National Diabetes Statistics, 2011
Fast Facts on Diabetes
Diabetes affects 25.8 million people of all ages
8.3 percent of the U.S. population
DIAGNOSED
18.8 million people
UNDIAGNOSED
7.0 million people
- Among U.S. residents ages 65 years and older, 10.9 million, or 26.9 percent, had diabetes in 2010.
- About 215,000 people younger than 20 years had diabetes—type 1 or type 2—in the United States in 2010.
- About 1.9 million people ages 20 years or older were newly diagnosed with diabetes in 2010 in the United States.
- In 2005–2008, based on fasting glucose or hemoglobin A1C (A1C) levels, 35 percent of U.S. adults ages 20 years or older had pre-diabetes—50 percent of adults ages 65 years or older. Applying this percentage to the entire U.S. population in 2010 yields an estimated 79 million American adults ages 20 years or older with pre-diabetes.
- Diabetes is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness among adults in the United States.
- Diabetes is a major cause of heart disease and stroke.
- Diabetes is the seventh leading cause of death in the United States.
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Estimation Methods
The estimates in this fact sheet were derived from various data systems of the Centers for Disease Control and Prevention (CDC), the Indian Health Service’s (IHS’s) National Patient Information Reporting System (NPIRS), the U.S. Renal Data System of the
National Institutes of Health (NIH), the U.S. Census Bureau, and published studies. The estimated percentages and the total number of people with diabetes and pre-diabetes were derived from 2005–2008 National Health and Nutrition Examination Survey (NHANES),
2007–2009 National Health Interview Survey, 2009 IHS data, and 2010 U.S. resident population estimates. The diabetes and pre-diabetes estimates from NHANES were applied to the 2010 U.S. resident population estimates to derive the estimated number of adults with diabetes or pre-diabetes.
The methods used to generate the estimates
for the fact sheet may vary over time and need
to be considered before comparing fact sheets.
In contrast to National Diabetes Statistics, 2007,
which used fasting glucose data to estimate
undiagnosed diabetes and pre-diabetes,
National Diabetes Statistics, 2011 uses both fasting
glucose and A1C levels to derive estimates
for undiagnosed diabetes and pre-diabetes.
These tests were chosen because they are most
frequently used in clinical practice.
Detailed information about the data sources,
methods, and references are available at
www.cdc.gov/diabetes/pubs/references11.htm.
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Diagnosed and Undiagnosed Diabetes among People Ages 20 Years or Older, United States, 2010
| Group |
Number or percentage who have diabetes |
| Ages 20 years or older |
25.6 million, or 11.3 percent, of all people in this age group |
| Ages 65 years or older |
10.9 million, or 26.9 percent, of all people in this age group |
| Men |
13.0 million, or 11.8 percent, of all men ages 20 years or older |
| Women |
12.6 million, or 10.8 percent, of all women ages 20 years or older |
| Non-Hispanic whites |
15.7 million, or 10.2 percent, of all non-Hispanic whites ages 20 years or older |
| Non-Hispanic blacks |
4.9 million, or 18.7 percent, of all non-Hispanic blacks ages 20 years or older |
Sufficient data are not available to estimate the total prevalence of diabetes—diagnosed and undiagnosed—for
other U.S. racial/ethnic minority populations.
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Diagnosed and Undiagnosed Diabetes
Source: 2005–2008 National Health and Nutrition
Examination Survey
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Diagnosed Diabetes
Diagnosed Diabetes among
People Younger than 20 Years of
Age, United States, 2010
About 215,000 people younger than 20 years
have diabetes—type 1 or type 2. This represents
0.26 percent of all people in this age
group. Estimates of undiagnosed diabetes are
unavailable for this age group.
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Racial and Ethnic Differences in Diagnosed Diabetes
National estimates of diagnosed diabetes for
some but not all minority groups are available
from national survey data and from the IHS
NPIRS, which includes data for about 1.9 million
American Indians and Alaska Natives in
the United States who receive health care from
the IHS. Differences in diabetes prevalence by
race/ethnicity are partially attributable to age
differences. Adjustment for age makes results
from racial/ethnic groups more comparable.
Data from the 2009 IHS NPIRS indicate that
14.2 percent of American Indians and Alaska
Natives ages 20 years or older who received
care from the IHS had diagnosed diabetes.
After adjusting for population age differences,
16.1 percent of the total adult population
served by the IHS had diagnosed diabetes, with
rates varying by region from 5.5 percent among
Alaska Native adults to 33.5 percent among
American Indian adults in southern Arizona.
