Who Has Diabetes? 

By Jean Oxendine


Closing the Gap, Diabetes • February/March 1999


Of the 16 million Americans suffering from diabetes, about 

5.4 million of these people do not know they have the 

disease. Each year, an additional 798,000 people are diagnosed with diabetes, and the number of people with diagnosed diabetes has risen from 1.5 million in 1958 to 10.6 million in 1998—a 

sixfold increase. 

The majority of people who suffer from diabetes have type 2 

diabetes, which accounts for 90 to 95 percent of all diagnosed cases of 

the disease. Diabetes affects men and women at equal rates, with 7.5 

million men (8.2 percent of all men), and 8.1 million women (8.2 

percent of all women) having the disease. Diabetes strikes all age 

groups—it is most prevalent in older Americans, with 6.3 million age 

65 and older having diabetes (18.4 percent of this age group), and 

15.6 million Americans age 20 and older having diabetes (8.2 percent 

of this age group). 

Minorities have particular reason to become aware and involved 

in NDEP and other diabetes education and treatment programs. 

Among African Americans, 2.3 million people age 20 and older (10.8 

percent) have diabetes. African Americans are 1.7 times as likely to 

have diabetes as Caucasians of similar age. Hispanic Americans are 

almost twice as likely to have diabetes as non-Hispanic whites of similar age. Both Mexican Americans and Puerto Ricans have higher rates 

of diabetes than non-Hispanic whites. 

American Indians have the highest rates of diabetes in the world, 

ranging from 5 to 50 percent. Among the Pima Indians of Arizona, 

half of all the adults have type 2 diabetes. The data for diabetes among 

Asian Americans and Pacific Islanders are limited, but we do know 

that some groups within this population are at increased risk for diabetes. Data collected from 1988 to 1995 show Native Hawaiians are 

twice as likely to have diagnosed diabetes as Caucasian residents of 

Hawaii. 

In 1995, diabetes contributed to 187,800 deaths, and was the 

seventh leading cause of death listed on U.S. death certificates (sixth 

leading cause of death by disease). Diabetes death rates vary considerably across racial and ethnic groups. Compared to non-Hispanic 

whites, diabetes death rates were 2.5 times higher among African 

Americans, 2.4 times higher among American Indian/Alaska Natives 

(AI/AN), and 1.7 times higher among persons of Hispanic origin. 

The complications from diabetes are numerous, affecting minorities at greater rates than non-minorities. According to NIDDK, 

African Americans experience higher rates of diabetes complications 

such as eye disease, kidney failure, and amputations, as compared to 

whites. The frequency of diabetic retinopathy is 40 percent to 50 

percent higher in African Americans than in whites, according to the 

National Center for Health Statistics. African Americans with diabetes experience end-stage renal disease about four times more often 

than whites with diabetes. And they are more likely to undergo 

lower-extremity amputations than whites with diabetes. 

According to the American Diabetes Association, in 1995, the 

rate of diabetic end stage renal disease among AI/ANs was six times 

higher than the general population with diabetes. More than half of 

lower limb amputations in the U.S. occurred among people with 

diabetes, and amputation rates among AI/ANs were significantly higher 

than the general population. 

Although studies don’t universally agree, there is some evidence 

that suggests Mexican Americans have a higher incidence of 

microalbuminuria—an early indicator of diabetic nephropathy—than 

non-Hispanic whites. Other research shows Mexican Americans have 

higher rates of diabetic retinopathy than white Americans. 

Diabetes costs the United States about $98.2 billion annually, 

for total health care and related costs for treatment. Of this total, 

direct medical costs (e.g. hospitalization, medial care, treatment supplies) account for about $44.1 billion. The other $54.1 billion covers 

indirect costs such as disability payments, time lost from work, and 

premature death. 

As evidenced by these statistics, diabetes is a disease that affects 

everyone, regardless of age, race, or gender.The good news is that the 

NDEP campaign is making efforts to turn these numbers around. 

For more information on NDEP, please call 1-800-438-5383; or 

visit the Web sites at http://ndep.nih.gov/ or http:///www.cdc.gov/diabetes

Office of Minority Health Resource Center U.S. Department of Health and Human Services