Trends in the Prevalence of Diabetes Among U.S. Adults: 1999-2016

Abstract

Introduction: The prevalence of diabetes has increased substantially over the past three decades. This study sought to estimate recent trends in the prevalence of diabetes among U.S. adults.

Methods: This paper estimated trends in the prevalence of diagnosed, undiagnosed, and total diabetes among U.S. adults from 1999-2000 to 2015-2016 (analyzed in 2017). Data come from 42,554 respondents aged ≥20 years who participated in the National Health and Nutrition Examination Survey. Diagnosed diabetes was measured through self-report, undiagnosed diabetes was measured as never being diagnosed with diabetes but having glycated hemoglobin levels ≥6.5%, and total diabetes was measured as the sum of individuals with diagnosed and undiagnosed diabetes.

Results: In the overall U.S. adult population, the unadjusted prevalence of total diabetes increased from 7.7% in 1999-2000 to 13.3% in 2015-2016 (p<0.001 for trend). Growth was observed for all subgroups, though the rate of change was higher in older adults, racial minorities, and those who were obese compared with their peers. Increasing prevalence among Mexican-American adults was particularly pronounced, rising by 10.1 percentage points during the study period (8.3% to 18.4%, p<0.001). Roughly 40% of the increase in total diabetes was accounted for by changes in the age and rates of obesity in the U.S.

Conclusions: From 1999 to 2016, the prevalence of diabetes among U.S. adults increased at a substantial rate. This growth occurred differentially across subgroups, particularly impacting Mexican-American adults, and was driven in large part by population aging and increasing obesity rates.