Diabetes Report Card 2019
The Diabetes Report Card pdf icon[PDF – 3MB] provides current information on the status of diabetes and its complications in the United States. It has been published every 2 years since 2012 by the Centers for Disease Control and Prevention (CDC).
This publication includes information and data on diabetes, preventive care practices, health outcomes, and risk factors such as race, ethnicity, level of education, and prediabetes. It also includes information about national trends and, to the extent possible, progress made by the states to meet national goals for improving diabetes care and reducing health care costs and the rate of new cases.
Public health professionals, policy makers, state health departments, and communities can use these data to focus their type 2 diabetes prevention and diabetes management efforts on areas of greatest need.1,2
- In the past decade, the annual rate of new cases of diabetes among US adults has been going down overall.
- Diabetes-related complications have increased among young adults aged 18–44 years and among middle-aged adults aged 45–64 years.
- The rate of new cases of diabetes among children and adolescents continues to grow.
- Nearly 1 in 5 adolescents aged 12–18 years and 1 in 4 young adults aged 19–34 years have prediabetes.
Diabetes is a group of diseases characterized by high blood sugar. When a person has diabetes, the body either does not make enough insulin (type 1) or is unable to properly use insulin (type 2). When the body does not have enough insulin or cannot use it properly, blood sugar (glucose) builds up in the blood. Prediabetes is a condition in which blood sugar is higher than normal but not high enough to be classified as diabetes.
People with diabetes can develop high blood pressure, high cholesterol, and high triglycerides (a type of fat in the blood). High blood sugar, particularly when combined with high blood pressure and high triglycerides, can lead to heart disease, stroke, blindness, kidney failure, amputations of the legs and feet, and even early death.
Diabetes is also associated with increased risk of certain types of cancer, such as liver, pancreas, uterine, colon, breast, and bladder cancer.3 High blood sugar also increases a person’s chance of developing dementia and Alzheimer’s disease.4 In addition, the average medical costs for people with diagnosed diabetes are 2.3 times higher than costs for people without diabetes.5 These higher costs are often caused by diabetes-related health conditions and resulting hospitalizations.
People with diabetes, their caregivers and health care providers, departments of health, policy makers, and community organizations can help to reduce the risk of serious diabetes-related complications.
For people with diabetes, research6–10 shows that:
- Blood sugar management can reduce the risk of eye disease, kidney disease, and nerve disease by 40%.
- Blood pressure management can reduce the risk of heart disease and stroke by 33% to 50% and decline in kidney function by 30% to 70%.
- Cholesterol management can reduce cardiovascular complications by 20% to 50%.
- Regular eye exams and timely treatment could prevent up to 90% of diabetes-related blindness.
- Regular foot exams and patient education could prevent up to 85% of diabetes-related amputations.
The estimates in this report were calculated by staff from CDC’s Division of Diabetes Translation and are available in more detail in CDC’s National Diabetes Statistics Report 2020 and from the USDSS. Diabetes data are from the US Census Bureau, the Indian Health Service’s National Data Warehouse, the SEARCH for Diabetes in Youth Study, and various surveys and data collection systems. These systems include the BRFSS, the National Health Interview Survey, the National Health and Nutrition Examination Survey, the National Hospital Discharge Survey, and the National Vital Statistics System.
To make meaningful comparisons between states and over time, we used the US Census Bureau’s 2000 US standard population to age-adjust our estimated rates. Age adjustment is a statistical process applied to rates of diseases, injuries, and health outcomes. It allows comparisons between communities with different age structures because it proportions rates to a standard age structure. Three-year moving averages are sometimes used to improve the precision of estimates. State estimates in this report card are based on BRFSS data. Because of the limitations of self-reported data in surveys, these estimates may underreport the rates of diagnosed diabetes and prediabetes in the US population.
- Centers for Disease Control and Prevention. Division of Diabetes Translation website. Diabetes Report Card. https://www.cdc.gov/diabetes/library/reports/reportcard.html. Accessed November 19, 2019.
- Patient Protection and Affordable Care Act of 2009. Pub. L No. 111-148,external icon Title X, Sec 10407, 42 USC 247b-9a.
- Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus reportexternal icon. Diabetes Care. 2010;33(7):1674–1685.
- Dolan C, Glynn R, Griffin S, et al. Brain complications of diabetes mellitus: a cross-sectional study of awareness among individuals with diabetes and the general population in Irelandexternal icon. Diabet Med. 2018;35(7):871–879.
- American Diabetes Association. Economic costs of diabetes in the U.S. in 2017external icon. Diabetes Care. 2018;41: 917–928.
- National High Blood Pressure Education Program. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressurepdf iconexternal icon. Bethesda, MD: National Heart, Lung, and Blood Institute; 2004.
- Daniel MJ. Lipid management in patients with type 2 diabetesexternal icon. Am Health Drug Benefits. 2011;4:312–322.
- Murchison AP, Hark L, Pizzi LT, et al. Non-adherence to eye care in people with diabetesexternal icon. BMJ Open Diabetes Res Care. 2017;5(1):e000333.
- Lewis EJ, Hunsicker LG, Clarke WR, et al; Collaborative Study Group. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetesexternal icon. N Engl J Med. 2001;345:851–860.
- Geiss LS, Li Y, Hora I, et al. Resurgence of diabetes-related nontraumatic lower-extremity amputation in the young and middle-aged adult US populationexternal icon. Diabetes Care. 2019;42(1):50–54.
- Bardenheier BH, Lin J, Zhuo X, et al. Disability-free life-years lost among adults aged ≥50 years with and without diabetesexternal icon. Diabetes Care. 2016;39(7):1222–1229.
