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Lifetime Risk for Diabetes Mellitus in the United States

Source: Narayan KMV, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF. Lifetime risk for diabetes mellitus in the United States. JAMA 2003 October 8;290(14):1884-1890.

Results from the Centers for Disease Control and Prevention (CDC) study show that the lifetime risk of developing diabetes for the average American is great. What is lifetime risk? According to this study, lifetime risk is the probability that a person will develop diabetes in his or her lifetime. Approximately one in three Americans born in 2000 will develop diabetes, which makes primary prevention of diabetes an important priority for the nation.

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Results

The lifetime risk of developing diabetes for an average person born in the United States in year 2000 until their death

Males – 1 in 3 chance
Females – 2 in 5 chance
Hispanic females – 1 in 2 chance (high risk)

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Public Health Implications

Our estimates suggest the average adult has a significant chance of developing diabetes in their lifetime, approximately 32.8% for males and 38.5% for females. Females are higher risk at all ages, while Hispanics have the highest risk with males at 45.4% and females at 52.5%. The good news is that in these categories, the numbers decline to 22.4% for females and 18.9% for males at age 60 years, and to 6.9% and 5.2%, at age 80 years.

The average American has a substantial possibility of being diagnosed with diabetes during their lifetime. Because we can prevent or delay the onset of Type 2 diabetes, primary prevention of diabetes should be an important priority for the nation.

The immediate challenge is primary prevention of diabetes

The following questions remain:

The lifetime risk of developing diabetes is alarming. How does this compare with the lifetime risk for other chronic diseases such as heart disease, cancer, Alzheimer's disease?
- According to our study the lifetime risk of diabetes is comparable with or higher than that for many diseases and conditions that are perceived as common. For example, at age 70 the residual lifetime risk of diabetes for men is about 1 in 10, the same as dementia. The lifetime risk of diabetes is also considerably higher than the widely publicized 1 in 8 risk for breast cancer among U.S. women.
What is primary prevention?
- Preventing a disease before it occurs.
Who can benefit most from primary prevention?
- All people who are at high risk for diabetes.
Why do minorities have a higher lifetime risk for diabetes?
- The lifetime risk of diabetes for all Americans is high. There are some differences between various groups, and the reasons for this are complex and not fully understood.
What is the government doing to increase diabetes awareness among the highest risk groups: women, Hispanics, Native Americans, and African Americans?
- Results of recent clinical trials show promise that diabetes itself may be prevented or at least delayed with lifestyle interventions that produce modest weight loss or with the use of drugs. The DHHS is implementing diabetes prevention efforts through “Steps to a Healthier US." CDC and NIH are also focusing efforts on primary prevention.