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The
th Annual Meeting of March 30-31, 2019 The Endocrine Society and The Diabetes Association of the R.O.C. (Taiwan)
SD1-1
UPDATE ON DIABETES EPIDEMIOLOGY IN THE UNITED STATES EDWARD J. BOYKO, M.D.,M.P.H. Professor, Department of Medicine, Adjunct Professor, Department of Epidemiology, Adjunct Professor, Department of Health Services, University of Washington
Since the early 1990s, the prevalence of type 2 diabetes in the United States has more than doubled from 3.6% in 1990 to 8.7% in 2015 among adults ages 18 years or older. The large increase occurred concomitantly with an epidemic of overweight and obesity. I will discuss whether the increase in body weight explains completely the increase in number of diabetes cases. Since 2015, the SUHYDOHQFH KDV OHYHOHG RII :KHWKHU WKLV UHÀHFWV D VWDELOL]DWLRQ RI WUXH GLDEHWHV LQFLGHQFH RU DQ DUWHIDFW of the method to identify diabetes cases is an active question that I will discuss. Multiple surveys are conducted at regular intervals in the United States that include laboratory testing (NHANES), in person interview (NHIS), and telephone survey (BRFSS). These different surveys are used to estimate occurrence of diabetes and its complications nationally and regionally, as well as identifying risk factors such as overweight/obesity. Laboratory testing to identify diabetes is based on fasting glucose, 2-hour oral glucose tolerance testing, and Hemoglobin A1c. Advantages and disadvantages of each methodology will be discussed. Although obesity is well recognized as a risk factor for diabetes, certain body composition differences at a normal weight have also been identified as risk factors. Such measurements though are typically not available in populations due to the need for imaging technology. Occurrences of diabetes complications in the United States are captured by multiple national data resources related to hospitalizations and payment for renal dialysis. Progress in reducing end stage renal disease (ESRD) occurrence was seen between 1996 and 2009, but ESRD incidence has since stabilized. Similarly, progress in reduction of diabetic amputations was seen over that same time period but since 2009 the number of hospitalizations for diabetic amputations has increased. I will discuss online database and search engine resources from the Centers for Disease Control and Prevention which once understood will allow any website visitor to track diabetes trends in the United States in real time.
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