Data Sources, Methods, and Definitions
Level
National Total
State Total
Definition
Total fiscal year (FY) national funding received from CDC’s Division of Diabetes Translation (DDT).
Total fiscal year (FY) state-level funding received from CDC’s Division of Diabetes Translation (DDT).
Methods
In FY 2022 (October 1, 2021-September 30, 2022), through Improving the Health of Americans Through Prevention and Management of Diabetes, Heart Disease, and Stroke (DP18-1815), CDC supported 50 states and Washington, DC to carry out work to prevent and manage diabetes, heart disease, and stroke. In addition, through Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes, Heart Disease, and Stroke (DP18-1817), CDC funded 21 state and local health departments to support programs and activities to prevent or delay the onset of type 2 diabetes and to improve health outcomes for people diagnosed with diabetes. Through Scaling the National Diabetes Prevention Program in Underserved Areas (DP17-1705), CDC also provided funding to 10 national organizations with affiliate program delivery sites in at least three states to deliver the National Diabetes Prevention Program lifestyle change program to populations disproportionately affected by prediabetes or at high risk for type 2 diabetes. These groups include Medicare beneficiaries; men; African American, Asian American, Hispanic or Latino, American Indian or Alaska Native, or Pacific Islander persons; and people with visual or physical disabilities. Data were calculated by combining the total funding amounts that DDT awarded under the DP18-1815, DP18-1817, and DP17-1705 programs.
In FY 2022 (October 1, 2021-September 30, 2022), through Improving the Health of Americans Through Prevention and Management of Diabetes, Heart Disease, and Stroke (DP18-1815), CDC supported 50 states and Washington, DC to carry out work to prevent and manage diabetes, heart disease, and stroke. In addition, through Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes, Heart Disease, and Stroke (DP18-1817), CDC funded 21 state and local health departments to support programs and activities to prevent or delay the onset of type 2 diabetes and to improve health outcomes for people diagnosed with diabetes. Data were calculated by combining the total funding amounts for these two programs. For recipients of DP18-1817 that are local jurisdictions, funds were attributed to the state in which the city or county is located.
Data Year
FY 2022
FY 2022
Data Source
Division of Diabetes Translation, CDC. For more information, visit https://www.cdc.go/diabetes/about/index.html.
Division of Diabetes Translation, CDC. For more information, visit https://www.cdc.go/diabetes/about/index.html.
Level
National
State
Definition
The number of US adults aged 18 years or older with diagnosed diabetes.
The number of people aged 18 years or older in the state who reported ever being told by a health professional that they have diabetes.
Methods
Data from CDC's National Health and Nutrition Examination Survey (NHANES) were used to estimate prevalence of diagnosed diabetes among adults (aged 18 years or older).
People who self-reported being told by a doctor or health professional that they had diabetes (other than during pregnancy) were classified as having diagnosed diabetes. Appropriate sampling weights were used so that estimates were representative of the total US adult population.
Data from the Behavioral Risk Factor Surveillance System (BRFSS) were used to estimate state-level prevalence of diagnosed diabetes among adults (aged 18 years or older). An ongoing, monthly telephone survey of the non-institutionalized adult population in each state, BRFSS provides self-reported, state-specific information on behavioral risk factors for disease and preventive health practices. Respondents were considered to have diagnosed diabetes if they responded "yes" to the question "Has a doctor, nurse, or other health professional ever told you that you have diabetes?" People who indicated that they only had diabetes during pregnancy were not considered to have diabetes.
Data Year(s)
2019
2018
Data Source
2017–March 2020 NHANES, National Center for Health Statistics, CDC.
Annual Estimates of the Resident Population by Sex, Single Year of Age, Race, and Hispanic Origin for the United States: April 1, 2010 to July 1, 2019, Population Division, US Census Bureau.
2000-2019 BRFSS, National Center for Chronic Disease Prevention and Health Promotion, CDC.
Level
National
State
Definition
The number of US adults aged 18 years and older who reported being told by a health professional in the last year that they have diabetes.
The number of adults aged 18 years and older in that state who reported being told by a health professional in the last year that they have diabetes.
