2017 Diabetes Facts & Statistics
2:56 AMPosted by: John S Kiernan
Diabetes costs the U.S. economy over $245 billion per year, making it the country’s most expensive disease. But the damage obviously extends well beyond dollars and cents. It’s the 3rd most deadly disease in the U.S., claiming over 80,000 lives per year and becoming a daily concern for millions more.
Yet the roughly 9 in 10 Americans who don’t have diabetes probably don’t understand the full extent of the struggle, either. The same can also be said of the nearly 1 in 4 people with diabetes who don’t know they have it.
So to help spread awareness, WalletHub assembled an interesting infographic exploring the impact of the disease as well as what folks are doing to fight back. We also surveyed a panel of diabetes experts about issues ranging from personal finance to policy. You can find everything below.
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For insights into how we can reduce the many costs of diabetes, WalletHub posed the following questions to a panel of experts. You can check out their bios and responses below.
- What are the warning signs that someone may have Type 1 Diabetes? What about Type 2?
- What steps can someone take today to help reduce diabetes risk?
- What should public officials do to raise awareness about diabetes and the need for screening?
- What are some common myths or misunderstandings people have about diabetes?
- How have individuals with diabetes fared under the Affordable Care Act?
- What tips do you have for a person with Type 2 diabetes looking to maintain a healthy and active lifestyle while on a budget?
William H. Herman Professor of Epidemiology and Internal Medicine at the University of Michigan School of Public Health
Ronny A. Bell Professor and Chair of the Department of Public Health at East Carolina University
Mercedes Carnethon Associate Professor, Chief of Epidemiology and Vice Chair of the Department of Preventive Medicine in the Feinberg School of Medicine at Northwestern University
Mark A. Pereira Professor in the Division of Epidemiology & Community Health at the University of Minnesota School of Public Health
Margaret M. McCarthy Assistant Professor in the Rory Meyers College of Nursing at New York University
Dana Dabelea Conrad M. Riley Professor of Epidemiology and Pediatrics and Director of the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center at the University of Colorado Anschutz Medical Campus
Briana Mezuk Associate Professor of Epidemiology at the University of Michigan School of Public Health
What are the warning signs that someone may have Type 1 Diabetes? What about Type 2? At the onset of type 1 diabetes, a person may experience increased thirst and increased urination, which may be especially noticeable at night. Occasionally, people may experience blurring of vision and unintentional weight loss. If diagnosis is delayed, people with type 1 diabetes may develop diabetic ketoacidosis or DKA. DKA is associated with abdominal pain, nausea, vomiting, dehydration, and heavy breathing. Left untreated, it may progress to coma or death. Like type 1 diabetes, type 2 diabetes may present with increased thirst, increased urination, and blurring of vision. People may also present with skin infections, especially yeast infections in the groin. More often than not, however, type 2 diabetes is asymptomatic and diagnosed on the basis of routine laboratory testing. What steps can someone take today to help reduce diabetes risk? Although the prevention of type 1 diabetes is an area of active research, there are as yet no proven effective strategies to prevent type 1 diabetes. There are, however, a number of steps an individual can take to reduce the risk of type 2 diabetes. Obesity and physical inactivity are the major modifiable risk factors for type 2 diabetes. Everyone should try to maintain a healthy weight and to be physically active. There is increasing interest in community interventions and public health policies to support healthy lifestyles. These have focused on creating disincentives to the consumption of “empty calories” such as sugar-sweetened beverages, and on creating a built environment that provides safe and inviting facilities to encourage physical activity. High-risk individuals may also choose to be screened for prediabetes, a condition in which blood sugar levels are higher than normal, but do not reach the threshold for type 2 diabetes. Many clinical trials have demonstrated that for people with prediabetes, lifestyle interventions designed to achieve a 7 percent reduction in initial body weight and 150 minutes of brisk walking per week (30 minutes per day, 5 days per week) can reduce the risk of developing type 2 diabetes by 58 percent over 3 years. Similarly, people with prediabetes who choose to take metformin, an oral medication also used to treat type 2 diabetes, can delay or prevent their rate of progression to type 2 diabetes by 31 percent over 3 years. What should public officials do to raise awareness about diabetes and the need for screening? Health care providers, health systems, and public health officials should all raise awareness about the risk factors for diabetes and its symptoms and signs. Universal community screening for prediabetes and diabetes is probably not a good use of resources. Asymptomatic individuals at high-risk for type 2 diabetes should, however, be periodically tested as a part of their ongoing medical care (with a blood test approximately every 3 years), so that those with diabetes can be promptly diagnosed and treated and those with prediabetes can be identified and offered the opportunity to participate in a diabetes prevention program, or take a medication to prevent