Study: Regional differences in type 2 diabetes prevalence and associated risk factors in the United StatesPhoto credit: Proxima Studio / Shutterstock.com
In a recent study published in Diabetes, obesity and metabolismResearchers assess national trends and differences in the prevalence of diabetes among adults in the United States.
The costs of diabetes
According to current estimates, approximately 96 million adults have prediabetes and 37 million people are diagnosed with diabetes in the United States. In 2022, the total cost of diabetes, which includes direct and indirect medical costs as well as lost wages and work, was $413 billion. By 2030, researchers predict that the cost of diabetes in the United States will reach $622 billion.
Various factors, such as a sedentary lifestyle, age and obesity, increase the risk of diabetes. Understanding risk factors, trends and differences in diabetes prevalence is therefore essential to develop effective management and prevention strategies.
About the study
In the current study, researchers examine recent trends and differences in the prevalence of diabetes among adults living in the United States. The data is drawn from the ongoing Behavioral Risk Factor Surveillance System, which involves more than 400,000 interviews with adults.
In total, this study recorded more than 5.31 million observations between 2012 and 2022. Diabetes was self-reported using standardized questionnaires.
Sociodemographic factors, including age, race, gender, education, body mass index (BMI), and physical activity level, were used to establish diabetes risk indicators. Age was standardized based on the 2010 US Census into three age groups: individuals aged 18 to 44, 45 to 64, and 65 and older.
Age-standardized diabetes prevalence was estimated overall and by sociodemographic groups. Logistic regression was used to assess associations between risk factors and diabetes.
Study results
Overall, the prevalence of diabetes increased by 18.6% over the study period, which was equally evident across all sociodemographic groups. However, significant differences in diabetes risk between racial and ethnic groups have also been observed.
For example, non-Hispanic black people had the highest prevalence of diabetes, nearly 16%. In addition, Hispanics, non-Hispanic Asians, and non-Hispanic blacks were 1.6, 1.67, and 2.1 times more likely to develop diabetes than non-Hispanic whites, respectively.
The incidence of diabetes was also 23.8% higher among people aged 65 and older, reflecting the important role that aging plays in the development of diabetes. Adults aged 45 to 64, as well as those aged 65 and older, were 5.1 and 10.2 times more likely to have diabetes than those aged 18 to 24, respectively.
Gender differences in diabetes risk were also evident, with men 1.15 times more likely to have diabetes than women.
Overweight and obese individuals also had a 1.57 and 3.64 increased risk of developing diabetes, respectively, compared to normal weight individuals. In addition, the incidence of diabetes was lower among physically active people than among inactive people, with regular physical activity reducing the risk of diabetes by 32%.
The prevalence of diabetes was also 56% higher among people with low incomes than among those with high incomes. Obese people had a diabetes prevalence of 19.23%. In addition, people with higher education and higher incomes were 24% and 41% less likely to have diabetes, respectively.
States in the Midwest and South of the United States reported an increase in their diabetes rates of between 9.2% and 12.8%. Some states like Arkansas, Nebraska and Kentucky saw the biggest increases.
Notable limitations of the current study include lack of clinical data and bias due to self-reported diagnoses.
Conclusions
The current study identifies significant increases in diabetes prevalence between 2012 and 2022 in the United States, which is consistent with increasing prevalence of diabetes reported in recent decades.
The high and steadily increasing incidence of diabetes highlights the importance of addressing the risks associated with the development of this disease and the prevalence of differences that exist between sociodemographic groups. Improving access to care, addressing social determinants, and implementing prevention programs focused on high-risk groups can help mitigate the diabetes epidemic in the United States.
“Promoting healthy eating habits, increasing physical activity and implementing community interventions to support weight control can play an important role in reducing the incidence of diabetes.”