- Centers for Disease Control and Prevention. National Diabetes Statistics Report 2020: Estimates of Diabetes and Its Burden in the United States. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2020.
- Benoit SR, Hora I, Albright AL, Gregg EW. New directions in incidence and prevalence of diagnosed diabetes in the USAexternal icon. BMJ Open Diab Res Care. 2019;7:e000657.
- Cheng YJ, Kanaya AM, Araneta MR, et al. Prevalence of diabetes by race and ethnicity in the United States, 2011-2016external icon. JAMA. 2019;322(24):2389–2398.
- Beckles GL, Chou C. Disparities in the prevalence of diagnosed diabetes — United States, 1999–2002 and 2011–2014. MMWR Morb Mortal Wkly Rep. 2016;65(45):1265–1269.
- Luo H, Beckles GL, Zhang X, Sotnikov S, Thompson T. The relationship between county-level contextual characteristics and use of diabetes care services.external icon J Public Health Manag Pract. 2014;20(4):401–410.
- Rutledge SA, Masalovich S, Blacher RJ, Saunders MM. Diabetes self-management education programs in nonmetropolitan counties — United States, 2016. MMWR Surveill Summ. 2017;66(10):1–6.
- ChangeLab Solutions. A Key Tool in Health Care: Diabetes Self-Management Education and Training (DSME/T). National Landscape: Background, Benefits, and Insurance Coverage of DSME/Tpdf iconexternal icon. Oakland, CA: ChangeLab Solutions; 2016.
- Divers J, Mayer-Davis EJ, Lawrence JM, et al. Trends in incidence of type 1 and type 2 diabetes among youths — selected counties and Indian reservations, United States, 2002–2015. MMWR Morb Mortal Wkly Rep. 2020;69:161–165.
- Dabelea D, Mayer-Davis EJ, Saydah S, et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009external icon. JAMA. 2014;311(17):1778–1786.
- Saydah S, Imperatore G, Cheng Y, Geiss LS, Albright A. Disparities in diabetes deaths among children and adolescents — United States, 2000–2014. MMWR Morb Mortal Wkly Rep. 2017;66(19):502–505.
- Andes LJ, Cheng YJ, Rolka DB, Gregg EW, Imperatore G. Prevalence of prediabetes among adolescents and young adults in the United States, 2005-2016.external icon JAMA Pediatrics. 2019:e194498.
- Introduction: standards of medical care in diabetes—2020external icon. Diabetes Care. 2020;43(1):S1–S2.
- Powers MA, Bardsley J, Cypress M, et al. Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics.external icon J Acad Nutr Diet. 2015;115(8):1323–1334.
- Burd C, Gruss S, Albright A, et al. Translating knowledge into action to prevent type 2 diabetes: Medicare expansion of the National Diabetes Prevention Program lifestyle interventionexternal icon. Milbank Q. 2020;98(1): 172–196.
- Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metforminexternal icon. N Engl J Med. 2002;346(6):393–403.
- New prediabetes awareness campaign features unexpected animal videos to encourage Americans to learn their risk [news release]. New York, NY: Ad Council; July 25, 2017.
- Centers for Disease Control and Prevention. US Diabetes Surveillance System website. https://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html. Accessed May 21, 2019.
- Centers for Disease Control and Prevention. Diabetes State Burden Toolkit website. https://nccd.cdc.gov/Toolkit/DiabetesBurden. Accessed November 20, 2019.
- Centers for Disease Control and Prevention. Diabetes Prevention Impact Toolkit website. https://nccd.cdc.gov/Toolkit/DiabetesImpact. Accessed November 20, 2019.
- Centers for Disease Control and Prevention. Diabetes Self-Management Education and Support Toolkit website. https://www.cdc.gov/diabetes/dsmes-toolkit. Accessed November 20, 2019.
- National Association of Chronic Disease Directors. National Diabetes Prevention Program Coverage Toolkit website. https://coveragetoolkit.org/external icon. Accessed November 20, 2019.
- Centers for Disease Control and Prevention. National Diabetes Prevention Program website. Registry of All Recognized Organizations. https://nccd.cdc.gov/DDT_DPRP/Registry.aspx. Accessed November 20, 2019.
- Centers for Disease Control and Prevention. National Diabetes Prevention Program Customer Service Center website. https://nationaldppcsc.cdc.gov/s/. Accessed February 10, 2020.
- Centers for Disease Control and Prevention. CDC-Recognized Lifestyle Change Program website. How Pharmacists Can Participate. https://www.cdc.gov/diabetes/prevention/lifestyle-program/deliverers/pharmacists.html. Accessed November 20, 2019.
- Centers for Disease Control and Prevention. Chronic Kidney Disease (CKD) Surveillance System website. https://nccd.cdc.gov/ckd/default.aspx. Accessed November 20, 2019.
- Centers for Disease Control and Prevention. Vision Health Initiative website. State Profiles. https://www.cdc.gov/visionhealth/data/state-profiles/index.htm. Accessed November 20, 2019.
Purpose of This Report
This report is required under the Catalyst to Better Diabetes Care Act of 2009 (Section 10407 of Public Law 111-148). This act calls for a diabetes report card that includes information and data about diabetes, prediabetes, preventive care practices, risk factors, quality of care, diabetes outcomes, and, to the extent possible, trend and state data.
Centers for Disease Control and Prevention. Diabetes Report Card 2019. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2020.
Website addresses of nonfederal organizations are provided solely as a service to readers. Provision of an address does not constitute an endorsement of this organization by CDC or the federal government, and none should be inferred. CDC is not responsible for the content of other organizations’ web pages.