Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Oct 22:8:29.
doi: 10.1186/1478-7954-8-29.

Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence

James P Boyle  1 , Theodore J Thompson, Edward W Gregg, Lawrence E Barker, David F Williamson
Affiliations

Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence

James P Boyle et al. Popul Health Metr. .

Abstract

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Incident cases of diagnosed diabetes per 1,000 people, 1980-2007, and three scenarios for projected cases per 1,000, 2008 -2050: a middle scenario (posterior means) and low and high scenarios (lower and upper limits of 95% Bayesian confidence intervals) from the projection model of diagnosed diabetes incidence.
Figure 2
Figure 2
Projections of total diabetes prevalence as a percentage of the total US adult population for four scenarios: low incidence projections and r1 = 1.77, r2 = 2.11; low incidence projections and r1 = 1.00, r2 = 4.08; middle incidence projections and r1 = 1.77, r2 = 2.11; middle incidence projections and r1 = 1.00, r2 = 4.08.
See this image and copyright information in PMC

Similar articles

  • Prevalence and Incidence of Type 2 Diabetes and Prediabetes.
    Cowie CC, Casagrande SS, Geiss LS. Cowie CC, et al. In: Cowie CC, Casagrande SS, Menke A, Cissell MA, Eberhardt MS, Meigs JB, Gregg EW, Knowler WC, Barrett-Connor E, Becker DJ, Brancati FL, Boyko EJ, Herman WH, Howard BV, Narayan KMV, Rewers M, Fradkin JE, editors. Diabetes in America. 3rd edition. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018 Aug. CHAPTER 3. In: Cowie CC, Casagrande SS, Menke A, Cissell MA, Eberhardt MS, Meigs JB, Gregg EW, Knowler WC, Barrett-Connor E, Becker DJ, Brancati FL, Boyko EJ, Herman WH, Howard BV, Narayan KMV, Rewers M, Fradkin JE, editors. Diabetes in America. 3rd edition. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018 Aug. CHAPTER 3. PMID: 33651562 Free Books & Documents. Review.
  • Tuberculosis.
    Bloom BR, Atun R, Cohen T, Dye C, Fraser H, Gomez GB, Knight G, Murray M, Nardell E, Rubin E, Salomon J, Vassall A, Volchenkov G, White R, Wilson D, Yadav P. Bloom BR, et al. In: Holmes KK, Bertozzi S, Bloom BR, Jha P, editors. Major Infectious Diseases. 3rd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Nov 3. Chapter 11. In: Holmes KK, Bertozzi S, Bloom BR, Jha P, editors. Major Infectious Diseases. 3rd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Nov 3. Chapter 11. PMID: 30212088 Free Books & Documents. Review.
  • Projection of the future diabetes burden in the United States through 2060.
    Lin J, Thompson TJ, Cheng YJ, Zhuo X, Zhang P, Gregg E, Rolka DB. Lin J, et al. Popul Health Metr. 2018 Jun 15;16(1):9. doi: 10.1186/s12963-018-0166-4. Popul Health Metr. 2018. PMID: 29903012 Free PMC article.
  • Modeling the impact of prevention policies on future diabetes prevalence in the United States: 2010-2030.
    Gregg EW, Boyle JP, Thompson TJ, Barker LE, Albright AL, Williamson DF. Gregg EW, et al. Popul Health Metr. 2013 Sep 18;11(1):18. doi: 10.1186/1478-7954-11-18. Popul Health Metr. 2013. PMID: 24047329 Free PMC article.
  • Implications of population growth on prevalence of diabetes. A look at the future.
    Helms RB. Helms RB. Diabetes Care. 1992 Mar;15 Suppl 1:6-9. doi: 10.2337/diacare.15.1.s6. Diabetes Care. 1992. PMID: 1559424
See all similar articles

Cited by

See all "Cited by" articles

References

    1. Engelgau MM, Geiss LS, Saaddine JB, Boyle JP, Benjamin JM, Gregg EW, Tierney EF, Rios-Burrows N, Mokdad AH, Ford ES, Imperatore G, Narayan KMV. The evolving diabetes burden in the United States. Ann Intern Med. 2004;140:945–950. - PubMed
    1. Zimmet PZ, Alberti KG, Shaw JE. Global and societal implications of the diabetes epidemic. Nature. 2001;414:782–787. doi: 10.1038/414782a. - DOI - PubMed
    1. American Diabetes Association. Economic costs of diabetes in the U.S. in 2007. Diabetes Care. 2008;32:596–615. - PubMed
    1. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2009;87:4–14. doi: 10.1016/j.diabres.2009.10.007. - DOI - PubMed
    1. Boyle JP, Honeycutt AA, Narayan KM, Hoerger TJ, Geiss LS, Chen H, Thompson TJ. Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S. Diabetes Care. 2001;24(11):1936–1940. doi: 10.2337/diacare.24.11.1936. - DOI - PubMed
-