A study published this month in JAMA reveals that roughly one-half of the U.S. adult population has either diabetes or prediabetes, the precursor of type 2 diabetes. The study also highlights an upward trend in the prevalence of diabetes as it climbed from 9.8 percent in 1988-1994 to 12.4 percent in 2011-2012. But in between those data points lie changes that may point to a different trajectory in the coming years.
According to the study, which uses National Health and Nutrition Examination Survey data, the estimated prevalence of diabetes among U.S. adults was 12-14 percent in 2011-2012, and the prevalence of prediabetes was 37-38 percent. Here’s a breakdown of what that looks like:
- The unadjusted prevalence was 14.3 percent for total diabetes, 9.1 percent for diagnosed diabetes, 5.2 percent for undiagnosed diabetes and 38 percent for prediabetes.
- Among those with diabetes, 36.4 percent were undiagnosed.
- The prevalence of total diabetes was 11.3 percent for non-Hispanic white participants, compared with much higher rates among other races: 21.8 percent among non-Hispanic black participants, 20.6 percent among non-Hispanic Asian participants and 22.6 percent among Hispanic participants.
- The prevalence of prediabetes was greater than 30 percent in all sex and racial/ethnic categories, and it generally was highest among non-Hispanic white individuals and non-Hispanic black individuals.
But amidst all the disturbing news, “the current data provide a glimmer of hope,” write the authors of a companion editorial piece published in JAMA. That’s because prevalence estimates plateaued between 2007-2008 and 2011-2012, a trend that is consistent with U.S. obesity rate for the same period.
“The shift in cultural attitudes toward obesity, the AMA’s recognition of obesity as a disease, and the increasing focus on societal interventions to address food policy and the built environment are beginning to address some of the broad environmental forces that have contributed to the epidemic of obesity,” the editorial stated.
“The effort of the AMA to promote screening, testing and referral of high-risk patients for diabetes prevention through its Prevent Diabetes STAT™ program and the Centers for Disease Control and Prevention’s (CDC) efforts to increase the availability of diabetes prevention programs, ensure their quality and promote their use appear to be helping to identify at-risk individuals and provide the infrastructure to support individual behavioral change,” the authors stated.
The editorial also pointed to insurance coverage of intensive behavioral therapies and incentives as furthering patient engagement and change. “Progress has been made, but expanded and sustained efforts will be required,” the authors wrote.
What you can do
As part of its Improving Health Outcomes initiative, the AMA worked with the YMCA of the USA and 11 physician practice pilot sites in four states over the past year to develop tools and resources to increase physician screening, testing and referral for prediabetes.
The practices referred their patients with prediabetes to diabetes prevention programs offered by local YMCAs, which were part of the National Diabetes Prevention Program. Medicare beneficiaries were able to participate in this program at no cost, thanks to an award from the Center for Medicare and Medicaid Innovation.
Now physicians across the country can join in this work. The AMA and the CDC have teamed up to issue a call to take urgent action with Prevent Diabetes STAT: Screen, Test, Act–Today™. This multi-year initiative helps physicians refer adults who have prediabetes to prevention programs in their communities and online.
A good time to engage your Hispanic patients
National Hispanic Heritage Month, underway from Sept.15 to Oct. 15, is a good opportunity to make sure your Hispanic patients understand their diabetes risk status and take action to improve their health accordingly. The AMA-CDC Prevent Diabetes STAT toolkit includes patient resources in English and Spanish. Download these free resources to use in your practice today.
