Prevalence and incidence trends for diagnosed diabetes among adults aged 20 to 79 years, United States, 1980-2012

Geiss LS, Wang J, Cheng YJ, et al. Prevalence and incidence trends for diagnosed diabetes among adults aged 20 to 79 years, United States, 1980-2012. JAMA. 2014;312(12):1218-1226.


This study assessed whether there have been periods of acceleration or deceleration in the rates of diabetes prevalence and incidence in the United States over the past three decades. It included 664,969 subjects aged 20 to 79 years with type 1 or type 2 diabetes.
    
From 1980-2012, the trends in age-adjusted prevalence and incidence of diagnosed diabetes were similar

  • The annual percentage change for neither prevalence nor incidence changed significantly during the 1980s
  • Both prevalence and incidence increased sharply during the period from 1990 through 2008, then leveled off with no significant change from 2008 through 2012
    • The prevalence per 100 persons was 3.5 (95% CI, 2.3-3.9) in 1990, 7.9 (95% CI, 7.4-8.3) in 2008, and 8.3 (95% CI, 7.9-8.7) in 2012
    • The incidence per 100 persons was 3.2 (95% CI, 2.2-4.1) in 1990, 8.8 (95% CI, 7.4-10.3) in 2008, and 7.1 (95% CI, 6.1-8.2) in 2012
     

 Increasing adiposity is a major factor contributing to increasing diabetes incidence. Adjusting for BMI reduced the incidence of diabetes from 1997-2008:

  • The annual percentage incidence of diabetes for this period controlling for age was 4.8% (95%CI, 3.4%-6.2%)
  • Controlling for both age and BMI reduced the incidence by about a third to 3.2% (95% CI, 2.0%-4.4%; P=0.06)


In many subpopulations, trends in the prevalence and incidence of diagnosed diabetes were similar to overall trends. Substantial increases were seen around 1990 that lasted 15 to 20 years before leveling off or decelerating. Exceptions:

  •  
  • Age
    • Prevalence continued to increase at a significantly greater rate for young adults aged 20 to 44 years compared with those older (for interaction, P=0.04 for those aged 45-64 years; P=0.003 for those aged 65-79 years).
    • Incidence rates continued to increase at a greater rate for adults aged 20 to 44 years compared with those aged 45 to 64 years (P=0.03)
         
  • Education
    • The rate of increase in prevalence was higher for adults who had a high school education or less compared with those who had more than a high school education (for interaction, P=0.006 for less than high school and P<0.001 for high school)
         
  • Race/ethnicity
    • The rate of increase in prevalence was higher for Hispanic adults compared with non-Hispanic black adults (P=.01 for interaction).
    • Incidence rates continued to increase at a greater rate among non-Hispanic black and Hispanic adults than non-Hispanic white adults (for interaction, P=0.03 for non-Hispanic black adults and P=0.01 for Hispanic adults) 
     

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Any pharmacologic agents discussed are approved for use in the United States by the U.S. Food and Drug Administration (FDA) unless otherwise noted. Consult individual prescribing information for approved uses outside of the United States. 

November 2014 

This overview was created by KnowledgePoint360 Group, LLC, and was not associated with funding via an educational grant or a promotional/commercial interest.  

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Last Modified: 11/14/2014