Methods
New cases of diabetes among adults aged 18 years or older were calculated using 2019 National Health Interview Survey (NHIS) data on respondents’ age at diagnosis and age at interview. Adults who reported being diagnosed with diabetes were asked at what age they were diagnosed. The number of years since diagnosis was calculated by subtracting the person’s age at diagnosis from the person’s current age. To calculate the rate of new cases, the weighted number of respondents who were diagnosed with diabetes within the last year (numerator) was divided by the weighted estimate of the US population aged 18 years and older (denominator). Adults who had been diagnosed with diabetes for more than 1 year and adults who answered "refused," or "don't know" or had missing values on the diabetes status question were excluded from the denominator. Adults who had a value of 0 were identified as having been diagnosed with diabetes within the last year. In addition, half of the adults who had a value of 1 were classified as having been diagnosed with diabetes within the last year.
Data from the Behavioral Risk Factor Surveillance System (BRFSS) were used to estimate state-level incidence of diagnosed diabetes among adults (aged 18 years or older). An ongoing, monthly telephone survey of the non-institutionalized adult population in each state, BRFSS provides self-reported, state-specific information on behavioral risk factors for disease and preventive health practices. Respondents were considered to have diagnosed diabetes if they responded "yes" to the question "Has a doctor, nurse, or other health professional ever told you that you have diabetes?" People who indicated that they only had diabetes during pregnancy were not considered to have diabetes. Adults who reported having diagnosed diabetes were asked at what age they were diagnosed. The number of years each person had been diagnosed with diabetes was calculated by subtracting the age at which they were diagnosed from their current age. Adults who had a value of 0 were identified as having been diagnosed with diabetes within the last year. In addition, half of the adults who had a value of 1 were classified as having been diagnosed with diabetes within the last year.
Data Year(s)
2019
2018
Data Source
2018–2019 NHIS, National Center for Health Statistics, CDC.
Annual estimates of the Resident Population by Sex, Single Year of Age, Race, and Hispanic Origin for the United States: April 1, 2010 to July 1, 2019, Population Division, US Census Bureau.
2000–2019 BRFSS, National Center for Chronic Disease Prevention and Health Promotion, CDC.
Level
National
State
Definition
The percentage of US adults aged 18 years or older with prediabetes.
N/A
Methods
The percentage of adults aged 18 years or older with prediabetes was estimated using 2017-2020 National Health and Nutrition Examination Survey (NHANES) data. NHANES combines interviews and physical examinations of a nationally representative sample of about 5,000 participants each year.
N/A
Data Year(s)
2017-2020
N/A
Data Source
2017–March 2020 NHANES, National Center for Health Statistics, CDC.
N/A
Level
National
State
Definition
The median percentage of US adults aged 18 years or older who reported ever being told by a health professional that they have prediabetes.The median percentage of US adults aged 18 years or older who reported ever being told by a health professional that they have prediabetes.
The percentage of adults aged 18 years or older in that state who reported ever being told by a health professional that they had prediabetes.
Methods
Data from the Behavioral Risk Factor Surveillance System (BRFSS) were used to estimate the percentage of adults (aged 18 years or older) that had ever been notified by a health professional that they had prediabetes. An ongoing, monthly telephone survey of the non-institutionalized adult population in each state, BRFSS provides self-reported, state-specific information on behavioral risk factors for disease and preventive health practices. Results include "Yes" responses to the question "Have you ever been told by a doctor or other health professional that you have prediabetes or borderline diabetes?" and "No, prediabetes or borderline diabetes" responses to the question, "Have you ever been told by a doctor, nurse, or other health professional that you have diabetes?" Responses from people who indicated that they only had prediabetes during pregnancy were not included. The national percentage is a median of percentages from US states and territories. Calculations are further described in the CDC National Diabetes Statistics Report, 2021. See footnotes of Table 2. Percentage of US Adults 18 or Older Who Had Ever Been Notified by a Health Professional That They Had Prediabetes, by State or US Territory, 2018.
Data from the Behavioral Risk Factor Surveillance System (BRFSS) were used to estimate the percentage of adults (aged 18 years or older) that had ever been notified by a health professional that they had prediabetes, at the state-level. An ongoing, monthly telephone survey of the non-institutionalized adult population in each state, BRFSS provides self-reported, state-specific information on behavioral risk factors for disease and preventive health practices. Results include "Yes" responses to the question "Have you ever been told by a doctor or other health professional that you have prediabetes or borderline diabetes?" and "No, prediabetes or borderline diabetes" responses to the question, "Have you ever been told by a doctor, nurse, or other health professional that you have diabetes?" Responses from people who indicated that they only had prediabetes during pregnancy were not included. Calculations are further described in the CDC National Diabetes Statistics Report, 2021. See footnotes of Table 2. Percentage of US Adults 18 or Older Who Had Ever Been Notified by a Health Professional That They Had Prediabetes, by State or US Territory, 2018.
