# Presentation: 760702

## Diabetes: The Numbers

**The National Diabetes Education Program**** *****Changing the Way Diabetes is Treated.***

## What is Diabetes?

- Diabetes is a group of diseases characterized by high levels of blood glucose (blood sugar)
- Diabetes can lead to serious health problems and premature death

- NIDDK, National Diabetes Statistics 2007.  www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
Diabetes is a group of diseases characterized by high levels of blood glucose (or blood sugar) which results from problems with insulin production, insulin action, or both. 

Diabetes can lead to serious problems and complications, such as heart disease, blindness, kidney failure, lower-limb amputations, and premature death.  But people with diabetes can lower the occurrence of these and other diabetes complications by controlling blood glucose (sugar) blood pressure and blood lipids.

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007.  Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## Diabetes & Cardiovascular Disease

- Cardiovascular disease is the leading cause of death for people with diabetes
- In adults with diabetes:
- 68% die of heart disease or stroke
- the risk for stoke is two to four times higher
- 75% have high blood pressure
- smoking doubles the risk for heart disease

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
Cardiovascular disease is the leading cause of death for people with diabetes.
Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes.  

68% of adults with diabetes die of heart disease or stroke.
The risk of stroke is 2 to 4 times higher in adults with diabetes.
75% of adults with diabetes have high blood pressure.
Smoking doubles the risk for heart disease.

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007.  Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## Diabetes Complications

- Diabetes is the leading cause of:
- kidney failure
- new cases of adult blindness
- nontraumatic lower-limb amputations
- In adults with diabetes:
- the risk of periodontal, or gum, disease is two to three times higher
- 60 to 70 %have mild to severe nervous system damage

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
Diabetes is the leading cause of Kidney failure – it accounts for 44% of new cases.

Diabetes is the leading cause of new cases of adult blindness – it accounts for 12,000 to 24,000 cases every year.

Diabetes is the leading cause (more than 60%) of nontraumatic lowerlimb amputations.  

Adults with diabetes have a 2 to 3 times greater risk of periodontal, or gum disease.

60 to 70 percent of adults with diabetes have mild to severe nervous system damage.

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007 Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## Common Types of Diabetes

- Type 1 diabetes
- 5% to 10% of diagnosed cases of diabetes
- Type 2 diabetes
- 90% to 95% of diagnosed cases of diabetes

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
Type 1 diabetes is an auto-immune disease that develops when the body’s immune system destroys pancreatic beta cells—the only cells in the body that make the hormone insulin that regulates blood glucose. People with type 1 diabetes must take insulin every day either by injection or pump. 
Type 1 diabetes accounts for 5% to 10% of all diagnosed cases of diabetes and usually affects children and young adults, although the disease can occur at any age. There is no known way to prevent type 1 diabetes. 

Type 2 diabetes usually begins as insulin resistance—a disorder in which cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce it. Insulin resistance and abnormal beta cell function may occur long before type 2 diabetes is diagnosed.
Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes. It is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians and other Pacific Islanders are at particularly high risk for type 2 diabetes and its complications. Although still rare, type 2 diabetes is being diagnosed more frequently in children and adolescents.

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## Common Types of Diabetes

- Gestational Diabetes occurs during pregnancy
- 5% to 10% of women with gestational diabetes are found to have type 2 diabetes
- 40% to 60% women with gestational diabetes will develop diabetes in the next 5 to 10 years

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
Gestational diabetes mellitus is a form of glucose intolerance diagnosed in some women during pregnancy. 

5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have an increased lifelong risk – a 40 to 60% chance—of developing diabetes in the next 5 to 10 years after pregnancy. Their offspring are also at higher risk for obesity and type 2 diabetes compared to other children. 

Gestational diabetes is more common among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes. 

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## Slide 7

## Slide 8

## U.S. Diabetes PrevalenceAll Ages, 2007

- 23.6 million people have diabetes
**Diagnosed:** 17.9 million people
- Type 1 diabetes accounts for 5% – 10%
- Type 2 diabetes accounts for 90% – 95%
**Undiagnosed:** 5.7 million people

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
23.6 million people have diabetes.

Of these 17.9 are diagnosed, and 5.7 million are undiagnosed.

Of the diagnosed population – type 1 accounts for 5 to 10 percent or about 895,000 – 1, 790,000 people.  Type 2 accounts for 90 to 95% or about 1,611,000 to 1,700,500cases,

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## U.S. Diabetes Prevalence, 2007

***Source*****: 2004–2006 National Health Interview**
**Survey estimates projected to year 2007.**

**Notes:**
2.6 percent of all people 20 through 39 years have diabetes.

10.8 percent all people 40 through 59 years have diabetes.

23.8 percent of all people aged 60 and older have diabetes – that is about one out of every 4 older adults! 

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics , 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## Diabetes Incidence

- A total of 1,600,000 new cases of diabetes were diagnosed in 2007 in the United States among people aged 20 years and older.

