Diabetes presents an enormous and expensive health challenge both in the United States and around the world. It affects over 30 million Americans, according to the American Diabetes Association, and diagnosed diabetes costs the country about $327 billion each year. So any rise or fall in the rate of diabetes is enormously consequential, to both the nation’s health and its finances.
A new report from the Centers for Disease Control and Prevention (CDC) on trends in diabetes contains both good and bad news, and may serve as a roadmap for where future prevention and treatment efforts should be targeted.
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The biggest piece of good news in the report is that overall, new diagnoses of diabetes in adults significantly decreased between 2008 and 2018. That puts the rate of new diabetes cases in 2018 around where it was in 2000, when diagnoses were on the rise. A major piece of bad news is that in people under age 20, rates of both type 1 and type 2 diabetes have increased significantly, and about 210,000 children and adolescents now have diabetes — including 187,000 with type 1 diabetes.
Even among adults, though, new cases of diabetes have added to a steadily growing diabetes burden, with the overall rate of diabetes — both diagnosed and undiagnosed — increasing from 9.5% in 1999–2002 to 12% in 2013–2016. This burden isn’t equally shared across the country, with estimates of diabetes rates at the county level ranging from 1.5% to 33%. Counties with the highest rates of diabetes were more likely to be located in the southeastern United States, but nearly all regions of the country saw an increase in diabetes between 2004 and 2016.
There were also major differences in diabetes rates based on age and racial or ethnic identity. Only 4.2% of people ages 18 to 44 had diabetes in 2013–2016, while 26.8% of those ages 65 and above did. Among adults, black Americans were more likely to have diabetes, at 16.4%, than white non-Hispanic Americans, at 11.9%. Hispanic Americans saw a rate of 14.7%, while the rate among Asian Americans was 14.9%.
Among children and youths, the greatest increases in both type 1 and type 2 diabetes were seen in black Americans. This was seen most starkly in type 2 diabetes, with the rate nearly doubling in people ages 10 to 19 among black Americans, while the rate for the same age group remained steady, and much lower overall, among white Americans.
These numbers suggest that while preventing diabetes in adults is still crucial toward curbing overall diabetes rates, the most alarming trends are seen in young people, especially among black Americans. Future research and health interventions will need to be informed by these findings.