Half of all American adults are diabetic or pre-diabetic, JAMA study finds

Diagnoses have increased over past two decades

About half of all U.S. adults have been diagnosed with diabetes or pre-diabetes as of 2012, according to a study published this week in the Journal of the American Medical Association

For the study, researchers estimated the rates of pre-diabetes—when individuals have elevated blood sugar levels that could result in diabetes—and diabetes among U.S. adults using data from CDC's National Health and Nutrition Examination Survey. The data included responses collected from 23,634 adults from 1988 to 2010 and 2,781 adults from 2011 to 2012.

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The study found that between 12% and 14% of U.S. adults had been diagnosed with diabetes by 2012. In most of those cases, individuals were diagnosed with Type 2 diabetes, which has been linked with inactivity and obesity. By comparison, about 10% of U.S. adults had been diagnosed with diabetes in the early 1990s.

According to the researchers, screenings for diabetes have caught more cases in recent years, accounting for the general increase in diagnoses over the past 20 years.

But the researchers estimated that more than one-third of U.S. diabetes cases likely go undiagnosed, and that about half of diabetes cases among Hispanic and Asian adults are likely undetected.

Results by racial/ethnic group, socioeconomic status

Further, the study found that diabetes rates—including both diagnosed and undiagnosed cases—are higher among racial and ethnic minorities. According to the study:

  • 23% of Hispanic adults have diabetes;
  • 22% of black adults have diabetes;
  • 21% of Asian adults have diabetes; and
  • 11% of white adults have diabetes.

Andy Menke, an epidemiologist at Social and Scientific Systems and the study's lead author, says researchers "were surprised to find that the prevalence of diabetes is relatively high among Asians ... despite having a lower BMI than other race/ethnicity groups in the United States." He added, "Physicians should remain cognizant that Asians have a higher risk of diabetes at a given BMI and should be screened for diabetes at a lower BMI threshold."

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In addition, researchers speculated that a lack of health insurance among Hispanic U.S. residents resulted in lower access to care could, which could account for the disparities.

The researchers also found that diabetes is more prevalent among lower-income individuals, though reasons for the correlation remain unclear. Menke notes the association could be based on factors such as access to care, access to healthy foods, and other environmental or neighborhood-related factors.

Menke says there is need for efforts "to better educate people on the risk factors for diabetes –including older age, family history and obesity—and improve screening for those at high risk" (Tanner, AP/Washington Times, 9/8; Rapaport, Reuters, 9/8; Robeznieks, Modern Healthcare, 9/8).

How six hospitals launched diabetes management programs

As obesity and diabetes rates rise across the country, many hospitals have developed outpatient diabetes centers. Projections estimate that by 2050, one in three Americans will have diabetes. The most progressive hospitals have combined diabetes treatment, education, wound care, ophthalmology, and other services into comprehensive programs.

In this briefing, we profiled six leading institutions have successfully integrated outpatient diabetes services into their primary care networks. Read it now to learn how an effectively implemented program can benefit PCPs who may otherwise be unable to provide quality diabetes care to their patients and help your organization set itself apart from the competition.

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