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New directions in incidence and prevalence of diagnosed diabetes in the USA
  1. Stephen R Benoit,
  2. Israel Hora,
  3. Ann L Albright,
  4. Edward W Gregg
  1. Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  1. Correspondence to Dr Stephen R Benoit; bvy8{at}


Objective To determine whether diabetes prevalence and incidence has remained flat or changed direction during the past 5 years.

Research design and methods We calculated annual prevalence and incidence of diagnosed diabetes (type 1 and type 2 combined) for civilian, non-institutionalized adults aged 18–79 years using annual, nationally representative cross-sectional survey data from the National Health Interview Survey from 1980 to 2017. Trends in rates by age group, sex, race/ethnicity, and education were calculated using annual percentage change (APC).

Results Overall, the prevalence of age-adjusted, diagnosed diabetes did not change significantly from 1980 to 1990, but increased significantly (APC 4.4%) from 1990 to 2009 to a peak of 8.2 per 100 adults (95% CI 7.8 to 8.6), and then plateaued through 2017. The incidence of age-adjusted, diagnosed diabetes did not change significantly from 1980 to 1990, but increased significantly (APC 4.8%) from 1990 to 2007 to 7.8 per 1000 adults (95% CI 6.7 to 9.0), and then decreased significantly (APC −3.1%) to 6.0 (95% CI 4.9 to 7.3) in 2017. The decrease in incidence appears to be driven by non-Hispanic whites with an APC of −5.1% (p=0.002) after 2008.

Conclusions After an almost 20-year increase in the national prevalence and incidence of diagnosed diabetes, an 8-year period of stable prevalence and a decrease in incidence has occurred. Causes of the plateauing and decrease are unclear but the overall burden of diabetes remains high and deserves continued monitoring and intervention.

  • adult diabetes
  • incidence
  • public health/surveillance

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  • Contributors SRB and EG developed the study concept, interpreted the data, and drafted the manuscript. IH conducted the analysis. ALA participated in study design, interpretation of data, and critically revised the manuscript. All authors have read and approved the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Publicly available data were used for analysis; no institutional review board was required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available in a public, open access repository.

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