After adjusting for population age differences,
2007–2009 national survey data for people
ages 20 years or older indicate that 7.1 percent
of non-Hispanic whites, 8.4 percent of
Asian Americans, 11.8 percent of Hispanics/
Latinos, and 12.6 percent of non-Hispanic
blacks had diagnosed diabetes. Among
Hispanics/Latinos, rates were 7.6 percent for
both Cuban Americans and for Central and
South Americans, 13.3 percent for Mexican
Americans, and 13.8 percent for Puerto Ricans.
Compared with non-Hispanic white adults, the
risk of diagnosed diabetes was 18 percent
higher among Asian Americans, 66 percent
higher among Hispanics/Latinos, and
77 percent higher among non-Hispanic
blacks. Among Hispanics/Latinos compared
with non-Hispanic white adults, the risk of
diagnosed diabetes was about the same for
Cuban Americans and for Central and South
Americans, 87 percent higher for Mexican
Americans, and 94 percent higher for Puerto
Ricans.
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New Cases of Diagnosed Diabetes
Source: 2007–2009 National Health Interview Survey
estimates projected to the year 2010
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New Cases of Diagnosed Diabetes among People Younger than 20 Years of Age, United States, 2002–2005
SEARCH for Diabetes in Youth is a multicenter
study funded by the CDC and the NIH
to examine diabetes—type 1 and type 2—among children and adolescents in the United
States. SEARCH findings for the communities
studied include the following:
- During 2002–2005, 15,600 youth were newly diagnosed with type 1 diabetes annually, and 3,600 youth were newly diagnosed with type 2 diabetes annually.
- Among youth ages younger than 10 years, the rate of new cases was 19.7 per 100,000 each year for type 1 diabetes and 0.4 per 100,000 for type 2 diabetes. Among youth ages 10 years or older, the rate of new cases was 18.6 per 100,000 each year for
type 1 diabetes and 8.5 per 100,000 for type 2 diabetes.
- Non-Hispanic white youth had the highest
rate of new cases of type 1 diabetes—24.8
per 100,000 per year among those younger
than 10 years and 22.6 per 100,000 per
year among those ages 10–19 years.
- Type 2 diabetes was extremely rare among
youth ages younger than 10 years. While
still infrequent, rates were greater among
youth ages 10–19 years than in younger children, with higher rates among U.S.
minority populations than in non-Hispanic
whites.
- Among non-Hispanic white youth ages
10–19 years, the rate of new cases was
higher for type 1 than for type 2 diabetes.
For Asian/Pacific Islander Americans and
American Indian youth ages 10–19 years,
the opposite was true—the rate of new
cases was greater for type 2 than for type 1
diabetes. Among non-Hispanic black and
Hispanic/Latino youth ages 10–19 years,
the rates of new cases of type 1 and type 2
diabetes were similar.
Source: SEARCH for Diabetes in Youth Study
NHW=non-Hispanic whites; NHB=non-Hispanic blacks; H=Hispanics/Latinos;
API=Asian/Pacific Islander Americans; AI=American Indians
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Pre-diabetes
Pre-diabetes among People Ages 20 Years or Older, United States, 2010
- Pre-diabetes is a condition in which
individuals have blood glucose, also called
blood sugar, or A1C levels higher than
normal but not high enough to be classified
as diabetes. People with pre-diabetes
have an increased risk of developing
type 2 diabetes, heart disease, and stroke.
- Studies have shown that people with pre-diabetes
who lose weight and increase
their physical activity can prevent or delay
type 2 diabetes and in some cases return
their blood glucose levels to normal.
- In 2005–2008, based on fasting glucose
or A1C levels, 35 percent of U.S. adults
ages 20 years or older had pre-diabetes—50 percent of those ages 65 years or older.
Applying this percentage to the entire
U.S. population in 2010 yields an estimated
79 million Americans ages 20 years
or older with pre-diabetes.
- On the basis of fasting glucose or A1C levels,
and after adjusting for population age
differences, the percentage of U.S. adults
ages 20 years or older with pre-diabetes in
2005–2008 was similar for non-Hispanic
whites, 35 percent; non-Hispanic blacks,
35 percent; and Mexican Americans,
36 percent.
- Using a different data source than for
other race/ethnicity groups, a different
age group, and a different definition on
the basis of fasting glucose levels only, and
after adjusting for population age differences,
20 percent of American Indians
ages 15 years or older had pre-diabetes in
2001–2004.
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Gestational Diabetes in the United States
- Reported rates of gestational diabetes range from 2 to 10 percent of pregnancies.
- Immediately after pregnancy, 5 to 10 percent
of women with gestational diabetes
are found to have diabetes, usually type 2.
