The Burden of Diabetes

1

Prevalence of Diabetes and Prediabetes in the United States

CDC. National diabetes fact sheet, 2008. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2008.pdf.CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.

39% increase

2

Prediabetes

35% of US population

Diabetes

8.3% of US population

Projected Prevalence of Diabetes in the United States: 1990 to 2050

National Diabetes Surveillance System. http://www.cdc.gov/diabetes/statistics/prev/national/figpersons.htm..Boyle JP, et al. Popul Health Metr. 2010 Oct 22;8:29.

CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.

Year

3

Prevalence of Diagnosed Diabetes in Different Ethnic Groups

CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.

US Adults ≥20 Years of Age

4

4

Annual Incidence of Diabetes in Children and Adolescents

NHW, non-Hispanic whites; NHB, non-Hispanic blacks; H, Hispanics;API, Asians/Pacific Islanders; AI, American Indians.

CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.

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<10 years 10-19 years

• Diabetes is the– Seventh leading cause of

death, according to death certificate data (which may be an underestimate)

– Leading cause of blindness among adults

– Leading cause of kidney failure

• >60% of nontraumatic lower limb amputations occur in people with diabetes

• Diabetes also– Doubles the risk of periodontal

disease among young adults

– Doubles the risk of developing depression, and depression increases the risk of type 2 diabetes by 60%

– Increases patients’ susceptibility to acute infections and illnesses (eg, pneumonia and influenza)

– Worsens the prognosis of patients with acute illnesses

Diabetes Morbidity and Mortality

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CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.

Diabetes and Morbidity and Mortality

2 times greater

2-4 times greater

2-4 times greater

(relative to individuals without diabetes)

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CDC. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.

Costs of Diabetes

Indirect

Direct 13% of total US healthcare expenditures

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ADA. Diabetes Care. 2013;36:1033-1046.

Goal Achievement in Diabetes

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<7 <8 >9 <70 <100

A1C(%)

LDL-C(mg/dL)

BP(mm/Hg)

<130/80

Nonsmoker All goals met

BP, blood pressure; LDL-C, low-density lipoprotein cholesterol; NHANES, National Health and Nutrition Examination Survey.

Ali MK, et al. N Engl J Med. 2013;368:1613-1624.

NHANES 2007-2010(N=1444)

A1C Achievement by Individualized Target

10 NHANES, National Health and Nutrition Examination Survey.

Ali MK, et al. N Engl J Med. 2013;368:1613-1624.

NHANES 2007-2010(N=1444)

Age (years) 18-44 45-64 ≥65 ≥65 18-44 45-64 ≥65

Target A1C (%) ≤6.5 ≤7.0 ≤7.0 ≤7.5 ≤7.0 ≤8.0 ≤8.0

Without complications With complications