Lifetime risk for diabetes mellitus in the United States.

CONTEXT Although diabetes mellitus is one of the most prevalent and costly chronic diseases in the United States, no estimates have been published of individuals' average lifetime risk of developing diabetes. OBJECTIVE To estimate age-, sex-, and race/ethnicity-specific lifetime risk of diabetes in the cohort born in 2000 in the United States. DESIGN, SETTING, AND PARTICIPANTS Data from the National Health Interview Survey (1984-2000) were used to estimate age-, sex-, and race/ethnicity-specific prevalence and incidence in 2000. US Census Bureau data and data from a previous study of diabetes as a cause of death were used to estimate age-, sex-, and race/ethnicity-specific mortality rates for diabetic and nondiabetic populations. MAIN OUTCOME MEASURES Residual (remaining) lifetime risk of diabetes (from birth to 80 years in 1-year intervals), duration with diabetes, and life-years and quality-adjusted life-years lost from diabetes. RESULTS The estimated lifetime risk of developing diabetes for individuals born in 2000 is 32.8% for males and 38.5% for females. Females have higher residual lifetime risks at all ages. The highest estimated lifetime risk for diabetes is among Hispanics (males, 45.4% and females, 52.5%). Individuals diagnosed as having diabetes have large reductions in life expectancy. For example, we estimate that if an individual is diagnosed at age 40 years, men will lose 11.6 life-years and 18.6 quality-adjusted life-years and women will lose 14.3 life-years and 22.0 quality-adjusted life-years. CONCLUSIONS For individuals born in the United States in 2000, the lifetime probability of being diagnosed with diabetes mellitus is substantial. Primary prevention of diabetes and its complications are important public health priorities.

[1]  M. Gail,et al.  Efficacy and Tolerability of Long-Acting Injectable Naltrexone for Alcohol Dependence: A Randomized Controlled Trial , 2005, Gynecologic oncology.

[2]  Stanley Lemeshow,et al.  Multiple Logistic Regression , 2005 .

[3]  A. Brix.  Bayesian Data Analysis, 2nd edn , 2005 .

[4]  Betsy L Cadwell,et al.  Trends in the prevalence and ratio of diagnosed to undiagnosed diabetes according to obesity levels in the U.S. , 2004, Diabetes care.

[5]  M. Engelgau,et al.  Review of the performance of methods to identify diabetes cases among vital statistics, administrative, and survey data. , 2004, Annals of epidemiology.

[6]  James P. Boyle,et al.  A Dynamic Markov Model for Forecasting Diabetes Prevalence in the United States through 2050 , 2003, Health care management science.

[7]  C. Jagger,et al.  Active life expectancy in people with and without diabetes. , 2003, Journal of public health medicine.

[8]  M. Engelgau,et al.  Valuing health-related quality of life in diabetes. , 2002, Diabetes care.

[9]  C. Loria,et al.  Age and the burden of death attributable to diabetes in the United States. , 2002, American journal of epidemiology.

[10]  K. Flegal,et al.  Prevalence and trends in obesity among US adults, 1999-2000. , 2002, JAMA.

[11]  Alastair Gray,et al.  Estimating Utility Values for Health States of Type 2 Diabetic Patients Using the EQ-5D (UKPDS 62) , 2002, Medical decision making : an international journal of the Society for Medical Decision Making.

[12]  Sudha Seshadri,et al.  Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study. , 2002, JAMA.

[13]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002 .

[14]  L S Geiss,et al.  Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S. , 2001, Diabetes care.

[15]  M. Engelgau,et al.  The continuing increase of diabetes in the US. , 2001, Diabetes care.

[16]  M. Engelgau,et al.  Population-based estimates of mortality associated with diabetes: use of a death certificate check box in North Dakota. , 2001, American journal of public health.

[17]  M. Engelgau,et al.  Translation research for chronic disease: the case of diabetes. , 2000, Diabetes care.

[18]  M. Engelgau,et al.  Screening for type 2 diabetes. , 2000, Diabetes care.

[19]  F Vinicor,et al.  Diabetes--a common, growing, serious, costly, and potentially preventable public health problem. , 2000, Diabetes research and clinical practice.

[20]  Michael M. Engelgau,et al.  Type 2 diabetes among North adolescents: An epidemiologic health perspective , 2000 .

[21]  Jack R. Anderson.  Design and estimation for the National Health Interview Survey, 1995-2004. , 2000, Vital and health statistics. Series 2, Data evaluation and methods research.

[22]  S. Haffner,et al.  Rapid rise in the incidence of type 2 diabetes from 1987 to 1996: results from the San Antonio Heart Study. , 1999, Archives of internal medicine.

[23]  P. Sasieni,et al.  Standardized lifetime risk. , 1999, American journal of epidemiology.

[24]  Enrique Sanchez-Delgado,et al.  Lifetime risk of developing coronary heart disease , 1999, The Lancet.

[25]  G. Glendon,et al.  Putting the risk of breast cancer in perspective. , 1999, The New England journal of medicine.

[26]  M. Harris,et al.  Mortality in Adults With and Without Diabetes in a National Cohort of the U.S. Population, 1971–1993 , 1998, Diabetes Care.

[27]  P. O’Connor,et al.  Identifying diabetes mellitus or heart disease among health maintenance organization members: sensitivity, specificity, predictive value, and cost of survey and database methods. , 1998, The American journal of managed care.

[28]  N. Ray,et al.  Economic Consequences of Diabetes Mellitus in the U.S. in 1997 , 1998, Diabetes Care.

[29]  R B D'Agostino,et al.  Lifetime risk of dementia and Alzheimer's disease , 1997, Neurology.

[30]  D. Williamson,et al.  Weight change and diabetes incidence: findings from a national cohort of US adults. , 1997, American journal of epidemiology.

[31]  P C O'Brien,et al.  Relative contributions of incidence and survival to increasing prevalence of adult-onset diabetes mellitus: a population-based study. , 1997, American journal of epidemiology.

[32]  M. Harris,et al.  Diabetes in America, 2nd edition , 1995 .

[33]  W D Flanders,et al.  The lifetime risk of developing breast cancer. , 1993, Journal of the National Cancer Institute.

[34]  N. Nagelkerke,et al.  A note on a general definition of the coefficient of determination , 1991 .

[35]  M. Rowland,et al.  Self-reported weight and height. , 1990, The American journal of clinical nutrition.

[36]  S. Cummings,et al.  Lifetime risks of hip, Colles', or vertebral fracture and coronary heart disease among white postmenopausal women. , 1989, Archives of internal medicine.

[37]  Massey Jt,et al.  Design and estimation for the National Health Interview Survey 1985-94. , 1989 .

[38]  John A. H. Lee.  Health: United States , 1986 .

[39]  E. Masterson,et al.  Summary , 1981, Vision Research.

[40]  G. Schwarz.  Estimating the Dimension of a Model , 1978 .

[41]  C. J. Stone,et al.  Introduction to Stochastic Processes , 1972 .

[42]  M. Graffar.  [Modern epidemiology]. , 1971, Bruxelles medical.

[43]  J. L. Harrison,et al.  The Government Printing Office , 1968, American Journal of Pharmaceutical Education.