As it stands, one in 10 Americans has diabetes, but this could double — or even triple — by 2050 if current trends continue. These trends include the aging of the population, increasing rates of obesity, the fact that people with diabetes are living longer, and increases in the number of people belonging to minority groups at high risk for diabetes.
“The numbers are alarming,” says Ann Albright, PhD, RD, director of the CDC’s division of diabetes translation.
“We really need to focus more attention and effort on prevention.”
Part of the increase in diabetes prevalence is positive in nature, she says. “People are living longer, and we are identifying diabetes earlier in course of the diseases and improving outcomes for those that have the disease.”
“The major negative is the new cases of type 2 diabetes, and that is why prevention is so important,” she says.
“If we don’t work on prevention, these gains will be undermined.” Obesity is a major risk for type 2 diabetes, and it plays an important role in the increasing rates of type 2 diabetes.
Forecasting Diabetes Trends
Researchers used data on diabetes prevalence and U.S. census data to develop models of diabetes prevalence over the next 40 years. They came up with several estimates based on which way current trends move. For example, if current trends continue or increase, diabetes prevalence will increase from 14% in 2010 to up to 33% of the population by 2050. If, however, there were a leveling off of the number of new cases of diabetes each year, the proportion of the population with diabetes will still increase from 14% to 21%, the study shows.
Put another way: The number of Americans who have diabetes will increase to one in three or one in five by 2050 based on how many people are diagnosed with diabetes and how long they live after this diagnosis.
Certain lifestyle interventions have been proven to work, including the CDC’s National Diabetes Prevention Program that began earlier this year, she says. This program focuses on reducing body weight by 5% to 7% by emphasizing dietary changes and by gradually building up to 150 minutes of physical activity per week. The program also focuses on developing coping and behavioral strategies to help deal with issues that cause people to backslide.
“It can reduce the development of diabetes by close to 60%,” she says. “It doesn’t say ‘OK, here is the diet, we hope you can follow it,’” Albright says. “We actually help identify what their own barriers are.”
“Some of the increase in prevalence is due to things we can or would want to do something about, like the risks due to increasing rates of obesity and physical inactivity,” says M. Sue Kirkman, MD, senior vice president of the American Diabetes Association in Alexandria, Va., in an email.
“However, some of it is due to things we can’t or even wouldn’t want to do something about: people are living longer in general, people with diabetes are living longer after they’re diagnosed, and non-Caucasians at higher risk for diabetes are becoming a larger part of the U.S. population,” she says.
When it comes to diabetes prevention, “weight loss and increasing physical activity can make a big difference in terms of keeping or delaying people [with] prediabetes from getting type 2 diabetes, but it’s oversimplistic to think that diabetes prevalence won’t increase if we just implement prevention programs,” Kirkman says.
“For people at risk for diabetes, the main take-home messages are to be aware that they’re at risk, and if they have risk factors, they should get tested,” she says. “If they are diagnosed with diabetes, early treatment and taking good care of themselves will increase the chances of living a long and complication-free life.”
“What needs to be done is mass screening to detect all at risk and intervene aggressively and early to reduce risk,” says Gerald Bernstein, MD, the director of the diabetes management program at the Friedman Diabetes Institute of Beth Israel Medical Center in New York City. “The numbers are very real and probably severely understated.”