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
1.6 million new cases of diabetes were diagnosed in people age 20 or older in 2007. 

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## American Indians and Alaska Natives & Diabetes

- About 16.5% ages 20 and older who are served by Indian Health Services have diabetes
- Rates vary:
- 6.0% of Alaska Native adults have diabetes
- 29.3% of American Indian adults in southern Arizona have diabetes

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
About 16.5 percent of American Indians and Alaska Natives aged 20 years or older who received care from the Indian Health Service (IHS) in 2003 have diabetes. 

Rates of diabetes vary among the American Indians and Alaska Natives:
6% among Alaska Native adults
29.3% among American Indian adults in Southern Arizona

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## African Americans & Diabetes

- 3.7 million; 14.7 % of all African Americans ages 20 and older have diagnosed and undiagnosed diabetes
- African Americans are 1.8 times as likely to have diabetes as non-Hispanic whites

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
3.7 million or 14.7 percent of all non-Hispanic blacks aged 20 years or older have diagnosed and undiagnosed diabetes.

African Americans are 1.8 times as likely to have diabetes as non-Hispanic whites.

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## Hispanics/Latinos & Diabetes

- 10.4 % of all Hispanics/Latinos ages 20 years and over have diabetes
- Rates vary among groups:
- Cubans 8.2%
- Mexican Americans 11.9%
- Puerto Ricans 12.6 %

- NIDDK, National Diabetes Statistics 2007.
- www/.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
 10.4  percent of all Hispanic/Latino Americans aged 20 years or older have diabetes. 

Rates vary:
Mexican Americans 11.9 percent
Cubans 8.2 percent
Puerto Ricans 12.6 percent

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## Asian Americans and Pacific Islanders & Diabetes

- 7.5% of all Asian Americans have diagnosed diabetes
- Prevalence data for diabetes among Pacific Islanders is limited

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**

 7.5 percent of all Asian American have diagnosed diabetes
The prevalence of diabetes is not available for Pacific Islanders. It is important to note that the absence of data for Pacific Islanders does not mean they are not affected by diabetes. 

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## 186,300 or 0.2% of young people have diabetes
Type 1 diabetes is more common than type 2, except in American Indians 
Type 2 diabetes is extremely rare in youth under 10 years of age 
Type 2 diabetes rates are higher in youth ages 10 to 19 years with higher rates among minority populations compared to non-Hispanic whites

- Type 1 diabetes is more common than type 2, except in American Indians
- Type 2 diabetes is extremely rare in youth under 10 years of age
- Type 2 diabetes rates are higher in youth ages 10 to 19 years with higher rates among minority populations compared to non-Hispanic whites

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

- U.S. Diabetes PrevalencePeople Younger than 20 Years of Age, 2007

**Notes:**
Close to 186,300 people under the age of 20—or 0.2 percent of young people under age 20 have diabetes.

Type 1 diabetes is more common than type 2 diabetes, except in American Indian youth.

Type 2 is extremely rare in youth under 10 years of age.

Rates of type 2 diabetes are higher in youth ages 10 to 19 years – higher rates are seen in minority populations as compared to non-Hispanic whites.

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## U.S. Diabetes PrevalenceYoung people ages 0-9 

- Diabetes occurs in less than 1 in 1,000 young people ages 0-9
- Type 1 diabetes accounts for 97% of diagnosed cases in this age group
- Non-Hispanic white youth have the highest rate of new cases of type 1 diabetes

*(SEARCH) Pediatrics.*2006; 118: 1510-1518.

**Notes:**
Diabetes occurs in less than 1 in 1,000 young people ages 0 to 9. 

Type 1 diabetes accounts for 97% of diagnosed cases in this age group.

Diabetes is more common in non-Hispanic white young people ages 0 – 9 than in any other ethic group. 

Reference
The Burden of Diabetes Mellitus Among US Youth: Prevalence Estimates From the SEARCH for Diabetes in Youth Study Group Pediatrics. 2006; 118: 1510-1518.

## U.S. Diabetes PrevalenceYoung people ages 10-19

- Diabetes occurs in 1 in 357 young people ages
- 	10 to 19 years
- Type 1 diabetes accounts for 81% of diagnosed cases in this age group
- Type 2 diabetes accounts for 6% (non-Hispanic white youth) to 76% (American Indian youth) of diagnosed diabetes in this age group

*(SEARCH) Pediatrics.*2006; 118: 1510-1518.

**Notes:**
Diabetes occurs in one in 357 young people ages 10 – 19.

Type 1 diabetes accounts for 81% of diagnosed cases in this age group.

Type 2 diabetes accounts for 6% (non Hispanic white youth) to 76% (American Indian youth) of diagnosed diabetes in this age group. 

