Close to half (40%) of the adult population of the USA is expected to develop type 2 diabetes at some point during their lifetime, suggests a major study published in The Lancet Diabetes & Endocrinology. The future looks even worse for some ethnic minority groups, with one in two (> 50%) Hispanic men and women and non-Hispanic black women predicted to develop the disease.
A team of US researchers combined data from nationally representative US population interviews and death certificates for about 600 000 adults to estimate trends in the lifetime risk of diabetes and years of life lost to diabetes in the USA between 1985 and 2011.
Over the 26 years of study, the lifetime risk of developing type 2 diabetes for the average American 20-year-old rose from 20% for men and 27% for women in 1985, to 40% for men and 39% for women in 2000. The largest increases were in Hispanic men and women, and non-Hispanic black women, for whom lifetime risk now exceeds 50%.
Dr Edward Gregg, study leader and Chief of the Epidemiology and Statistics Branch, Division of Diabetes Translation at the Centers for Disease Control and Prevention said, "Soaring rates of diabetes since the late 1980s and longer overall life expectancy in the general population have been the main drivers of the striking increase in the lifetime risk of diabetes over the last 26 years. At the same time, a large reduction in death rates in the US population with diabetes has reduced the average number of years lost to the disease. However, the overwhelming increase in diabetes prevalence has resulted in an almost 50% increase in the cumulative number of years of life lost to diabetes for the population as a whole: years spent living with diabetes have increased by 156% in men and 70% in women."*
He concludes, "As the number of diabetes cases continue to increase and patients live longer there will be a growing demand for health services and extensive costs. More effective lifestyle interventions are urgently needed to reduce the number of new cases in the USA and other developed nations."
Writing in a linked Comment, Dr Lorraine Lipscombe from Women's College Hospital and the University of Toronto, Toronto, Canada says, "The trends reported by Gregg and colleagues are probably similar across the developed world, where large increases in diabetes prevalence in the past two decades have been reported...Primary prevention strategies are urgently needed. Excellent evidence has shown that diabetes can be prevented with lifestyle changes. However, provision of these interventions on an individual basis might not be sustainable. Only a population-based approach to prevention can address a problem of this magnitude. Prevention strategies should include optimisation of urban planning, food-marketing policies, and work and school environments that enable individuals to make healthier lifestyle choices. With an increased focus on interventions aimed at children and their families, there might still be time to change the fate of our future generations by lowering their risk of type 2 diabetes."