The number of people in the United States with diabetes has now risen to nearly 26 million, while another 79 million have prediabetes, according to data released Jan. 26 by the Centers for Disease Control and Prevention.
Diabetes is present in 8.3% of all Americans and 11.3% of those aged 20 years and older, according to the CDC’s 2011 National Diabetes Fact Sheet. More than a third (35%) of those aged 20 and older have prediabetes. Over a quarter of Americans aged 65 years and older have diabetes, and half have prediabetes.
Among those with diabetes, about 27% (or 7 million people) are undiagnosed.
"Although consecutive fact sheets aren’t meant to determine trends, it’s discouraging that the proportion of people undiagnosed has remained at about one in four since the last fact sheet [was published in 2008]. This is after falling from one in two and then one in three over the decade prior to 2007," said Dr. Sue Kirkman, senior vice president of medical affairs and community information for the American Diabetes Association, in an interview.
"The take-home message is what ADA has been recommending all along: Health care professionals need to assess patients for risk factors and test those who are at risk, including those who are overweight; have a family history of diabetes or gestational diabetes, high-risk ethnicity, hypertension, [or] dyslipidemia; or are [older than age 45]," Dr. Kirkman said.
In 2008, the CDC estimated that 23.6 million Americans (or 7.8% of the population) had diabetes, and another 57 million adults had prediabetes. The rise in diabetes prevalence seen in the 2011 data results from both the fact that more people are developing the disease and the fact that people are living longer with it, thanks to better management of cardiovascular risk factors and a reduction in complications such as renal failure and amputations. These new estimates of national prevalence are the first to include cases diagnosed using hemoglobin A1c, which means that the estimates of prediabetes and diabetes may not be directly comparable to previous estimates, the agency noted.
Dr. Kirkman said she believes that the impact of this change is greater for prediabetes than for diabetes. "The incorporation of A1C into the diagnosis of diabetes didn’t make a significant difference in the prevalence of diabetes, so the 25.8 million estimate reflects a true increase in prevalence. In contrast, adding the A1C does increase the number estimated to have prediabetes a lot, although there is also an underlying true increase in prevalence there as well," she noted.
She advised that people with prediabetes be referred to programs that can support them in losing weight and exercising. "With the roll-out of the National Diabetes Prevention programs in the community, such as through YMCAs, the hope is that in the next few years there will be more and more programs to refer people to."
Dr. Kirkman stated that she has no financial disclosures.