Diabetes is a common disease. In 1996, about 8.5 million people in the United States (3.2% of the population) had been diagnosed with this disease. Between 1980 and 1996, diabetes became more common. The number of persons with diagnosed diabetes increased by 2.7 million, and in the 1990s the number of new cases averaged more than 760,000 per year. Between 1980 and 1996, the age-adjusted prevalence of diabetes increased by 19%, and the age-adjusted incidence increased by 18%. Most of the increase in both prevalence and incidence occurred in the 1990s. It is unknown whether the increased incidence of diabetes is due to increased incidence of disease, increased disease ascertainment, or both. Regardless of the reasons for the increase, effective intervention strategies are urgently needed for the primary prevention of diabetes. Currently, clinical trials are ongoing to determine whether type 2 diabetes (the most prevalent form of diabetes, accounting for 90%-95% of diabetes) and type 1 diabetes can be prevented.

In addition to being a common disease, diabetes is a complex, serious, and costly disease. Diabetes can affect nearly every body organ. Microvascular (e.g., kidney) and macrovascular (e.g., IHD) complications are common and can be devastating. In 1996, diabetes was the 7th leading cause of death in the United States and contributed to the deaths of over 193,000 persons. In 1996, diabetes also contributed to 3.8 million hospital discharges, and about half of all persons with diabetes reported being limited in activity. Furthermore, diabetes has become increasingly more serious and costly in terms of death, human suffering and disability, and use of health care services. Between 1980 and 1996, diabetes-related deaths per year increased from about 136,000 deaths to about 193,000 deaths. Hospitalizations increased from 2.2 million discharges to 3.8 million discharges. Hospital discharges for CVD increased from 573,000 to more than 1.3 million. Hospitalizations for diabetes-related amputations increased from 36,000 to 86,000 per year. Persons with diabetes who were limited in activity increased from 3.1 million persons to 4.1 million. New cases of ESRD-DM increased from about 7,000 cases in 1984 to more than 31,000 cases in 1996.

In 1996, major CVD accounted for a large proportion of diabetes-related deaths (43%) and diabetes-related hospitalizations (34%). Although there have been few long-term clinical trials of the effect of cardiovascular risk factor reduction on morbidity and mortality in the population with diabetes, it is possible that a substantial proportion of mortality and morbidity related to diabetes could be prevented by reducing or preventing cardiovascular risk factors. Furthermore, in recent clinical trials, treatment of lipid abnormalities and uncontrolled blood pressure has been found effective in reducing CVD events (35-41). Other efforts to reduce CVD among persons with diabetes should promote exercise, weight control, smoking prevention and cessation, hypertension prevention, glycemic control, and elimination of barriers to preventive care and treatment.

Diabetes is the leading cause of renal failure, accounting for approximately 40% of all new cases (26). In 1996, diabetes was responsible for more than 31,000 new cases of ESRD, and the rate of new cases per 100,000 diabetic population more than tripled between 1984 and 1996. In addition to the intervention efforts outlined above for reducing CVD, annual monitoring for early markers of renal disease should be undertaken to prevent or slow the progression of ESRD.

Minority populations share a disproportionate burden of diabetes compared to non-Hispanic whites (8-11). Blacks and other racial/ethnic minorities were more likely than whites to develop diabetes and to be at greater risk for many of the complications of the disease. Blacks, American Indians, and persons of Hispanic origin had higher diabetes death rates than whites. Compared with whites, blacks had higher rates of hospital discharges with diabetes and DKA as the primary diagnoses, DKA death rates, hospital discharges involving an LEA, ESRD-DM incidence, and disability. Whether this increased risk of mortality and complications among minority populations reflects more severe disease, barriers to health care services (including preventive care services), or a combination of these and other factors remains undetermined. Our surveillance data and other data sources highlight the need to intensify prevention efforts among blacks, Hispanics, American Indians, and other minorities who disproportionately suffer from the burden of diabetes and its complications.

Diabetes is a common, complex, serious, and costly disease. The human suffering and economic burden of diabetes on the U.S. population is substantial and growing. Many Americans are affected by diabetes, either by having the disease themselves or by having a friend or loved one with the disease. The human suffering caused by diabetes may be reduced by effective, targeted interventions. This report has tracked and identified trends in diabetes and its complications. These public health surveillance data will provide vital information to formulate an effective public health response.

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This page last reviewed January 18, 2005.

United States Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Diabetes Translation