Reference
The Burden of Diabetes Mellitus Among US Youth: Prevalence Estimates From the SEARCH for Diabetes in Youth Study Group Pediatrics. 2006; 118: 1510-1518.

## Every 24 Hours...

- 4,384 new cases of diabetes are diagnosed
- 195 non-traumatic lower limb amputations are performed
- 128 people begin treatment for end-stage renal disease
- 50 people develop blindness
- 839 people die of diabetes or diabetes is a contributing cause of death

*Derived from:*
- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
The following are rough approximations to help emphasize what diabetes prevalence numbers mean to people with diabetes each and every day.

Approximately,

4384 new cases of diabetes diagnosed; 

839 people die from diabetes or diabetes is a contributing cause of death

195 people with diabetes will have an amputation

128 people with diabetes will begin treatment for end-stage renal disease

50 people with diabetes will go blind

Approximations were determined using information from the following reference:
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007.Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## Preventing Diabetes Complications 

- Glucose control
- Blood pressure control
- Blood lipid control
- Preventive care practices for eyes, kidneys, feet, teeth, and gums

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
People with diabetes and their health care providers can reduce the occurrence of diabetes complications by controlling the levels of blood glucose, blood pressure, and blood lipids, and by receiving other preventive care practices in a timely manner. 

Studies have found that improved glycemic control benefits people with either type 1 or type 2 diabetes. In general, every percentage point drop in A1C blood test results (i.e., from 8.0% to 7.0%) reduces the risk of microvascular complications—like eye, kidney, and nerve diseases—by 40%. 

Blood pressure control reduces the risk of heart disease or stroke among persons with diabetes by 33% to 50%, and the risk of microvascular complications by about 33%.  In general, each 10 mm Hg drop in systolic blood pressure, the risk of any complication of diabetes is reduced by 12 percent!

Improved blood lipids – improved control of LDL cholesterol can reduce cardiovascular complications by 20% to 50%.

Detecting and treating diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50% to 60%. 

Comprehensive foot care programs can reduce amputation rates by 45% to 85%. 

Detecting and Treating early diabetic kidney disease by lowering blood pressure can reduce the decline in kidney function by 30% to 70%. 
Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## Estimated Cost of Diabetes in U.S.

- Total: **$174 billion**
- Direct Medical Cost: $**116 billion**
- Indirect Cost: **$58 billion**

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
The total estimated cost of diabetes in the United States is $174 billion.

The estimated direct medical cost of diabetes is $116 billion. This includes medical care and services.

The estimated indirect cost of diabetes is $58 billion. This includes disability, work loss, and premature mortality. 

Medicines and supplies and outpatient services are responsible for a minority of these costs. 

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## What is Pre-diabetes? 

- Pre-diabetes is a medical condition where blood glucose levels are higher than normal but not high enough to be called diabetes
- Studies have shown that the onset of type 2 diabetes can be delayed or prevented by:
- losing weight, and
- increasing physical activity

- NIDDK, National Diabetes Statistics 2007.                            www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
People with pre-diabetes have high blood glucose levels higher than normal, but not yet high enough to be diagnosed with diabetes.

People with pre-diabetes can prevent or delay the onset of type 2 diabetes through lifestyle change and/or medication - though no medications are approved for diabetes prevention.

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## Pre-Diabetes in the U.S.

- At least **57 million** adults ages 20 and older have **pre-diabetes**
- Pre-diabetes raises the risk for type 2 diabetes and cardiovascular disease

- NIDDK, National Diabetes Statistics 2007.
- www.diabetes.niddk.nih.gov/dm/pubs/statistics

**Notes:**
At least 57 million U.S. adults age 20 and older have pre-diabetes, which independently raises the risk of developing type 2 diabetes and cardiovascular disease. 

It is important to note that progression to diabetes among people with pre-diabetes is not inevitable. 

The NIDDK-funded Diabetes Prevention Program (DPP) clinical trial showed us that people who lost 5 to 7 percent of their body weight by making healthy food choices and being physically active 30 minutes a day, 5 days a week reduced the onset of type 2 diabetes by 58%. This powerful reduction in risk was found in all subgroups, including men and women, ethnic groups at high risk, women with a history of GDM, and people age 60 and older. 

In fact, participants over the age of 60—who as a group have a nearly 20 percent prevalence of diabetes—reduced their development of diabetes by 71%. 

Reference
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

## For more information about NDEP and to order free diabetes materials:

Call 1-888-693-NDEP (6337)
or
Click www.YourDiabetesInfo.org

*The U.S. Department of Health and Human Services’ **National Diabetes Education Program is jointly sponsored by the **National Institutes of Health and the Centers for Disease Control and Prevention with the support of more than 200 partner organizations.*

**For more information about NDEP and to order free diabetes materials:**
**Call 1-888-693-NDEP (6337)**
**or**
**Click **_[www.YourDiabetesInfo.org](http://www.yourdiabetesinfo.org/)_