diabetes. What are some common myths or misunderstandings people have about diabetes? The most common myths or misunderstandings about diabetes are that it cannot be prevented and that once it occurs, complications are inevitable. As indicated above, both lifestyle and medication interventions have been shown to delay or prevent the development of type 2 diabetes when adopted by high-risk individuals. In addition, randomized controlled clinical trials have clearly demonstrated that intensive blood sugar control early in the course of type 1 and type 2 diabetes can delay or prevent the development of the eye, kidney, and nerve complications of diabetes, and potentially reduce the risk of cardiovascular disease. In addition, it is now well established that aggressive treatment of common cardiovascular risk factors that often occur in conjunction with type 2 diabetes, such as high blood pressure, high cholesterol, and cigarette smoking, can dramatically reduce the incidence of cardiovascular disease. How have individuals with diabetes fared under the Affordable Care Act? Type 2 diabetes is more likely to afflict racial and ethnic minority groups and the working poor, who traditionally have been less likely to have health insurance. The increased access to care provided under the Affordable Care Act (ACA) has dramatically improved both the detection and treatment of diabetes. Proactive care is important for both the prevention and early treatment of complications before they cause blindness, kidney failure, amputations, cardiovascular disease, or death. The costs of diabetes treatments and ongoing medical care can be many thousands of dollars per year. Removing financial barriers to care can greatly decrease the incidence of complications and improve both health-related quality-of-life and survival. What tips do you have for a person with Type 2 diabetes looking to maintain a healthy and active lifestyle while on a budget? Diabetes self-management does not require expensive foods, personal trainers, or fancy gyms. Selecting healthy foods and cooking from scratch can be healthier and cheaper than purchasing highly processed foods or eating in restaurants. In addition, the physical activity necessary to maintain health may just require brisk walks in a park. Ronny A. Bell Professor and Chair of the Department of Public Health at East Carolina University 
What are the warning signs that someone may have Type 1 Diabetes? What about Type 2? According to the American Diabetes Association, the following are common symptoms of diabetes:
- Urinating often;
- Feeling very thirsty;
- Feeling very hungry -- even though you are eating;
- Extreme fatigue;
- Blurry vision;
- Cuts/bruises that are slow to heal;
- Weight loss -- even though you are eating more (type 1);
- Tingling, pain, or numbness in the hands/feet (type 2).
- Walk or run for exercise -- no need to join a gym;
- Plan your meals ahead;
- Look for budget-friendly recipes;
- Drink water instead of costly beverages;
- If you eat out, portion out your entree so you can eat it over two meals.
What are the warning signs that someone may have Type 1 Diabetes? What about Type 2? The onset of type 1 diabetes typically occurs younger than age 18, but adults can develop type 1 diabetes. Symptoms of type 1 diabetes can include extreme thirst, frequent urination and tiredness. Type 2 diabetes is much more common, typically develops in adults, and in particular among adults who are overweight or obese and have one or more cardiovascular disease risk factors. Many of the symptoms are the same, but can easily be confused with other conditions, particularly in middle-aged and older adults who may have other health-related issues. Type 2 diabetes is more commonly detected when adults receive regular blood screenings to test for hemoglobin A1c or glucose. In most adults above age 45, these screenings are recommended every five years, or more often in an adult with risk factors, such as obesity or a history of gestational diabetes (women). What steps can someone take today to help reduce diabetes risk? Although one’s genes can predispose them to developing diabetes, type 2 diabetes, which accounts for 90-95 percent of diabetes, is thought to be predominately attributable to lifestyle factors. Because 80-85 percent of adults who have diabetes are overweight or obese, the most important step to take to reduce diabetes risk is to lose weight if they are already overweight or obese, or to maintain a healthy body weight through a healthy diet, regular physical activity and regular sleep. What should public officials do to raise awareness about diabetes and the need for screening? Diabetes is a devastating disease for individuals, their families and society as a whole. Persons with diabetes can suffer a series of complications including blindness, kidney failure, depression, the need for amputations and cardiovascular diseases. The leading cause of death in adults with diabetes is cardiovascular disease, and cardiovascular disease occurs earlier in adults with diabetes than in those who do not. These complications can have a significant effect on an individual’s ability to work and to function within his/her family. As a result, medical care costs can rise as earning potential goes down due to disability and days off work managing their illness. If the challenges that individuals who have diabetes face are prominently featured, it is possible that adults will follow physician screening recommendations and commit to healthy lifestyles to reduce the likelihood of developing diabetes. What are some common myths or misunderstandings people have about diabetes? Diabetes is preventable, even in families where one member already has diabetes. Most