Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence
Open accessAbstract
BACKGROUND: People with diabetes can suffer from diverse complications that seriously erode quality of life. Diabetes, costing the United States more than $174 billion per year in 2007, is expected to take an increasingly large financial toll in subsequent years. Accurate projections of diabetes burden are essential to policymakers planning for future health care needs and costs. METHODS: Using data on prediabetes and diabetes prevalence in the United States, forecasted incidence, and current US Census projections of mortality and migration, the authors constructed a series of dynamic models employing systems of difference equations to project the future burden of diabetes among US adults. A three-state model partitions the US population into no diabetes, undiagnosed diabetes, and diagnosed diabetes. A four-state model divides the state of "no diabetes" into high-risk (prediabetes) and low-risk (normal glucose) states. A five-state model incorporates an intervention designed to prevent or delay diabetes in adults at high risk. RESULTS: The authors project that annual diagnosed diabetes incidence (new cases) will increase from about 8 cases per 1,000 in 2008 to about 15 in 2050. Assuming low incidence and relatively high diabetes mortality, total diabetes prevalence (diagnosed and undiagnosed cases) is projected to increase from 14% in 2010 to 21% of the US adult population by 2050. However, if recent increases in diabetes incidence continue and diabetes mortality is relatively low, prevalence will increase to 33% by 2050. A middle-ground scenario projects a prevalence of 25% to 28% by 2050. Intervention can reduce, but not eliminate, increases in diabetes prevalence. CONCLUSIONS: These projected increases are largely attributable to the aging of the US population, increasing numbers of members of higher-risk minority groups in the population, and people with diabetes living longer. Effective strategies will need to be undertaken to moderate the impact of these factors on national diabetes burden. Our analysis suggests that widespread implementation of reasonably effective preventive interventions focused on high-risk subgroups of the population can considerably reduce, but not eliminate, future increases in diabetes prevalence.
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Even if diabetes incidence rates level off, CDC projections suggest prevalence of diabetes will double in the next 20 years, in part due to aging of the population.
“projections by the Centers for Disease Control and Prevention (CDC) suggest that even if diabetes incidence rates level off, the prevalence of diabetes will double in the next 20 years, in part due to aging of the population6.”
From Diabetes in Older Adults: A Consensus Report (2012) · cites this paper as [6]
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- Authors
- Boyle, J. P., Thompson, T. J., Gregg, E. W., Barker, L. E., & Williamson, D. F.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Emory University (US)
- Corresponding author
- Thompson, Theodore J
- Venue
- Population Health Metrics
- Published
- 2010-10-22
- Volume
- 8
- Issue
- 1
- Pages
- 29-29
- ISSN
- 1478-7954 (ISSN-L)
- PMC
- PMC2984379
- OpenAlex
- W2112532934
- Cited by
- 1,309
- References
- 4
- Citations by year
- 2026: 25 · 2025: 37 · 2024: 39 · 2023: 39 · 2022: 67 · 2021: 64 · 2020: 84 · 2019: 92 · 2018: 120 · 2017: 100 · 2016: 119 · 2015: 147 · 2014: 116 · 2013: 110 · 2012: 78
- FWCI
- 61.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Population Health Metrics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- Funders
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- diabetes burden, diabetes incidence, diabetes mortality, prediabetes prevalence, diabetes prevalence projections, undiagnosed diabetes, population aging, health care costs, United States adults
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