Diabetes Bridget Dillon and Rachel Pryor EPID 691 January 28, 2013
Incidence Incidence of Diabetes Type 2 remained relatively steady during the 1980’s, but has steadily increased since 1990 Incidence in 2010 was 1,735,000 people in the United States Incidence in 1980 was 493,000
Source: 2007–2009 National Health Interview Survey estimates projected to the year 2010.
Crude v. Age-Adjusted Incidence “From 1980 to 2011, the crude incidence of diagnosed diabetes increased 133% from 3.3 to 7.7 per 1,000 population. Similarly, the age–adjusted incidence increased 117% from 3.5 to 7.6 per 1,000 population, suggesting that the majority of the change was not due to the aging of the population. ”
Age-Adjusted Incidence http://www.cdc.gov/diabetes/statistics/incidence/fig3.htm
Age-adjusted incidence by sex http://www.cdc.gov/diabetes/statistics/incidence/fig4.htm
Age-Adjusted Incidence by Race http://www.cdc.gov/diabetes/statistics/incidence/fig6.htm
Rate of new cases of type 1 and type 2 diabetes among youth aged <20 years, by race/ethnicity, 2002–2005 <10 years 10–19 years Source: SEARCH for Diabetes in Youth Study NHW=non-Hispanic whites; NHB=non-Hispanic blacks; H=Hispanics; API=Asians/Pacific Islanders; AI=American Indians
Prevalence 20.9 million Americans currently have Diabetes (http://www.cdc.gov/diabetes/statistics/prev/national/figpersons.htm) 20.7 million of the population who have Diabetes are adults aged 18 and older (http://www.cdc.gov/diabetes/statistics/prev/national/figadults.htm) 8.3% of the US population
Prevalence by age http://www.cdc.gov/diabetes/statistics/prev/national/figbyage.htm
Prevalence by race, sex, education in the US http://www.cdc.gov/diabetes/statistics/prevalence_national.htm
Virginia and Diabetes http://apps.nccd.cdc.gov/DDTSTRS/Index.aspx?stateId=51&state=Virginia&cat=prevalence&Data=data&view=TO&trend=prevalence&id=1 508,000 Virginians were living with Diabetes in 2010
Related Complications People with diabetes are 2-4 times more likely to die from heart disease or suffer a stroke. 70% of people with diabetes have high blood pressure. Diabetes can also lead to kidney disease, blindness, and nerve damage in extremities.
Financial Impact of Diabetes • On average, people with diabetes spend $6,000 annually to treat their condition. • As of 2008, the estimate cost of diabetes in the United States was $218 billion. • This included costs for those with diagnosed diabetes ($174.4 billion), undiagnosed ($18 billion), gestational diabetes ($636 million) and pre-diabetes ($25 million).
Current Research in Diabetes Diabetes Type 2 used to be unheard of in children. Now that the incidence is ever-increasing, when is it appropriate to screen at risk (ie, obese) children? (Zeitler, Phil. Type 2 Diabetes Mellitus Challenges in Diagnoses and Treatment. Contemporary Pediatrics, 2012 Jul; 29(7): 16-23)
Research continued Diabetes and Self-Management Education (DSME). There is an association between women who have had DSME and better health outcomes related to Diabetes. (Gumbs, Jean Maydalyne. Relationship between diabetes self-management and education and self-care behaviors among African-American women with Type 2 Diabetes. Journal of Cultural Diversity, 2012 Spring; 19(1): 18-22.
Research continued There is an increased risk of mortality for post-MI patients with diabetes and depression. (Bot, M; Pouwer, F; Zuidersma, M; van Melle, JP; de Jonge, P. Association of coexisting diabetes and depression with mortality after myocardial infarction. Diabetes Care. 2012 March; 35(3): 503-9)
Research continued • The FDA is currently considering the approval of a new class of drugs to treat diabetes. The SGLT2 inhibitors target glucose uptake in the kidneys to prevent the absorption of glucose. • This treatment takes a new approach from insulin injections. • There are concerns about its efficacy in patients with renal impairment.
Other research efforts • Islet transplantation • No need for insulin a year after surgery. • Episodes of low blood sugar reduced for five years. • Effects are not permanent. • DCCT/EDIC • Large scale study conducted from 1983 to 1993. • Demonstrated that keeping blood glucose close to normal slowed progression of eye, kidney and nerve damage.