Preventing Chronic Diseases: 

Investing Wisely in Health 

Preventing Diabetes and
 U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

Its Complications


The Reality 

• Over 18.2 million Americans have diabetes, and about 


one-third of them don’t know that they have the disease.


• By 2050, an estimated 39 million U.S. residents are expected


to have diagnosed diabetes.


• American Indians, African Americans, and Hispanics are about 

2 times more likely than whites to have diabetes. 

• Type 2 diabetes, once believed to affect only adults, is being


diagnosed increasingly among young people.


• One in three U.S. children born in 2000 could develop


diabetes during their lifetime.


• Diabetes is the sixth leading cause of death. Over 200,000


people die each year of diabetes-related complications.


• Diabetes is a leading cause of kidney failure, new blindness in


adults, and leg and foot amputations unrelated to injury.


• Diabetes is a major cause of heart disease and stroke, which are 

responsible for about 65% of deaths among people with diabetes. 

• About 18,000 women with preexisting diabetes deliver babies 

each year, and 135,000 expectant mothers learn they have 

gestational diabetes. Diabetes increases a woman’s risk for 

pregnancy complications and increases her child’s risk for 

obesity and diabetes later in life. 

• Diabetes is most common among people aged 65–74 and 

least common among people under age 45, regardless of 

race, ethnicity or sex. 

• An estimated 41 million Americans have a high risk for 

developing type 2 diabetes—a condition known as prediabetes. People with pre-diabetes have impaired fasting 

glucose (IFG), impaired glucose tolerance (IGT), or both. 

The Cost of Diabetes in 2002 

• Total costs (direct and indirect): $132 billion. 

• Direct medical costs: $92 billion. 

• Indirect costs (disability, work loss, premature death): $40 billion. 

• Average health care costs per year: $13,243 for a person with 

diabetes vs. $2,560 for a person without diabetes. 

Hispanics 

1 of 2 

Hispanic 

females 

What is the lifetime risk for diabetes for 

people born in the United States in 2000? 

Control diabetes. For life. 

2 of 5 African 

Americans and 

1 of 3 Americans 

American 

Preventing Diabetes Complications 

• Regular eye exams and timely treatment could prevent


up to 90% of diabetes-related blindness.


• Foot care programs that include regular examinations and 

patient education could prevent up to 85% of diabetesrelated amputations. 

• Treatment to better control blood pressure can reduce heart 

disease and stroke by 33%–50% and diabetes-related kidney 

failure by 33%. 

Diabetes Control: A Good Investment 

• Intensified blood pressure control can cut health care costs 

by $900 (2000 US dollars) over the lifetime of a person with 

type 2 diabetes. It can also extend life by 6 months. 

• In just 5 years, a foot care program can save $900 (2000 

U.S. dollars) in health care costs for a person with diabetes 

who has had foot ulcers. Such care prevents amputations. 

• Outpatient training to help people self-manage their 

diabetes prevents hospitalizations. Every $1 invested in 

such training can cut health care costs by up to $8.76. 

• Preconception care for women with diabetes leads to healthier 

mothers and babies. Every $1 invested in such care can reduce 

health costs by up to $5.19 by preventing costly complications. 

Revised July 2005 
for homeless patients is the goal 

Louisiana Diabetes 

Improving diabetes education 

of this exemplary partnership 

between the Louisiana Diabetes Prevention and Control 

Program (DPCP) and the City of New Orleans Health 

Department’s Healthcare for the Homeless Clinic. The 

ultimate goal is to improve patient compliance with 

treatment regimens such as regular A1C testing, which 

is highly effective in showing if a person’s blood sugar is 

under control. The A1C detects problems early so that 

disabling, costly complications can be prevented. 

Patient compliance at the clinic had been extremely low: 

in September 2001, less than 16% of patients had at least 

one A1C check, and less than 26% had at least two A1C 

checks in the past year. By June 2004, however, compliance 

had risen remarkably: 99% of patients had at least one 

A1C check, and 54% had at least two A1C checks in the 

past year. Moreover, over 99% of patients had met their 

goals for self-managing their diabetes, compared with 

94% in September 2001. 

This Louisiana program is a successful example of how 

state programs can promote healthy behaviors, prevent 

disease, and reduce the economic burden for homeless 

people who have diabetes or are at risk for this disease. 

State Program in Action: 

Prevention and 

Control Program 

Effective Strategies 

Early detection, improved delivery of care, and better selfmanagement are key for preventing diabetes complications. 

Here are several examples of these strategies in action: 

• Small Steps. Big Rewards. Prevent Type 2 Diabetes is a national 

campaign that targets people hardest hit by diabetes, including 

African Americans, American Indians and Alaska Natives, Asians 

and Pacific Islanders, Hispanics, and older adults. The National 

Diabetes Education Program (NDEP) launched the campaign to 

encourage people with pre-diabetes to make modest lifestyle changes 

that could delay and possibly prevent the onset of the disease. By 

losing 5%–7% of their body weight and getting just 2 1/2 hours of 

physical activity a week, people with pre-diabetes can cut their risk 

for developing type 2 diabetes by more than half. 

• The National Diabetes Collaborative (also known as the Diabetes 

Prevention Prototype) is helping federally funded health centers 

improve diabetes care for their patients and prevent pre-diabetes 

from progressing to diabetes. Three major partners are involved: 

CDC, the Bureau of Primary Health Care, and the Institute 

for Healthcare Improvement. Supported by a network of 48 

CDC-funded Diabetes Prevention and Control Programs, the 

collaborative aims to improve care delivery systems for people 

with diabetes, increase people’s access to diabetes care, and help 

medically underserved people at the participating centers. 

Preliminary results are promising. A greater percentage of diabetes 

patients are having the highly effective A1C blood test, and the 

centers have identified 1,660 people who are at risk for pre-diabetes. 

All of these individuals have had an oral glucose tolerance test, and 

over 850 of them have been diagnosed with either pre-diabetes or 

diabetes. In addition, the collaborative is pilot-testing to identify 

strategies for reaching people at high risk for diabetes. 

Hope for the Future 

Congress has given CDC the funds to expand Diabetes Prevention 

and Control Programs in all states, U.S. territories, and the District 

of Columbia. CDC currently provides 22 states with limited funding 

(capacity-building) and 28 states with more substantial support 

(basic implementation). The 28 states receiving basic implementation 

funds have improved preventive care practices for people with 

diabetes and worked with partners to improve people's access to 

high-quality diabetes care. Thus, CDC will continue to expand the 

number of state programs receiving basic implementation funds and 

will work with them to launch primary prevention pilot programs. 

Such activities generate innovations that enable states to continue 

preventing diabetes and improve the lives of millions of people. 

For more information and references supporting these facts, 

visit www.cdc.gov/nccdphp. For additional copies of this 

document, E-mail ccdinfo@cdc.gov.