- Women who have had gestational diabetes
have a 35 to 60 percent chance of developing
diabetes in the next 10–20 years.
- New diagnostic criteria for gestational
diabetes will increase the proportion of
women diagnosed with gestational diabetes.
Using these new diagnostic criteria,
an international, multicenter study of
gestational diabetes found that 18 percent
of the pregnancies were affected by gestational
diabetes.
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Treatment of Diabetes
Source: 2007–2009 National Health Interview Survey
Among adults with diagnosed diabetes—type 1 or type 2—12 percent take insulin only,
14 percent take both insulin and oral medication,
58 percent take oral medication only, and
16 percent do not take either insulin or oral
medication.
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Deaths among People with Diabetes, United States, 2007
- Diabetes was the seventh leading cause
of death based on U.S. death certificates
in 2007. This ranking is based on the
71,382 death certificates in 2007 in which
diabetes was the underlying cause of
death. Diabetes was a contributing cause
of death in an additional 160,022 death
certificates for a total of 231,404 certificates
in 2007 in which diabetes appeared
as any-listed cause of death.
- Diabetes is likely to be underreported as
a cause of death. Studies have found that
about 35 to 40 percent of decedents with
diabetes had it listed anywhere on the
death certificate and about 10 to 15 percent
had it listed as the underlying cause
of death.
- Overall, the risk for death among people
with diabetes is about twice that of people
of similar age but without diabetes.
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Estimated Diabetes Costs in the United States, 2007
| Total costs—direct and indirect |
$174 billion |
| Direct medical costs |
$116 billion—after adjusting
for population age and sex
differences, average medical
expenditures among people
with diagnosed diabetes were
2.3 times higher than what
expenditures would be in the
absence of diabetes |
| Indirect costs |
$58 billion—disability, work
loss, premature mortality |
Medical expenses for people with diabetes
are more than 2 times higher than for people
without diabetes.
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Complications of Diabetes in the United States
Heart Disease and Stroke
- In 2004, heart disease was noted on 68 percent of diabetes-related death certificates among people ages 65 years or older.
- In 2004, stroke was noted on 16 percent of diabetes-related death certificates among people ages 65 years or older.
- Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.
- The risk for stroke is 2 to 4 times higher among people with diabetes.
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Hypertension
- In 2005–2008, of adults ages 20 years
or older with self-reported diabetes,
67 percent had blood pressure greater
than or equal to 140/90 millimeters of
mercury (mmHg) or used prescription
medications for hypertension.
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Blindness and Eye Problems
- Diabetes is the leading cause of new cases of blindness among adults ages 20–74 years.
- In 2005–2008, 4.2 million—28.5 percent—people with diabetes ages 40 years or
older had diabetic retinopathy, and of
these, 655,000—4.4 percent of those with
diabetes—had advanced diabetic retinopathy
that could lead to severe vision loss.
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Kidney Disease
- Diabetes is the leading cause of kidney
failure, accounting for 44 percent of all
new cases of kidney failure in 2008.
- In 2008, 48,374 people with diabetes
began treatment for end-stage kidney
disease.
- In 2008, a total of 202,290 people with
end-stage kidney disease due to diabetes
were living on chronic dialysis or with a
kidney transplant.
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Nervous System Disease
- About 60 to 70 percent of people with
diabetes have mild to severe forms of
nervous system damage. The results of
such damage include impaired sensation
or pain in the feet or hands, slowed digestion
of food in the stomach, carpal tunnel
syndrome, erectile dysfunction, or other
nerve problems.
- Almost 30 percent of people with diabetes
ages 40 years or older have impaired
sensation in the feet, for example, at least
one area that lacks feeling.
- Severe forms of diabetic nerve disease
are a major contributing cause of lower-extremity
amputations.
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Amputations
- More than 60 percent of nontraumatic
lower-limb amputations occur in people
with diabetes.
- In 2006, about 65,700 nontraumatic lower-limb
amputations were performed in
people with diabetes.
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Dental Disease
- Periodontal, or gum, disease is more
common in people with diabetes. Among
young adults, those with diabetes have
about twice the risk of those without
diabetes.
- Adults ages 45 years or older with
poorly controlled diabetes—A1C above
9 percent—were 2.9 times more likely
to have severe periodontitis than those
without diabetes. The likelihood was even
greater—4.6 times—among smokers with
poorly controlled diabetes.
- About one-third of people with diabetes
have severe periodontal disease consisting
of loss of attachment—5 millimeters or
more—of the gums to the teeth.
