Diabetes Prevention: How About NOW?1

STUDY

Mokdad AH, Ford ES, Bowman BA, Nelson DE, Engelgau MM, Vinicor F, Marks JS: Diabetes trends in the U.S.: 1990-1998. Diabetes Care 23:1278–1283, 2000

SUMMARY

Objective. The objective of this study was to evaluate trends in the prevalence of diabetes in the United States between 1990 and 1998.

Design and Methods. The Behavioral Risk Factor Surveillance System is a standardized telephone survey operated by state health agencies in collaboration with the Centers for Disease Control Prevention. A sample of adult residents (age ≥18 years) with telephones from all states including the District of Columbia were asked standardized questions to provide data that could be compared across states. Diabetes status was assessed over the telephone by a trained interviewer who asked, “Have you been told by a doctor that you have diabetes?” Issues regarding gestational diabetes were coded separately. A total of 149,806 individuals were interviewed and completed the survey.

Results. The prevalence of diagnosed diabetes in the United States increased 33% between 1990 and 1998. This rise was seen across all ages, races, educational levels, and weight levels. There was a 70% increase in diagnosed diabetes among individuals aged 30–39 years. There were significant increases among Hispanics (38% increase), caucasians (29% increase), and African Americans (26% increase). For every 1-kg increase in self-reported weight, the risk of diabetes increased by 9%.

Conclusions. The prevalence of diabetes continues to rise. As the prevalence of obesity also continues to increase in the United States, diabetes will become an even greater health care problem, contributing to a worldwide diabetes epidemic that is largely preventable.

COMMENTARY

“It is proper at the present time to devote time not alone to treatment but still more to prevention of diabetes. The results may not be so striking or immediate, but they are sure to come and to be important.” …