Data Year(s)
2018
2014-2018
Data Source
2018 BRFSS, National Center for Chronic Disease Prevention and Health Promotion, CDC.
2014–2018 BRFSS, National Center for Chronic Disease Prevention and Health Promotion, CDC.
Level
National, State
Definition
Estimated health resource use among the population with diabetes in excess of resource use that would be expected in the absence of diabetes.
Methods
Please refer to the data source for an in-depth review of the methods utilized to calculate medical costs
Data Year
2017
Data Source
American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care. 2018 May;41(5):917-928. doi: 10.2337/dci18-0007. Epub 2018 Mar 22. PMID: 29567642; PMCID: PMC5911784.
Level
National, State
Definition
The indirect costs associated with diabetes include workdays missed due to health conditions (absenteeism); reduced work productivity while working due to health conditions (presenteeism); and reduced workforce participation due to disability, household productivity losses, and lost productivity due to premature mortality.
Methods
Please refer to the data source for an in-depth review of the methods utilized to calculate indirect costs.
Data Year
2017
Data Source
American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care. 2018 May;41(5):917-928. doi: 10.2337/dci18-0007. Epub 2018 Mar 22. PMID: 29567642; PMCID: PMC5911784.
Level
National
State
Definition
N/A
A report developed by state public health agencies that assesses the status of and outlines plans to address the burden of diabetes in the state.
Methods
Total number of states with a Diabetes Action Plan.
Legislation for state diabetes action plans was identified by searching the Westlaw legal database for statutes that mandate a diabetes action plan. A search engine query was conducted to locate written plans for each state, including plans for states that did not have legislation for a diabetes action plan. Results with a publicly available report on the state health agency website as of February 17, 2022, were accepted as diabetes action plans for this analysis.
Data Year(s)
N/A
2011-2022
Data Source
N/A
Data provided by the Division of Diabetes Translation, CDC. Calculations performed by CDC. Unpublished data.
Level
National
State
Definition
Diabetes funding received among all recipients through the Improving the Health of Americans Through Prevention and Management of Diabetes, Heart Disease, and Stroke (DP18-1815) cooperative agreement in Year 5 (budget period June 30, 2022–June 29, 2023). This 5-year cooperative agreement, which began in October 2018, funds all 50 states and Washington, DC to carry out work to prevent and manage diabetes, heart disease, and stroke.
Diabetes funding received among all recipients through the Improving the Health of Americans Through Prevention and Management of Diabetes, Heart Disease, and Stroke (DP18-1815) cooperative agreement in Year 5 (budget period June 30, 2022–June 29, 2023). This 5-year cooperative agreement, which began in October 2018, funds all 50 states and Washington, DC to carry out work to prevent and manage diabetes, heart disease, and stroke.
Methods
Data were calculated by combining the annual DP18-1815 diabetes funding amounts for all 50 states and the District of Colombia.
Data provided by the Division of Diabetes Translation, CDC.
Data Year
Budget period: June 30, 2022–June 29, 2023
Budget period: June 30, 2022–June 29, 2023
Data Source
Division of Diabetes Translation, CDC. For more information, visit https://www.cdc.go/diabetes/about/index.html.
Division of Diabetes Translation, CDC. For more information, visit https://www.cdc.go/diabetes/about/index.html.
Level
National
State
Definition
Diabetes funding received by a state through the Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes, Heart Disease, and Stroke (DP18-1817) cooperative agreement in Year 5 (budget period September 30, 2022–-September 29, 2023). This 5-year cooperative agreement, which began in October 2018, funds 21 state health departments, large city and county health departments, and their bona-fide agents.
Diabetes funding received by a state through the Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes, Heart Disease, and Stroke (DP18-1817) cooperative agreement in Year 5 (budget period September 30, 2022–-September 29, 2023). This 5-year cooperative agreement, which began in October 2018, funds 21 state health departments, large city and county health departments, and their bona-fide agents.
Methods
Data provided by the Division of Diabetes Translation, CDC. The national total was calculated by combining the annual diabetes DP18-1817 funding amounts for all 21 awardees.
Data provided by the Division of Diabetes Translation, CDC. For recipients of DP18-1817 that are local jurisdictions, funds are attributed to the state in which the city or county is located.
Data Year
Budget period: September 30, 2022–September 29, 2023
Budget period: September 30, 2022–September 29, 2023
Data Source
Division of Diabetes Translation, CDC. For more information, visit https://www.cdc.go/diabetes/about/index.html.
