Diabetes expected in up to 1/3 of Americans by 2050

Over the past 40 years, the total prevalence of diabetes in the United States is expected to increase from its current level of about 1 in 10 adults to as many as 1 in 3 by 2050.

The estimate, which includes both diagnosed and undiagnosed diabetes, comes from a new statistical modeling of data from the 2000 Census of the Centers for Disease Control and Prevention (CDC). The project increase in diabetes prevalence is attributed to the aging of the US population, increasing size of higher-risk minority populations, and declining mortality among people with diabetes, according to the CDC’s Division of Diabetes Translation and Emory University, Atlanta.

“Our estimates of diabetes prevalence paint a sobering picture of the future growth of diabetes. The projected loss in quality of life and the projected costs of providing health care could be significant,” the investigators said in their paper, published in the journal Population Health Metrics.

Previous projections of the prevalence, incidence, and total number of diabetes cases in the United States are outdated because they relied on 1990 census projections, which overestimated current mortality rates and did not account for the increasing size of the Hispanic and foreign-born US populations at higher risk for diabetes. In contrast, the current analysis included 2000 Census-based estimates of the 2007 population and estimates of mortality rates, births, and migration from 2009 through 2050, along with CDC data on diabetes incidence rates among adults aged 18-79 years during 1980-2007.

Historically, incidence of diabetes in the United States ranged from 3 cases per 1,000 population in 1980 to 8 per 1,000 in 2007. The “middle incidence” scenario — reflecting recent rate increases — projects an increase of 8 cases per 1,000 in 2008 to 15 cases per 1,000 in 2050.

According to the new projection, the prevalence of diagnosed or undiagnosed diabetes would increase from 14% in 2010 to 25% in 2050 under a low incidence/low mortality risk scenario, 21% with low incidence/high mortality, 33% with middle incidence/low mortality risk, and 28% for middle incidence/high mortality.