Is the incidence of diabetes leveling off?

From JAMA, “Prevalence and Incidence Trends for Diagnosed Diabetes Among Adults Aged 20 to 79 Years, United States, 1980-2012“:

IMPORTANCE Although the prevalence and incidence of diabetes have increased in the United States in recent decades, no studies have systematically examined long-term, national trends in the prevalence and incidence of diagnosed diabetes.

OBJECTIVE To examine long-term trends in the prevalence and incidence of diagnosed diabetes to determine whether there have been periods of acceleration or deceleration in rates.

DESIGN, SETTING, AND PARTICIPANTS We analyzed 1980-2012 data for 664 969 adults aged 20 to 79 years from the National Health Interview Survey (NHIS) to estimate incidence and prevalence rates for the overall civilian, noninstitutionalized, US population and by demographic subgroups (age group, sex, race/ethnicity, and educational level).

MAIN OUTCOMES AND MEASURES The annual percentage change (APC) in rates of the prevalence and incidence of diagnosed diabetes (type 1 and type 2 combined).

In a nutshell, researchers used the National Health Interview Survey to examine trends in the prevalence and incidence of diabetes in the US. In the 1980’s, these rates were pretty steady. Not surprisingly to anyone who hasn’t been living under a rock, rates started to rise after that, and in each year from 1990-2008, there was a pretty dramatic increase in the age-adjusted prevalence and incidence.

But what was surprising to me was that, starting in 2008, and continuing through 2012, there was no significant change. In fact, the incidence (or new diagnoses), seems to be dropping:

Diabetess trends

There are always caveats. There have been changes to how diabetes is diagnosed over this time, but the 1997 changes were well into the increase, and didn’t seem to affect the rate much. The 2010 change shouldn’t have affected things this dramatically either. There are still subgroups, such as Hispanic and African-American adults, for whom incidence is still rising. And even if the incidence continues to drop, the increased prevalence will mean that diabetes-related health issues and costs will continue to be a problem in the US.

That said, any good news about diabetes in the US is welcome. If this is real, then something has changed. A continued decrease in the incidence of diabetes in the future would have major implications for our health, and our spending on health care.


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