Sugar Nation: Diabetes and Prediabetes in the US

Diabetes, prediabetes may affect nearly half of Americans

(RxWiki News) Diabetes is a major cause of illness and death in the US. But there may be some hope on that front.

A major new study found that an estimated 50 percent of all US adults may have diabetes or prediabetes — whether or not they've been diagnosed. However, data on the topic from recent years suggests that the problem may be leveling off.

"Diabetes mellitus has been steadily increasing in this country for several decades," said David Winter, MD, MSc, president, chairman of the board and chief clinical officer of Baylor's HealthTexas Provider Network, in an interview with dailyRx News. "This correlates with the increase in obesity in America. Efforts to lower obesity in our country should be intensified and would be expected to reduce the incidence in this chronic medical condition that can lead to blindness, heart disease, strokes, kidney failure and amputations."

In an editorial about this study, William H. Herman, MD, MPH, and Amy E. Rothberg, MD, PhD, of the University of Michigan Health System, wrote, "Although obesity and type 2 diabetes remain major clinical and public health problems in the United States, the current data provide a glimmer of hope. Efforts ... to promote screening, testing, and referral of high-risk patients for diabetes prevention [and] efforts to increase the availability of diabetes prevention programs, ensure their quality, and promote their use appear to be helping ... Progress has been made, but expanded and sustained efforts will be required."

Andy Menke, PhD, an epidemiologist at Social & Scientific Systems Inc., in Silver Spring, MD, led this study of more than 25,000 US adults.

Dr. Menke and team used data from the National Health and Nutrition Examination Survey (NHANES), an ongoing study of nutrition and disease in US adults.

The NHANES includes interviews, physical exams and other data, such as lab test results. These researchers looked at data from 1988 to 1994 and from 1999 to 2012. Lab test results were used to assess whether patients had diabetes or prediabetes.

In 2011 to 2012, the estimated prevalence of US adults with type 2 diabetes was between 12 and 14 percent. The estimated prevalence of US adults with prediabetes was between 37 and 38 percent for the same period.

Type 2 diabetes is a chronic condition that affects the way the body processes blood sugar. If left untreated, diabetes can lead to serious health problems.

Patients with prediabetes have blood sugar levels that are higher than normal but not high enough to be classified as diabetes.

Dr. Menke and team found that obesity (a primary risk factor for diabetes) rates leveled off between 2007 and 2008, and also between 2011 and 2012. Diabetes rates also leveled off during these periods.

Compared with non-Hispanic white patients, black patients, Asian patients and Hispanic patients had a higher risk of diabetes.

The prevalence of prediabetes was greater than 30 percent for patients from all sexes and racial/ethnic categories.

Asian and Hispanic patients were the groups most likely to have undiagnosed diabetes, with more than half of all Asian patients with diabetes not having been formally diagnosed.

According to Dr. Menke and team, the reason for that discrepancy may be that Asians tend to be smaller in size than white, black and Hispanic patients.

However, Asian patients have a higher percentage of body fat compared to other groups — which puts them at a higher risk of diabetes.

The study and editorial were published Sept. 8 in the journal JAMA.

The National Institute of Diabetes and Digestive and Kidney Diseases funded this research. Dr. Menke and team disclosed no conflicts of interest.

Review Date: 
September 7, 2015