individuals with type 2 diabetes are overweight or obese. By maintaining a healthy lifestyle and preventing weight gain, an individual -- even one with a strong family history -- can lower their likelihood of developing diabetes. Many people also underestimate the importance of regular restorative sleep for diabetes risk. Prior studies have consistently demonstrated that adults who sleep less than the recommended 7-9 hours per night on a regular basis, who have trouble falling asleep or have trouble staying asleep are significantly more likely than their counterparts to develop diabetes. Placing a priority on regular, restorative sleep may lower the risk of developing diabetes. How have individuals with diabetes fared under the Affordable Care Act? Under the Affordable Care Act, we have seen the individual uptake of preventing screenings go up. These observations were more pronounced in individuals who did not have private insurance, had a lower family income and were more likely to be racial/ethnic minorities. These are the groups who are at a higher risk for developing diabetes. It’s too early to tell whether that has led to earlier detection of diabetes and the initiation of therapy to manage diabetes and prevent complications. What tips do you have for a person with Type 2 diabetes looking to maintain a healthy and active lifestyle while on a budget? Leading a healthy lifestyle does not have to be expensive. It is most important that individuals maximize the resources around them to safely find places to build physical activity into their lives, to carefully control portion sizes in meals and to make food selections that include fresh vegetables, fruits and lean meats. Mark A. Pereira Professor in the Division of Epidemiology & Community Health at the University of Minnesota School of Public Health 
What are the warning signs that someone may have Type 1 Diabetes? What about Type 2? Symptoms are similar, but typically much more acute and dramatic for type 1 diabetes than for type 2. Type 1 occurs early in life, typically the first two decades, and almost never in middle age. With type 1, the cells in the pancreas that secrete the hormone insulin have been destroyed, and as a result, blood sugar cannot be moved into the tissues for use as energy. Blood sugar rises rapidly and results in the classic symptoms of fatigue, thirst, blurry vision, and frequent urination (the blood sugar passes into the urine). With type 1, these symptoms typically appear over a short period of time and worsen rapidly, leading to coma and death if not treated by injecting insulin into the patient. Multiple insulin injections per day are required for the rest of life in order to control blood sugar in the normal range. With type 2, the onset is later in life typically, related to western lifestyle -- sedentary behavior, processed western diet, obesity. Type 2 is typically diagnosed in mid- to late-life, but has become more common in young adults and even youth due to the obesity epidemic in the U.S. The symptoms for type 2 are similar to type 1, but much more gradual and slow to evolve over time. With type 2, blood sugar increases much more slowly, and the disease is often silent/undiagnosed for many years, but unfortunately, the blood sugar is in a state above normal levels for a long time, and can increase risk for cardiovascular diseases even before the disease is diagnosed and treated. What steps can someone take today to help reduce diabetes risk? Find out your risk. The best and most direct way to do this is to get a fasting blood sugar test. To be truly fasted and have the most valid test, refrain from eating or drinking anything except water for 10 hours -- usually, an overnight fast with the blood sugar test in the morning. There are kits that can be purchased over the counter to check your blood sugar at home. Check with your local pharmacist or schedule a physical exam with your physician and request a diabetes screening. Fasting blood sugar below 100 milligrams/dL is normal, between 100 and 125 indicates possible "prediabetes," and 126 or higher indicates possible diabetes diagnosis. You would want to follow up on this, talk to physician, and repeat the test. If you are in the prediabetes range, there is a lot you can do to prevent diabetes from taking hold. Regular exercise and healthful diet are very effective. Modest weight reduction will help, if necessary and possible, but it is not required. The key is to be physically active each and every day for at least 30 minutes. More is better. Even mild exercise, like moderate steady walking, has been shown to prevent diabetes. Exercise helps to make the muscles more sensitive to the hormone insulin, which controls blood sugar by allowing more blood sugar to enter the muscles to be used as energy, and thereby keeps the level of sugar in the blood from rising too high. Follow the dietary guidelines for Americans, or the American Diabetes Association’s dietary guidelines for optimal diet and the ideal sources and amounts of carbohydrates in the diet. Highly processed foods with a lot of added sugar, and refined flours will increase risk for prediabetes and diabetes. Poor sleep habits, stress, and cigarette smoking may also play a role. Look into the Diabetes Prevention Program for more details on lifestyle tips and ideas. What should public officials do to raise awareness about diabetes and the need for screening? Regular campaigns, advertisements, education in schools and community centers, blood sugar screening promotion, insurance discounts or free services for diabetes prevention programs; advocacy through the American Diabetes Association. What are some common myths or misunderstandings people have about diabetes?
