Epidemiology of diabetes mellitus

Prevalence (per 1,000 inhabitants) of diabetes worldwide in 2000 - world average was 2.8%.
  no data
  ≤ 7.5
  7.5–15
  15–22.5
  22.5–30
  30–37.5
  37.5–45
  45–52.5
  52.5–60
  60–67.5
  67.5–75
  75–82.5
  ≥ 82.5
Disability-adjusted life year for diabetes mellitus per 100,000 inhabitants in 2004
  No data
  <100
  100–200
  200–300
  300–400
  400–500
  500–600
  600–700
  700–800
  800–900
  900–1,000
  1,000–1,500
  >1,500

Globally, as of 2010, an estimated 285 million people had diabetes, with type 2 making up about 90% of the cases.[1] In 2013, according to International Diabetes Federation, an estimated 381 million people had diabetes.[2] Its prevalence is increasing rapidly, and by 2030, this number is estimated to almost double.[3] Diabetes mellitus occurs throughout the world, but is more common (especially type 2) in the more developed countries. The greatest increase in prevalence is, however, expected to occur in Asia and Africa, where most patients will probably be found by 2030.[3] The increase in incidence in developing countries follows the trend of urbanization and lifestyle changes, perhaps most importantly a "Western-style" diet. This has suggested an environmental (i.e., dietary) effect, but there is little understanding of the mechanism(s) at present, though there is much speculation, some of it most compellingly presented.[3]

Australia

Indigenous populations in first world countries have a higher prevalence and increasing incidence of diabetes than their corresponding nonindigenous populations. In Australia, the age-standardised prevalence of self-reported diabetes in indigenous Australians is almost four times that of nonindigenous Australians.[4] Preventative community health programs are showing some success in tackling this problem.

China

Almost one Chinese adult in ten has diabetes. A 2010 study estimated that more than 92 million Chinese adults have the disease, with another 150 million showing early symptoms.[5] The incidence of the disease is increasing rapidly; a 2009 study found a 30% increase in 7 years.[6] Indigenous nomadic peoples like Tibetans and Mongols are at much higher susceptibility than Han Chinese.

India

India has more diabetics than any other country in the world, according to the International Diabetes Foundation,[7] although more recent data suggest that China has even more.[5] According to the Indian Heart Association, India is the diabetes capital of the world with a projected 109 million individuals with diabetes by 2035.[8] The disease currently affects more than 62 million Indians, which is more than 7.1% of India's adult Population.[9] An estimate shows that nearly 1 million Indians die due to Diabetes every year.[7] The average age on onset is 42.5 years.[7] The high incidence is attributed to a combination of genetic susceptibility plus adoption of a high-calorie, low-activity lifestyle by India's growing middle class.[10] Additionally, a study by the American Diabetes Association reports that India will see the greatest increase in people diagnosed with diabetes by 2030.[11]

United Kingdom

About 3.8 million people in the United Kingdom have diabetes mellitus, but the charity Diabetes U.K. have made predictions that could become high as 6.2 million by 2035/2036. The NHS spent a daily average of £2.2m (€2.6m; $3.7m) in 2013 on prescriptions for managing diabetes in primary care, and about 10% of the primary care prescribing budget is spent on treating diabetes.[12] Diabetes U.K. have also predicted that the National Health Service could be spending as much as 16.9 billion pounds on diabetes mellitus by 2035, a figure that means the NHS could be spending as much as 17% of its budget on diabetes treatment by 2035.[13][14][15]

United States

Diabetes rates at county levels 2004 - 2009.
Diabetes rates in the United States, 1994-2010

For at least 20 years, diabetes rates in North America have been increasing substantially. While the number of people with diabetes in the US continues to grow, the number of new cases has been declining since 2009, a reversal of a decades long pattern of increases in new cases. [16] In 2014, more than 29 million people had diabetes in the United States, of whom 7 million people remain undiagnosed. [17] Another 57 million people are estimated to have prediabetes.[18][19] There were approximately 12.1 million diabetes-related emergency department (ED) visits in 2010 for adults aged 18 years or older (515 per 10,000 U.S. population), accounting for 9.4 percent of all ED visits.[20]

The Centers for Disease Control and Prevention (CDC) has termed the change an epidemic.[21] The National Diabetes Information Clearinghouse estimates diabetes costs $132 billion in the United States alone every year. About 5%–10% of diabetes cases in North America are type 1, with the rest being type 2. The fraction of type 1 in other parts of the world differs. Most of this difference is not currently understood. The American Diabetes Association (ADA) cites the 2003 assessment of the National Center for Chronic Disease Prevention and Health Promotion (Centers for Disease Control and Prevention) that one in three Americans born after 2000 will develop diabetes in their lifetimes.[22][23]

4.9% of American adults had diabetes in 1990. By 1998, that number rose by a third to 6.5%. The prevalence of diabetes increased for both sexes and every racial group. American women have suffered from diabetes at a higher rate than men, with 7.4% of women being diabetic in 1998, as opposed to only 5.5% of men. The increase in diabetes coincides with an increase in average weight across both genders. In the same time frame, average weight in both men and women increased by nearly 4 kilograms. This relates to the fact that the most common form of diabetes, type 2, is strongly associated with unhealthy weight. Older Americans have suffered from diabetes at a much higher rate than younger people, with over 12% of those in their 60s and 70s being diabetic in 1998. In the same year, less than 2% of those under 30 suffered from diabetes. Weight is also a strong factor in one's likelihood of becoming diabetic, with 13.5% of obese Americans in 1998 being diabetic. In the same year, only 3.5% of people at a healthy weight had the disease.[24]