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Complications of Pregnancy
- Poorly controlled diabetes before conception
and during the first trimester of
pregnancy among women with type 1
diabetes can cause major birth defects
in 5 to 10 percent of pregnancies and
spontaneous abortions in 15 to 20 percent
of pregnancies. On the other hand, for a
woman with pre-existing diabetes, optimizing
blood glucose levels before and
during early pregnancy can reduce the risk
of birth defects in their infants.
- Poorly controlled diabetes during the second
and third trimesters of pregnancy can
result in excessively large babies, posing a
risk to both mother and child.
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Other Complications
- Uncontrolled diabetes often leads
to biochemical imbalances that can
cause acute life-threatening events,
such as diabetic ketoacidosis and
hyperosmolar—nonketotic—coma.
- People with diabetes are more susceptible
to many other illnesses. Once they
acquire these illnesses, they often have
worse prognoses. For example, they are
more likely to die with pneumonia or
influenza than people who do not have
diabetes.
- People with diabetes ages 60 years or
older are 2 to 3 times more likely to report
an inability to walk one-quarter of a mile,
climb stairs, or do housework compared
with people without diabetes in the same
age group.
- People with diabetes are twice as likely
to have depression, which can complicate
diabetes management, than people without
diabetes. In addition, depression is
associated with a 60 percent increased risk
of developing type 2 diabetes.
As indicated above, diabetes can affect many
parts of the body and can lead to serious
complications such as blindness, kidney damage,
and lower-limb amputations. Working
together, people with diabetes, their support
network, and their health care providers can
reduce the occurrence of these and other diabetes
complications by controlling the levels of
blood glucose, blood pressure, and blood lipids,
and by receiving other preventive care practices
in a timely manner.
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Preventing Diabetes Complications
Glucose Control
- Studies in the United States and abroad
have found that improved glycemic control
benefits people with either type 1 or
type 2 diabetes. In general, every percentage
point drop in A1C blood test results,
for example, from 8.0 to 7.0 percent,
can reduce the risk of microvascular
complications—eye, kidney, and nerve
diseases—by 40 percent. The absolute
difference in risk may vary for certain
subgroups of people.
- In patients with type 1 diabetes, intensive
insulin therapy has long-term beneficial
effects on the risk of cardiovascular
disease.
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Blood Pressure Control
- Blood pressure control reduces the risk of
cardiovascular disease—heart disease or
stroke—among people with diabetes by
33 to 50 percent and the risk of microvascular
complications—eye, kidney, and
nerve diseases—by about 33 percent.
- In general, for every 10 mmHg reduction
in systolic blood pressure, the risk for
any complication related to diabetes is
reduced by 12 percent.
- No benefit of reducing systolic blood pressure
below 140 mmHg has been demonstrated
in randomized clinical trials.
- Reducing diastolic blood pressure from
90 mmHg to 80 mmHg in people with
diabetes reduces the risk of major cardiovascular
events by 50 percent.
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Control of Blood Lipids
- Improved control of LDL, or bad, cholesterol
can reduce cardiovascular complications
by 20 to 50 percent.
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Preventive Care Practices for Eyes, Feet, and Kidneys
- Detecting and treating diabetic eye
disease with laser therapy can reduce the
development of severe vision loss by an
estimated 50 to 60 percent.
- About 65 percent of adults with diabetes
and poor vision can be helped by appropriate
eyeglasses.
- Comprehensive foot care programs—ones
that include risk assessment, foot-care
education and preventive therapy, treatment
of foot problems, and referral to
specialists—can reduce amputation rates
by 45 to 85 percent.
- Detecting and treating early diabetic
kidney disease by lowering blood pressure
can reduce the decline in kidney function
by 30 to 70 percent. Treatment with
particular medications for hypertension
called angiotensin-converting enzyme
(ACE) inhibitors and angiotensin receptor
blockers (ARBs) is more effective in
reducing the decline in kidney function
than is treatment with other blood pressure
lowering drugs.
- In addition to lowering blood pressure,
ARBs and ACE inhibitors reduce proteinuria,
a risk factor for developing kidney
disease, by about 35 percent.
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General Information
What is diabetes?
Diabetes is a group of diseases marked by high
levels of blood glucose resulting from defects
in insulin production, insulin action, or both.
Diabetes can lead to serious complications and
premature death, but people with diabetes,
working together with their support network
and their health care providers, can take steps
to control the disease and lower the risk of
complications.
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Types of Diabetes
Type 1 diabetes was previously called insulin-dependent
diabetes mellitus (IDDM) or
juvenile-onset diabetes. Type 1 diabetes develops
when the body’s immune system destroys
pancreatic beta cells, the only cells in the body
that make the hormone insulin that regulates
blood glucose. To survive, people with type 1
diabetes must have insulin delivered by injection
or a pump.
