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Review
. 2012 Aug;102(8):1482-97.
doi: 10.2105/AJPH.2011.300616. Epub 2012 Jun 14.

Aging, diabetes, and the public health system in the United States

Carl J Caspersen  1 , G Darlene Thomas, Letia A Boseman, Gloria L A Beckles, Ann L Albright
Affiliations
Review

Aging, diabetes, and the public health system in the United States

Carl J Caspersen et al. Am J Public Health. 2012 Aug.

Abstract

Diabetes (diagnosed or undiagnosed) affects 10.9 million US adults aged 65 years and older. Almost 8 in 10 have some form of dysglycemia, according to tests for fasting glucose or hemoglobin A1c. Among this age group, diagnosed diabetes is projected to reach 26.7 million by 2050, or 55% of all diabetes cases. In 2007, older adults accounted for $64.8 billion (56%) of direct diabetes medical costs, $41.1 billion for institutional care alone. Complications, comorbid conditions, and geriatric syndromes affect diabetes care, and medical guidelines for treating older adults with diabetes are limited. Broad public health programs help, but effective, targeted interventions and expanded surveillance and research and better policies are needed to address the rapidly growing diabetes burden among older adults.

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Figures

FIGURE 1—
FIGURE 1—
Projected number of cases of diagnosed diabetes among total population and older adults aged 65 years and older: United States, 2005–2050. Source. Narayan et al.6
FIGURE 2—
FIGURE 2—
Prevalence of major chronic diseases in adults aged 65 years and older: United States, 1999–2004. Note. AR = arthritis; CHD = coronary heart disease; CLRT = chronic lower respiratory tract disease; CVA = cerebrovascular accident; DM = diabetes mellitus. Source. Weiss et al.14
FIGURE 3—
FIGURE 3—
Reductions in diabetes incidence, by intervention and age group, in 1043 men and 2191 women, with mean age 51 years, with IGT and IFG: Diabetes Prevention Program, 1997–2001. Note. IFG = impaired fasting glucose; IGT = impaired glucose tolerance. Source. Knowler et al.159
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