According to the ADA, about 18.3% (8.6 million) of Americans age 60 and older have diabetes.[25] Diabetes mellitus prevalence increases with age, and the numbers of older persons with diabetes are expected to grow as the elderly population increases in number. The National Health and Nutrition Examination Survey (NHANES III) demonstrated, in the population over 65 years old, 18% to 20% have diabetes, with 40% having either diabetes or its precursor form of impaired glucose tolerance.[26] Older individuals are also more likely to be seen in the emergency department (ED) for diabetes. A study by the Agency for Healthcare Research and Quality (AHRQ) found that in 2010, diabetes-related ED visit rates were highest for patients aged 65 and older (1,307 per 10,000 population), compared with 45- to 64-year-olds (584 per 10,000 population) and 18- to 44-year-olds (183 per 10,000 population).[20]

A second study by AHRQ found that diabetes with complications was one of the twenty most expensive conditions seen in U.S. inpatient hospitalizations in 2011, with an aggregate cost of nearly $5.4 billion for 561,000 stays. It was among the top five most expensive conditions for uninsured patients, at an aggregate cost of $440 million for 62,000 hospitalizations.[27]

References

  1. ↑ Williams textbook of endocrinology (12th ed.). Philadelphia: Elsevier/Saunders. pp. 1371–1435. ISBN 978-1-4377-0324-5.
  2. ↑ "Simple treatment to curb diabetes". January 20, 2014.
  3. 1 2 3 Wild S, Roglic G, Green A, Sicree R, King H (2004). "Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030". Diabetes Care 27 (5): 1047–53. doi:10.2337/diacare.27.5.1047. PMID 15111519.
  4. ↑ Australian Institute for Health and Welfare. "Diabetes, an overview". Archived from the original on 2008-06-17. Retrieved 2008-06-23.
  5. 1 2 "China faces 'diabetes epidemic', research suggests". BBC. March 25, 2010. Retrieved 8 June 2012.
  6. ↑ Grens, Kerry (April 4, 2012). "Diabetes continuing to spike in China". Reuters. Retrieved 8 June 2012.
  7. 1 2 3 Gale, Jason (November 7, 2010). "India’s Diabetes Epidemic Cuts Down Millions Who Escape Poverty". Bloomberg. Retrieved 8 June 2012.
  8. ↑ Indian Heart Association Why South Asians Facts Web. 30 April 2015.<http://indianheartassociation.org/why-indians-why-south-asians/overview/>
  9. ↑ "Diabetes can be controlled in 80 percent of Cases in India". IANS. news.biharprabha.com. Retrieved 6 February 2014.
  10. ↑ Kleinfield, N. R. (September 13, 2006). "Modern Ways Open India’s Doors to Diabetes". New York Times. Retrieved 8 June 2012.
  11. ↑ Wild, Sarah, Gojka Roglic, Anders Green, Richard Sicree, and Hilary King. "Global Prevalence of Diabetes." Diabetes Care. American Diabetes Association, 26 Jan. 2004. Web. 22 Apr. 2014.
  12. ↑ "Diabetes prescribing in England consumes nearly 10% of primary care budget". BMJ 349: g5143. 2014. doi:10.1136/bmj.g5143.
  13. ↑ "NHS spending on diabetes 'to reach £16.9 billion by 2035'". 2012-04-25. Retrieved 2012-04-26.
  14. ↑ http://managingdiabetes.co.uk/articles/diabetesnhsspending.php
  15. ↑ http://www.nhs.uk/news/2012/04april/Pages/nhs-diabetes-costs-cases-rising.aspx
  16. ↑ Shute, Nancy. "Fewer People Are Getting Diabetes, But The Epidemic Isn't Over". NPR.org. Retrieved 2015-12-02.
  17. ↑ "CDC Features - Diabetes Latest". www.cdc.gov. Retrieved 2015-12-02.
  18. ↑ "Number of Americans with Diabetes Rises to Nearly 26 Million" (Press release). Centers for Disease Control and Prevention. 2011-01-26. Retrieved 2012-05-27.
  19. ↑ "National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011" (PDF). Centers for Disease Control and Prevention. 2011. Retrieved 2012-05-31.
  20. 1 2 Washington R.E., Andrews R.M., Mutter R.L. Emergency Department Visits for Adults with Diabetes, 2010. HCUP Statistical Brief #167. November 2013. Agency for Healthcare Research and Quality, Rockville, MD. .
  21. ↑ "Diabetes Rates Rise Another 6 Percent in 1999 — January 26, 2001". Retrieved 2008-06-23.
  22. ↑ Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF (October 2003). "Lifetime risk for diabetes mellitus in the United States". JAMA 290 (14): 1884–90. doi:10.1001/jama.290.14.1884. PMID 14532317.
  23. ↑ "Total Prevalence of Diabetes & Pre-diabetes". American Diabetes Association. 2005. Archived from the original on 2006-02-08. Retrieved 2006-03-17.
  24. ↑ Mokdad, A.; Ford, E.; Bowman, B.; Nelson, D.; Engelgau, M.; Vinicor, F.; Marks, J. (2000). "Diabetes trends in the U.S.: 1990-1998". Diabetes Care 23 (9): 1278–1283. doi:10.2337/diacare.23.9.1278.
  25. ↑ "Seniors and Diabetes". Elderly And Diabetes-Diabetes and Seniors. LifeMed Media. 2006. Retrieved 2007-05-14.
  26. ↑ Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD (April 1998). "Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988–1994". Diabetes Care 21 (4): 518–24. doi:10.2337/diacare.21.4.518. PMID 9571335.
  27. ↑ Torio CM, Andrews RM. National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011. HCUP Statistical Brief #160. Agency for Healthcare Research and Quality, Rockville, MD. August 2013.
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