Division of Diabetes Translation, CDC. For more information, visit https://www.cdc.go/diabetes/about/index.html.
| Metric | Number of CDC-recognized organizations offering the lifestyle change program* | Number of Medicare Diabetes Prevention Program suppliers* | Number of participants enrolled in the National DPP lifestyle change program (LCP)* | State Medicaid coverage of the National DPP LCP* |
|---|---|---|---|---|
| Level | State | State | State | State |
| Definition | Delivery organizations with CDC recognition by state, based on the physical location of the organization. | Delivery organizations offering the Medicare Diabetes Prevention Program by state, based on the physical location of the organization. | Cumulative enrolled participants in the National DPP LCP that report the state as their state of residence. | Includes any level of Medicaid coverage for the National DPP LCP through existing Medicaid state plans or state plan amendments, Medicaid waivers, state Medicaid agency decisions, Medicaid managed care organization (MCO) contract language, voluntary MCO offerings, or pilot projects under way to make the case for coverage. |
| Methods | Since March 2014, the Diabetes Prevention Recognition Program (DPRP) has generated a quarterly DPRP State Report for use by state and city/county health department recipients funded by CDC to report on required performance measures for two CDC cooperative agreements: DP18-1815, Improving the Health of Americans Through Prevention and Management of Diabetes, Heart Disease, and Stroke; and DP18-1817, Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes, Heart Disease, and Stroke. | State Medicaid coverage for the National DPP LCP is reported in the National DPP Coverage Toolkit at coveragetoolkit.org. | ||
| Data Year | 2022 | 2022 | 2022 | 2022 |
| Data Source | Division of Diabetes Translation, CDC. Diabetes Prevention Recognition Program Quarterly State-Level Evaluation Report. January 2022. | Data provided by the Division of Diabetes Translation, CDC. Calculations performed by CDC. | ||
*For the National Diabetes Profile, the totals were calculated by adding together the state numbers.
| Metric | Number of recognized/accredited DSMES service providers* | Number of people with diabetes with at least 1 encounter at a recognized/accredited DSMES service* |
|---|---|---|
| Level | State | State |
| Definition | Organizations with American Diabetes Association (ADA) recognition or Association of Diabetes Care & Education Specialists (ADCES) accreditation for DSMES services. | People with diabetes that have had at least one DSMES encounter with an organization that is ADA-recognized or ADCES-accredited. |
| Methods | Data were synthesized by CDC from 2020 ADA and ADCES annual status reports shared with CDC. | Data were synthesized by CDC from 2020 ADA and ADCES annual status reports shared with CDC. |
| Data Year | 2020 | 2020 |
| Data Source | Data provided by the Division of Diabetes Translation, CDC. Calculations performed by CDC. Unpublished data. | Data provided by the Division of Diabetes Translation, CDC. Calculations performed by CDC. Unpublished data. |
*For the National Diabetes Profile, the totals were calculated by adding together the state numbers.
Level
National
State
Definition
N/A
Program highlights related to type 2 diabetes prevention or diabetes management from two cooperative agreements: DP18-1815, Improving the Health of Americans Through Prevention and Management of Diabetes, Heart Disease, and Stroke (DP18-1817) and DP18-1817, Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes, Heart Disease, and Stroke (DP18-1817).
Methods
N/A
Each year of DP18-1815 and DP18-1817, recipients report their progress to CDC on required performance measures. CDC performed qualitative analysis of annual progress reports from the programs’ Year 3 budget period and developed a summary of each recipient’s progress. Year 3 covers June 2020-June 2021 for DP18-1815 and September 2020-September 2021 for DP18-1817. For each state, two high points (one related to type 2 diabetes prevention and one related to diabetes management) were selected by CDC to be featured on the state diabetes profile. For recipients of DP18-1817 that are local jurisdictions, highlights are attributed to the state in which the city or county is located.
Data Year(s)
N/A
2021
Data Source
N/A
Division of Diabetes Translation, CDC.
Level
National
State
Definition
The total number of people aged 18 years or older with diagnosed chronic kidney disease (CKD), excluding those with kidney failure.
N/A
Methods
Estimates are based on a single measure of albuminuria or serum creatinine; they do not account for persistence of albuminuria or levels of creatinine that are higher than normal as indicated by the Kidney Disease Improving Global Outcomes recommendations. For that reason, CKD cases in this report might be overestimated. Blood-pressure-lowering medications included angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers; diagnosed diabetes was self-reported.