This form of diabetes usually strikes children
and young adults, although disease onset can
occur at any age. In adults, type 1 diabetes
accounts for about 5 percent of all diagnosed
cases of diabetes. Risk factors for type 1
diabetes may be autoimmune, genetic, or
environmental. No known way to prevent
type 1 diabetes exists. Several clinical trials
for preventing type 1 diabetes are currently in
progress or are being planned.
Type 2 diabetes was previously called
non-insulin-dependent diabetes mellitus
(NIDDM) or adult-onset diabetes. In adults,
type 2 diabetes accounts for about 90 to
95 percent of all diagnosed cases of diabetes.
Type 2 diabetes usually begins as insulin
resistance, a disorder in which the cells do not
use insulin properly. As the need for insulin
rises, the pancreas gradually loses its ability to
produce insulin.
Type 2 diabetes is associated with older age,
obesity, family history of diabetes, history of
gestational diabetes, impaired glucose metabolism,
physical inactivity, and race/ethnicity.
African Americans, Hispanic/Latino Americans,
American Indians, and some Asian Americans
and Native Hawaiians or other Pacific Islander
Americans are at particularly high risk for
type 2 diabetes and its complications. Type 2
diabetes in children and adolescents, although
still rare, is being diagnosed more frequently
among American Indians, African Americans,
Hispanic/Latino Americans, and Asian/Pacific
Islander Americans.
Gestational diabetes is a form of glucose intolerance
diagnosed during pregnancy. Gestational
diabetes occurs more frequently among African
Americans, Hispanic/Latino Americans, and
American Indians. Gestational diabetes is also
more common among obese women and women
with a family history of diabetes. During pregnancy,
gestational diabetes requires treatment to
optimize maternal blood glucose levels to lessen
the risk of complications in the infant.
Other types of diabetes result from specific
genetic conditions, such as maturity-onset diabetes
of youth; surgery; medications; infections;
pancreatic disease; and other illnesses. Such
types of diabetes account for 1 to 5 percent of all
diagnosed cases.
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Treating Diabetes
Diet, insulin, and oral medication to lower blood
glucose levels are the foundation of diabetes
treatment and management. Patient education
and self-care practices are also important
aspects of disease management that help people
with diabetes lead normal lives.
- To survive, people with type 1 diabetes
must have insulin delivered by injection or
a pump.
- Many people with type 2 diabetes can
control their blood glucose by following a
healthy meal plan and exercise program, losing excess weight, and taking oral medication.
Medications for each individual
with diabetes will often change during the
course of the disease. Some people with
type 2 diabetes may also need insulin to
control their blood glucose.
- Self-management education or training
is a key step in improving health outcomes
and quality of life. This type of
education or training focuses on self-care
behaviors, such as healthy eating, being
active, and monitoring blood sugar.
Self-management education or training is
a collaborative process in which diabetes
educators help people with or at risk for
diabetes gain the knowledge and problemsolving
and coping skills needed to successfully
self-manage the disease and its
related conditions.
- Many people with diabetes also need to
take medications to control their cholesterol
and blood pressure.
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Prevention or Delay of Type 2 Diabetes
- The Diabetes Prevention Program (DPP),
a large prevention study of people at high
risk for diabetes, showed that lifestyle
intervention to lose weight and increase
physical activity reduced the development
of type 2 diabetes by 58 percent during a
3-year period. The reduction was even
greater, 71 percent, among adults ages
60 years or older.
- Treatment with the drug metformin
reduced the risk by 31 percent overall
and was most effective in younger—ages
25–44 years—and in heavier—body mass
index greater than or equal to 35—adults.
- Prevention or delay of type 2 diabetes with
either lifestyle or metformin intervention
was effective in all racial and ethnic
groups studied and has been shown to
persist for at least 10 years.
- Interventions to prevent or delay type 2
diabetes in individuals with pre-diabetes
can be feasible and cost-effective.
Research has found that lifestyle interventions
are more cost-effective than
medications.
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Acknowledgments
Publications produced by the Clearinghouse
are carefully reviewed by both NIDDK scientists
and outside experts. The following
organizations collaborated in compiling the
information for this fact sheet:
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Citation
Centers for Disease Control and Prevention. National Diabetes Fact Sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.
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You may also find additional information about this topic by visiting MedlinePlus at www.medlineplus.gov.
This publication may contain information about medications. When prepared, this publication included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1–888–INFO–FDA (1–888–463–6332) or visit www.fda.gov. Consult your health care provider for more information.
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