A report in the September 24 issue of JAMA has some mildly encouraging news regarding the health of the American public.
In contrast to the doubling of the incidence and prevalence of diabetes during the years 1990 through 2008, new data indicates that this trend at least in many populations has stabilized.
Using the National Health Interview Survey Linda Giess and colleagues in the Division of Diabetes Translation, Centers for Disease Control and Prevention in Atlanta and colleagues analyzed data for more than 660,000 US adults (ages 20 through 79) during a 32 year period beginning in 1980.
Key findings were:
The prevalence (total number of cases) per 100 persons was:
- 3.5 in 1990
- 7.9 in 2008
- 8.3 in 2012.
Also, the incidence (the number of new cases during a specified time period) was:
- 3.2 new cases per 1,000 people in 1990
- 8.8 in 2008
- 7.1 in 2012
The authors conclude ,Both prevalence and incidence increased sharply during 1990-2008 (for prevalence, 4.5 percent, for incidence, 4.7 percent) before leveling off with no significant change during 2008-2012 (for prevalence, 0.6 percent, for incidence, -5-4 percent).
Their proposed explanation of this trend is that the drop over the past four years may reflect the decrease in obesity during this interval. Obesity is the most important risk factor in the development of type 2 (non-insulin dependent) diabetes.
This trend did not hold true within certain groups. For example, the increase in incidence continued to rise in Hispanic and black adults, as well as people who had a only a high school diploma or less.
The authors commented, This threatens to exacerbate racial/ethnic and socioeconomic disparities in diabetes prevalence and incidence. Furthermore, in light of the well-known excess risk of amputation, blindness, end-stage renal disease, disability, mortality, and health care costs associated with diabetes, the doubling of diabetes incidence and prevalence ensures that diabetes will remain a major public health problem that demands effective prevention and management programs.
ACSH s Dr. Gil Ross says, The recent decreases in the incidence and prevalence of type 2 diabetes reflects the fact that people are making better dietary choices on their own. Not because of ill-advised and intrusive policies. The obesity epidemic, while serious, has been used by certain individuals and groups that want to control what you eat and drink. There is no better example than Mayor Bloomberg s silly attempt to limit the size of sodas in New York to 16 ounces. What we must do is make sure our educational efforts reach a greater proportion of the population.
