Data & Trends

Diabetes Surveillance System

1999 Surveillance Report

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

Introduction

Diabetes is a complex, serious, costly, and increasingly common disease (1-4). Diabetes can affect nearly every organ system of the body and is the most frequent cause of blindness among working-age adults; the leading cause of nontraumatic lower extremity amputation and end-stage renal disease; and a principal cause of congenital malformations, perinatal mortality, premature mortality, and disability. Persons with diabetes are at increased risk for stroke, ischemic heart disease, peripheral vascular disease, and neuropathy. Diabetes is a costly disease not only in terms of the economic burden it imposes on society but also in terms of the human suffering imposed by the disease and its complications. The burden of diabetes and its complications is great, disproportionately affects minority populations and the elderly, and is likely to increase as minority populations grow and the U.S. population becomes older (5-11). Thus, diabetes poses an enormous public health challenge in America.

Public health surveillance of diabetes and its complications is critical for increasing the recognition of the disease, identifying high-risk groups, developing strategies to reduce the economic and human cost of this disease, formulating health care policy, and evaluating progress in disease prevention and control. The Centers for Disease Control and Prevention (CDC) has established an ongoing surveillance system that collects, analyzes, and disseminates national data on diabetes and its complications. The surveillance system uses periodic and representative data from vital statistics, the National Health Interview Survey, the National Hospital Discharge Survey, the National Ambulatory Medical Care Survey, the National Hospital Ambulatory Medical Care Survey, the Behavioral Risk Factor Surveillance System, and the U.S. Renal Data System.

Although they are representative, the data provided by these sources tend to be insufficient for analyzing national trends in diabetes and its complications among most minority populations. This deficiency is unfortunate because data from special surveys and studies reveal that minority populations are disproportionately affected by diabetes (8-11). For example, the 1982-1984 age-adjusted prevalence of diabetes among Puerto Ricans in the New York City area and Mexican Americans in the Southwest was more than twice that for non-Hispanic whites (12,13). In 1996, the age-adjusted prevalence of diabetes among American Indian and Alaska Native adults was 2.8 times that among U.S. non-Hispanic white adults (14). The prevalence among American Indians varies by tribe, and the Pima Indians of Arizona have the highest recorded prevalence (approximately 50% of adults aged greater than or equal to 35 years) (15). Furthermore, racial and ethnic minority populations not only are more likely to have diabetes, but also are at greater risk for many of the complications.

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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