- Myth -- you cannot prevent it or control it. Reality -- type 2 diabetes is highly preventable and controllable.
- Myth -- it is due to genetics. Reality -- although family history and genetics play a role, the vast majority of type 2 diabetes is caused by lifestyle and obesity.
- Myth -- I have to lose all my excess weight and that will never happen. Reality -- most of the benefits to preventing diabetes come from routine exercise and healthful dietary changes, and even with little weight loss, people can still prevent this disease.
What are the warning signs that someone may have Type 1 Diabetes? Type 2? Type 1 diabetes accounts for 5-10 percent of all diabetes cases. Type 1 is an autoimmune disorder where the pancreas no longer produces enough of the hormone insulin, which allows the body to convert the food you eat into energy or into storage for future use. This results in elevated blood sugar. Some of the early signs that someone might have type 1 diabetes include frequent urination, extreme thirst, increasingly hungry, but losing weight. They may also experience other symptoms such as dry mouth and itchy skin due to dehydration. These symptoms may appear to occur suddenly. The majority of the cases of type 1 diabetes first occur in those younger than 18, but can be diagnosed in young adults. Because of the loss of insulin produced by the pancreas, those with type 1 diabetes need insulin replacement by injection on a daily basis. In contrast, type 2 diabetes, which accounts for the majority (90-95 percent) of diabetes cases, develops more slowly. In type 2 diabetes, there is elevated blood sugar due to an insufficient amount of insulin in the body. Most with type 2 diabetes are older and overweight, but type 2 diabetes can occur in children. Increased body weight makes it more difficult for the body to use insulin, leading to insulin resistance. Some of the symptoms of type 2 diabetes are similar to type 1, but can be subtler and go unnoticed. They include frequent urination, feeling thirsty and hungry, fatigue, blurry vision, and cuts that are slow to heal. What steps can someone take today to help reduce diabetes risk? Because the causes of type 1 diabetes are autoimmune destruction of the pancreas, or may be unknown, it is not possible to reduce the risk of getting type 1 diabetes. Conversely, there are several behaviors one can do to prevent the onset of type 2 diabetes. The Diabetes Prevention Program (DPP) was a large clinical study to evaluate whether weight loss through changes in diet and physical activity could prevent the onset of type 2 diabetes in adults that were overweight and had elevated blood sugar (a blood sugar not high enough to be diagnosed with diabetes, but high enough to be diagnosed with prediabetes). The DPP found that people who lost a modest amount of weight through changes in diet and physical activity decreased their chances of getting type 2 diabetes. Maintaining a healthy weight, eating a healthy diet, and getting regular exercise (150 minutes per week of moderate intensity) can reduce risk of getting type 2 diabetes. What tips do you have for a person with Type 2 diabetes looking to maintain a healthy and active lifestyle while on a budget? For most adults, moderate physical activity should be encouraged on most days of the week, accumulating at least 150 minutes per week. For those with a significant medical history, they can consult with their health care provider prior to engaging in physical activity. Joining a gym or fitness center is not necessary. The physical activity can be as simple as walking 30 minutes per day, perhaps during a commute to and from work, or during a lunch break. A healthy diet can be maintained by following a diet that is high in fresh fruits and vegetables, whole grains, fiber, foods dense in nutrients, while also keeping in mind total calories needed for weight loss or weight maintenance. Foods containing saturated fats should be limited. Eating out may be quicker, but it is generally more expensive and less healthy than something made at home focusing on healthy food choices. Dana Dabelea Conrad M. Riley Professor of Epidemiology and Pediatrics and Director of the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center at the University of Colorado Anschutz Medical Campus 
What are the warning signs that someone may have Type 1 Diabetes? What about Type 2? Both types of diabetes may present with increased thirst, frequent urination, visual blurring, and later, lowered consciousness. However, this pattern is more common among those with type 1 diabetes, as the amount of insulin produced by the body drops and this pattern may evolve into diabetic ketoacidosis (DKA), a medical emergency. In type 2 diabetes, the onset is slower, and it may be first picked up at a regular physical examination, if blood sugar is tested and found to be high. After a number of months, the same symptoms may occur. Type 1 is more common in persons under the age of 30 years, whereas type 2 is more common after that age; however, cases of type 2 now occur in children as young as 3 years, due to the increasing amount of childhood obesity. What steps can someone take today to help reduce diabetes risk? Many studies worldwide have shown that type 2 