N/A
Data Year(s)
2019
N/A
Data Source
Data from the 2015–2018 National Health and Nutrition Examination Survey and the CKD Epidemiology Collaboration (CKD-EPI) equation.
The number of adults with CKD stages 1–4 was estimated by applying the overall percentage to the 2019 US Census population aged 18 years or older.
For more information, visit: www.cdc.gov/kidneydisease/pdf/Chronic-Kidney-Disease-in-the-US-2021-h.pdf [PDF - 411 KB].
N/A
Level
National
State
Definition
Total Medicare fee-for-service (FFS) spending for beneficiaries aged >66 years with chronic kidney disease (CKD), excluding those with kidney failure.
N/A
Methods
The United States Renal Data System estimates the cost of caring for individuals with CKD using claims from Medicare Parts A, B, and D. Data are based on the Medicare 5% sample of FFS beneficiaries who reside in the 50 states, District of Columbia, or territories and aged ≥66 years on January 1, 2019, with CKD, and without ESRD the previous year. Costs are defined as insurance expenditures rather than true economic costs.
N/A
Data Year(s)
2019
N/A
Data Source
The United States Renal Data System (USRDS), funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH). For more information, visit: https://adr.usrds.org/2021/chronic-kidney-disease/6-healthcare-expenditures-for-persons-with-ckd.
N/A
Level
National
State
Definition
Permanent or uncorrectable vision loss among persons of all ages based on best-corrected visual acuity in the better-seeing eye.
Methods
Data were obtained through the Vision and Eye Health Surveillance System and estimates were produced using Bayesian meta-regression which allowed for the combination of multiple datasets to produce state-level prevalence estimates for visual acuity loss or blindness as reported by Flaxman et. al (2021). In addition to measured and self-reported data from nationally representative surveys, data from five population-based studies were also used to calculate the combined prevalence of visual acuity loss (best-corrected visual acuity) ([20/40 or worse Snellen score in the better-seeing eye] as measured by an eye care professional or blindness [20/200 or worse Snellen score in the better-seeing eye]). These estimates measure the best visual function obtainable with proper glasses or contact lenses. These estimates do not include vision loss due to inadequate corrective glasses or contacts (uncorrected refractive error). They also do not capture impairment caused only by visual field or contrast sensitivity problems. For more detailed information on methods please see publication: https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2779910
Data Year(s)
Estimates based on 2017 population estimates
Data Source
- Nationally representative survey data from the American Community Survey (2017), National Health and Nutrition Examination Survey (1999-2008), and National Survey of Children’s Health (2017).
- Population-based studies: (1) the Baltimore Pediatric Eye Disease Study (data collection period, 2003-2007; publication date, 2008); (2) the Chinese American Eye Study (data collection period, 2010-2013; publication date, 2016);(3) the Eye Diseases Prevalence Research Group (a meta-analysis of several earlier population-based studies; data collection period, 1985-1998; publication date, 2004); (4) the Los Angeles Latino Eye Study (data collection period, 2000-2003; publication date, 2004); and (5) the Multi-Ethnic Study of Atherosclerosis Cohort (data collection period, 2000-2004; publication date, 2015).
- Vision & Eye Health Surveillance System (VEHSS), CDC, Vision Health Initiative. For more information, visit: https://www.cdc.gov/visionhealth/vehss/index.html
Level
National
State
Definition
Total national direct and indirect costs attributable to vision loss.
Total state-level direct and indirect costs attributable to vision loss.
Methods
The total cost of vision loss nationally and in each state was obtained from CDC’s Vision Loss Economic Explorer, which uses federally funded national surveys and databases. Costs included medical costs, nursing home costs, productivity losses, and supportive services costs. Medical costs are defined as all payments exchanged for medical services and included inpatient services, ambulatory services, prescriptions, and other medical care services. Productivity losses include the monetary value of absenteeism, loss of household productivity, reduced labor force participation, informal care, and reduced wages. Supportive services costs include federal programs, school screening, special education, and vision rehabilitation. Costs of eye care not attributable to vision loss are not included.
Data Year(s)
2017
Data Source
The American Community Survey, State and National Health Expenditure Accounts, the Medical Expenditure Panel Survey, the National Health Interview Survey, and the Centers for Medicare and Medicaid Services Minimum Data Set. Vision & Eye Health Surveillance System , CDC, Vision Health Initiative. For more information, visit: https://www.cdc.gov/visionhealth/economics/index.html
Page last reviewed: September 15, 2022
Content source: Centers for Disease Control and Prevention