The continuing epidemics of obesity and diabetes in the United States. JAMA 286:1195–1200

    Article  PubMed  CAS  Google Scholar 

  5. Honeycutt AA, Boyle JP, Broglio KR et al (2003) A dynamic Markov model for forecasting diabetes prevalence in the United States through 2050. Health Care Manage Sci 6:155–164

    Article  Google Scholar 

  6. Helms RB (1992) Implications of population growth on prevalence of diabetes: a look at the future. Diabetes Care 15(Suppl 1):6–9

    PubMed  Google Scholar 

  7. King H, Aubert RE, Herman WH (1998) Global burden of diabetes 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care 21:1414–1431

    Article  PubMed  CAS  Google Scholar 

  8. Boyle JP, Honeycutt KM, Narayan KMV et al (2001) Projection of diabetes burden and cost through 2050: impact of changing demography and disease prevalence in the US. Diabetes Care 24:1936–1940

    Article  PubMed  CAS  Google Scholar 

  9. Ruwaard D, Hoogenveen RT, Verkleij H, Kromhout D, Casparie AF, van derVeen EA (1993) Forecasting the number of diabetic patients in The Netherlands in 2005. Am J Public Health 83:989–995

    Article  PubMed  CAS  Google Scholar 

  10. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The evidence report (1998). NIH Publication no. 98-4083 National Institutes of Health, Bethesda

  11. Sturm R (2003) Increases in clinically severe obesity in the United States, 1986–2000. Arch Intern Med 163:2146–2148

    Article  PubMed  Google Scholar 

  12. Flegal KM, Carroll MD, Ogden CL, Johnson CL (2002) Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288:1723–1727

    Article  PubMed  Google Scholar 

  13. Glumer C, Carstensen B, Sandbaek A, Lauritzen T, Jorgensen T, Borch-Johnsen KA (2004) Danish diabetes risk score for targeted screening: the Inter99 study. Diabetes Care 27:727–733

    Article  PubMed  Google Scholar 

  14. Herman WH, Smith PJ, Thompson TJ, Englegau MM, Aubert RE (1995) A new and simple questionnaire to identify people at increased risk for undiagnosed diabetes. Diabetes Care 18:382–387

    Article  PubMed  CAS  Google Scholar 

  15. Baan CA, Ruige JB, Stolk RP et al (1999) Performance of a predictive model to identify undiagnosed diabetes in a healthcare setting. Diabetes Care 22:213–219

    Article  PubMed  CAS  Google Scholar 

  16. Griffin SJ, Little PS, Hales CN, Kinmonth AL, Wareham NJ (2000) Diabetes risk score: towards earlier detection of type 2 diabetes in general practice. Diabetes/Metab Res Rev 16:164–171

    Article  CAS  Google Scholar 

  17. Franciosi M, De Berardis G, Rossi MC et al (2005) Use of the diabetes risk score for opportunistic screening of undiagnosed diabetes and impaired glucose tolerance: the IGLOO (Impaired Glucose Tolerance and Long-term Outcomes Observational) study. Diabetes Care 28:1187–1194

    Article  PubMed  Google Scholar 

  18. Schmidt MI, Duncan BB, Bang H et al (2005) Identifying individuals at high risk for diabetes: The Atherosclerosis Risk in Communities study. Diabetes Care 28:2013–2018

    Article  PubMed  Google Scholar 

  19. Lindstrom J, Tuomilehto J (2003) The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care 26:725–731

    Article  PubMed  Google Scholar 

  20. Stovring H, Andersen M, Beck-Nielsen H, Green A, Vach W (2003) Rising prevalence of diabetes: evidence from a Danish pharmaco-epidemiological database. Lancet 362:503–504

    Article  Google Scholar 

  21. Harris MI, Flegal KM, Cowie CC et al (1998) Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults: The Third National Health and Nutrition Examination Survey, 1988–2004. Diabetes Care 21:518–524

    Article  PubMed  CAS  Google Scholar 

  22. US Census Bureau (NP-D1-A) (2000) Projections of the resident population by age, sex, race, and hispanic origin: 1999 to 2100. Department of Commerce, Washington, DC, www.census.gov/population/www/projections/natdet-D1A.html

  23. Agency for Healthcare Research and Quality (2005) National health care disparities report. www.qualitytools.ahrq.gov/disparitiesreport

  24. Koopman RJ, Mainous AG III, Liszka HA et al (2006) Evidence of nephropathy and peripheral neuropathy in US adults with undiagnosed diabetes. Ann Fam Med 4:427–432

    Article  PubMed  Google Scholar 

  25. Venkat Narayan KM, Boyle JP, Geiss LS, Saadine JB, Thompson TJ (2006) Impact of recent increase in incidence on future diabetes burden. Diabetes Care 29:2114–2116

    Article  Google Scholar 

  26. American Diabetes Association (2006) Standards of medical care in diabetes 2006. Diabetes Care 29:S4–S42

    Google Scholar 

Download references

Acknowledgements

This study was supported in part by grant 1D12HP00023 from the Health Resources and Services Administration; grant 1 P30 AG21677 from the National Institute on Aging; and grant 1R21 DK066066 from the National Institute of Diabetes and Digestive and Kidney Disease. A grant was also provided by the Robert Wood Johnson Foundation.

Duality of interest

None of the authors has a conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. G. Mainous III.

Electronic supplementary material

Below is the link to the electronic supplementary material.

125_2006_528_MOESM1_ESM.doc

125_2006_528_MOESM2_ESM.doc

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mainous, A.G., Baker, R., Koopman, R.J. et al. Impact of the population at risk of diabetes on projections of diabetes burden in the United States: an epidemic on the way. Diabetologia 50, 934–940 (2007). https://doi.org/10.1007/s00125-006-0528-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00125-006-0528-5

Keywords

Navigation