Risk Factors for Diabetes-Related Complications

Among US adults aged 18 years or older with diagnosed diabetes, crude estimates for 2015–2018 shown in Appendix Table 8 were:

Smoking

• 19.8% were tobacco users based on self-report or levels of serum cotinine.
• 13.8% reported current cigarette smoking.
• 37.1% had quit smoking but had a history of smoking at least 100 cigarettes in their lifetime.

Overweight and Obesity

• 89.8% were overweight or had obesity, defined as a body mass index (BMI) of 25 kg/m² or higher. Specifically:
  • 27.7% were overweight (BMI of 25.0 to 29.9 kg/m²).
  • 45.8% had obesity (BMI of 30.0 to 39.9 kg/m²).
  • 16.2% had extreme obesity (BMI of 40.0 kg/m² or higher).

Physical Inactivity

• 34.3% were physically inactive, defined as getting less than 10 minutes a week of moderate or vigorous activity in each physical activity category of work, leisure time, and transportation.

A1C

• 49.4% had an A1C value of 7.0% or higher. Specifically:
  • 24.9% had an A1C value of 7.0% to 7.9%.
  • 11.4% had an A1C value of 8.0% to 9.0%.
  • 13.2% had an A1C value higher than 9.0%.
• 10.4% of adults aged 18–44 years had A1C levels of 10% or higher, compared to 9.4% of those aged 45–64 years and 2.6% of those aged 65 years or older (Appendix Table 9).

High Blood Pressure

• 69.0% had a systolic blood pressure of 140 mmHg or higher or diastolic blood pressure of 90 mmHg or higher or were on prescription medication for their high blood pressure (Appendix Table 8).

High Cholesterol*

• 44.3% had a non-HDL level of 130 mg/dL or higher. Specifically:
  • 22.1% had a non-HDL level of 130 to 159 mg/dL.
  • 12.5% had a non-HDL level of 160 to 189 mg/dL.
  • 9.7% had a non-HDL level of 190 mg/dL or higher.

* Non-high-density lipoprotein cholesterol (non-HDL) contains all the atherogenic lipoproteins, including low-density lipoprotein cholesterol (LDL), very-low-density lipoprotein, lipoprotein(a), and others. Growing evidence supports non-HDL as a better predictor of cardiovascular disease risk than LDL.²