Memorandum
Today, JAMA published what is sure to be a closely-studied article on the prevalence and trends in diabetes among US adults between 1988 and 2012. The study examined the 2011-2012 NHANES data (n=2,781) and compared this to the surveys between 1988-1994 and 1999-2012 (an additional 23,634 adults from 1988-2010). Results demonstrated that in 2011-2012, the estimated prevalence of diabetes was 12% to 14% among US adults, with higher prevalence among blacks, Asians, and Hispanics. Specifically, prevalence increased from 9.8% in 1988-1994 to 10.8% in 2001-2002 to 12.4% in 2011-2012, increasing significantly in virtually every group you can think of – specifically, both sexes, all age groups, all racial/ethnic groups, all education levels, and all poverty income ratio tertiles. Regarding prediabetes, researchers estimated that 38% of adults had prediabetes in 2011-2012, increasing from 29% in 1999-2002 and from 36% in 2007-2010. While some media may call this a “plateau” given it’s brand new data from only two years after the last data, we wouldn’t say that the addition of an extra close to five million people with prediabetes in two to four years should be perceived as comforting. In sum, the 2011-2012 data estimate that 49% to 52% of the adult population had either diabetes or prediabetes; for those over 65 years of age, this number is a whopping 83% (33% with diabetes, 50% with prediabetes). However, as the article points out, “total prevalence” estimates seemed to have plateaued between 2007-2008 and 2011-2012 from 12.5% to 12.4% (consistent with JAMA’s past prevalence data using NHIS data), reflecting similar recent obesity trends. We’ll dig into the numbers to better understand this. On what we see as a truly bright note (perhaps the main one in the report), the proportion of undiagnosed diabetes has decreased from 40% in 1988-1994 to 31% in 2011-2012, reflecting better screening among those with diagnosed diabetes – we are especially glad to see this trend as the greater public health movement toward prevention (such as the USPSTF recommendation on screening) may be making a positive impact. An accompanying editorial and review (by the renowned Dr. David Nathan at Mass General) also express a more positive reflection on the field’s recent trends. Specifically, Dr. Nathan emphasizes that better treatments for cardiovascular disease and microvascular complications have led to a more optimistic outlook for people with diabetes – we’ll have more on his view later this week. In the meantime, please see our last coverage on diabetes prevalence data from JAMA and stay tuned for a more in-depth analysis of this new research. In the meantime, we’d love your take.