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Diabetes Report Card 2012: National and State Profile of Diabetes and Its Complications

Diabetes Overview

Diabetes is a group of diseases characterized by high blood glucose (blood sugar). When a person has diabetes, the body either does not produce enough insulin or is unable to use its own insulin effectively. Glucose builds up in the blood and causes a condition that, if not controlled, can lead to serious health complications and even death. The risk of death for a person with diabetes is twice the risk of a person of similar age who does not have diabetes.

Diabetes is a major cause of heart disease and stroke. Death rates for heart disease and the risk of stroke are about 2–4 times higher among adults with diabetes than among those without diabetes.¹ In addition, 67% of U.S. adults who report having diabetes also report having high blood pressure.¹ For people with diabetes, high blood pressure levels, high cholesterol levels, and smoking increase the risk of heart disease and stroke.² This risk can be reduced by controlling blood pressure and cholesterol levels and stopping smoking.

Diabetes can also lead to other complications, such as vision loss, kidney failure, and amputations of legs or feet. Effective glucose control, as measured by A1c levels, and blood pressure control can prevent or delay these complications.¹

Average medical expenses are more than twice as high for a person with diabetes as they are for a person without diabetes. In 2007, the estimated cost of diabetes in the United States was $174 billion. That amount included $116 billion in direct medical care costs and $58 billion in indirect costs (from disability, productivity loss, and premature death).¹

The most common forms of diabetes are as follows

Type 1 diabetes accounts for about 5% of all diagnosed cases of diabetes. Type 1 is usually first diagnosed in children and young adults, although it can occur at any time. To survive, people with type 1 diabetes use insulin from an injection or a pump. Risk factors for type 1 diabetes can be autoimmune, genetic, or environmental. At this time, there are no known ways to prevent type 1 diabetes.¹
Type 2 diabetes accounts for about 95% of diagnosed diabetes in adults. Several studies have shown that healthy eating and regular physical activity, used with medication if prescribed, can help control health complications from type 2 diabetes or can prevent or delay the onset of type 2 diabetes.¹
Gestational diabetes develops and is diagnosed as a result of pregnancy in 2%–10% of pregnant women.³ Gestational diabetes can cause health problems during pregnancy for both the child and mother. Children whose mothers have gestational diabetes have an increased risk of developing obesity and type 2 diabetes.⁴ Women who have gestational diabetes face a higher risk of developing type 2 diabetes in the future. Research has shown that 10–20 years after a woman has had gestational diabetes, she has a 35%–60% chance of developing type 2 diabetes.⁵

Rates for type 2 diabetes rise sharply with age for both men and women and for members of all racial and ethnic groups. The prevalence of diagnosed diabetes is about seven times as high among adults aged 65 years or older as among those aged 20–44 years. Race and ethnicity also are risk factors for diabetes. Most minority populations in the United States, including Hispanic Americans and non-Hispanic blacks, have a higher prevalence of diabetes than their white non-Hispanic counterparts.

Although diabetes prevalence varies widely among populations and tribes, diabetes disproportionately affects American Indians and Alaska Natives in the United States, with diagnosed diabetes rates more than twice as high as the rates for non-Hispanic whites.¹ Asian Americans are at higher risk of developing type 2 diabetes, despite having, on average, a substantially lower body mass index when compared with non-Hispanic white counterparts.⁶ Diabetes develops at younger ages in racial and ethnic minority populations, which puts minorities at higher risk of developing complications at a younger age.⁷

Prevalence of Diagnosed Diabetes, 2007–2009

U.S. Adults, by Age^a
20–44 years	2.6%
45–64 years	11.7%
>=65	18.9%
U.S. Adults Aged >=20 Years, by Race and Ethnicity^b,c
American Indian and Alaska Native	16.1%
Asian American	8.4%
Hispanic	11.8%
Non-Hispanic black	12.6%
Non-Hispanic white	7.1%