diabetes can be delayed or prevented by changing to a healthy lifestyle -- one with a healthy diet, lower calories to attain weight loss of 5-10 percent (if overweight) and increased physical activity -- 30 minutes of brisk walking or other moderate exercise, five days a week. While there continues to be controversy about what a healthy diet contains, the basic advice of increased fruits and vegetables, lower amounts of saturated fats from red meat, and limited simple sugars is still true. Taking a drug called metformin also reduces the risk of type 2. What should public officials do to raise awareness about diabetes and the need for screening? Information about what diabetes is and how serious it can be is always useful. Diabetes Awareness Month, which started November 1st, is one way that more people can learn about diabetes, for example. Making diabetes prevention courses available through wellness clinics, worksites, health care settings, and public health clinics is another. Screening is somewhat controversial for the general population; however, it is now recommended that health care providers screen for diabetes in people without symptoms who are 45 years old and over, or those with risk factors, such as being of a high-risk race/ethic group (African American, Latino, Native American, Asian American, Pacific Islander), and in women who have had gestational diabetes (during pregnancy), among others. What are some common myths or misunderstandings people have about diabetes? I think the most common myth, especially in high-risk race/ethnic groups, is that there is nothing you can do to help prevent diabetes -- “you are going to get it.” As I mentioned earlier, there are many things you can do to delay or prevent type 2 diabetes through improved lifestyle or medication. The same holds if diabetes is diagnosed -- there are a number of things patients can do to lower the risk of complications. Medications for sugar control to keep it as close to normal as possible, medications and diet to reduce cardiovascular risks are also helpful. None of these are necessarily easy, but they are very important. Another myth is that type 1 diabetes is linked to eating sugar. Type 1 diabetes is an autoimmune disease, and thus far there isn’t evidence that it is link to obesity or sugar consumption. How have individuals with diabetes fared under the Affordable Care Act? Results of the ACA on diabetes diagnosis and care are just becoming available. It appears that in those states that expanded Medicaid, there has been a substantial increase in the number of people being diagnosed with diabetes. This may lead to a lower risk of complications in the future. There are only a few studies available now that track how persons with new access to care actually did, but I expect to see several in the near future. What tips do you have for a person with Type 2 diabetes looking to maintain a healthy and active lifestyle while on a budget? Increasing physical activity doesn’t have to be expensive -- a new pair of sneakers may help with brisk walking. You don’t need to join a gym to walk. Many of us spend more on fast food than we realize. Check to see how much you spend in a week, and cut it in half -- using the other half to buy healthy fruits and vegetables. Same cost -- better health. And starting a garden at home or in a community garden plot is a great way to get more vegetables at low cost and to increase physical activity. Briana Mezuk Associate Professor of Epidemiology at the University of Michigan School of Public Health 
What steps can someone take today to help reduce diabetes risk? Reducing diabetes risk can seem like a daunting task, but it is important to remember that small positive changes accumulate over time (in the same way that small negative behaviors accumulate over time). It is really difficult to make dramatic behavior changes all at once (and stick with it), but there are several small changes you can make every day that can -- over time -- reduce diabetes risk:
- Get between 7 and 9 hours of sleep on a regular basis. Sleeping too much and sleeping too little have both been associated with diabetes risk.
- Be physically active at least 30 minutes a day. This can include everything from a brisk walk after dinner, to lifting weights, to yoga, to swimming, to dancing. You don't have to do all 30 minutes at once -- you can break it up throughout the day by going for a walk on your lunch break, walking the stairs at work, etc. Physical activity is a very effective way to reduce feelings of emotional distress as well.
- Reduce the sources of stress in your life -- or if that isn't possible, change how you cope with those stressors. Often, the sources of stress in our life are outside of our control (e.g., traffic on the way to work), but sometimes we can do things to reduce stress (e.g., reduce the number of commitments you have to make more time for self-care, ask for support from a counselor, minister, or neighbor). Even if we can't reduce the stressors in our lives, it is important to develop positive ways to cope with those stressors (e.g., going for a walk, getting advice from friends, prayer or meditation).
- Stop smoking and limit alcohol intake.
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