Data & Trends

Diabetes Surveillance System

1999 Surveillance Report

Chapter 1: The Public Health Burden of Diabetes Mellitus in the United States

Data Analysis

This report presents data from CDC's diabetes surveillance system. The report contains chapters with figures and tables on diabetes prevalence and incidence, mortality, use of health care services, cardiovascular disease, nontraumatic lower extremity amputation, diabetic ketoacidosis, end-stage renal disease, and disability. In each chapter, the data displayed were limited to specific demographic subgroups for which relatively stable estimates could be obtained. Where possible, we examined trends in diabetes and its complications by age, sex, and race. More than 1 year of data was used for some estimates to improve the precision and reliability. Typically, these estimates were based on 3-year moving averages, where 3 years of data were used to provide an estimate for the middle year. Also, where possible, estimates were provided by state.

In many chapters, we examined the burden of diabetes by using two different methods for calculating rates. First, we calculated rates by using estimates of the resident population of the United States as the denominator. These rates were age-adjusted according to the direct method, and the 1980 U.S. population was the standard (Table 1.1). Second, we calculated rates of diabetes complications and use of health services by using estimates of the number of persons with diabetes as the denominator. These rates were age-adjusted according to the direct method, and the 1980 U.S. population of persons with diabetes was the standard.

Both types of rates in this report are important but give a different view of diabetes. Rates with the U.S. population in the denominator are useful for describing the extent of diabetes and its complications in the whole population. For example, such rates can be used to rank diabetes among leading causes of death or describe the proportion of the population having diagnosed diabetes. In contrast, rates based on estimates of the number of persons with diabetes in the denominator describe the effect of conditions and complications in the diabetic population rather than in the whole population. By adjusting for the prevalence of diabetes, we can use these rates to compare the risk of mortality and diabetic complications among subgroups of persons with diabetes. For example, such rates can be used to describe the characteristics of persons with diabetes who are at risk for hospitalization, end-stage renal disease, or lower extremity amputation.

This report differs from prior reports in that it contains a new chapter on preventive care practices. Information about the methods used in this report, including the data sources and their limitations, can be found in the Appendix

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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