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

Population Health Metrics - Tập 8 Số 1 - 2010
James P. Boyle1, Theodore Thompson1, Edward W. Gregg1, Lawrence Barker1, David F. Williamson2
1Division of Diabetes Translation,Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway NE, Atlanta, GA, 30341, USA
2Hubert Department of Global Health,Rollins School of Public Health RM 740, Emory University, Atlanta, GA, 30329, USA

Tóm tắt

AbstractBackgroundPeople 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.MethodsUsing 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.ResultsThe 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.ConclusionsThese 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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Tài liệu tham khảo

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.

Zimmet PZ, Alberti KG, Shaw JE: Global and societal implications of the diabetes epidemic. Nature 2001, 414: 782-787. 10.1038/414782a

American Diabetes Association: Economic costs of diabetes in the U.S. in 2007. Diabetes Care 2008, 32: 596-615.

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. 10.1016/j.diabres.2009.10.007

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. 10.2337/diacare.24.11.1936

Honeycutt AA, Boyle JP, Broglio KR, Thompson TJ, Hoerger TJ, Geiss LS, Narayan KMV: A dynamic Markov model for forecasting diabetes prevalence in the United States through 2050. Health Care Management Science 2003,6(3):155-164. 10.1023/A:1024467522972

Narayan KM, Boyle JP, Geiss LS, Saaddine JB, Thompson TJ: Impact of recent increase in incidence on future diabetes burden: U.S., 2005-2050. Diabetes Care 2006,29(9):2114-2116. 10.2337/dc06-1136

Magliano DJ, Shaw JE, Shortreed SM, Nusselder WJ, Liew D, Barr ELM, Zimmet PZ, Peeters A: Lifetime risk and projected population prevalence of diabetes. Diabetologia 2008,51(12):2179-2186. 10.1007/s00125-008-1150-5

U.S. Census Bureau. National Population Projections Released 2008 (Based on Census 2000)[http://www.census.gov/population/www/projections/downloadablefiles.html]

Centers for Disease Control and Prevention. Crude and Age-Adjusted Incidence of Diagnosed Diabetes per 1,000 Population Aged 18-79 Years, United States, 1980-2007[http://www.cdc.gov/diabetes/statistics/incidence/fig2.htm]

Gelman A, Carlin JB, Stern HS, Rubin DB: Bayesian Data Analysis. Boca Raton, FL: Chapman & Hall; 2004.

Knowler WC, Bennett PH, Hamman RF, Miller M: Diabetes incidence and prevalence in Pima Indians: a 19-fold greater incidence than in Rochester, Minnesota. Am J Epidemiol 1978,108(6):497-505.

Gilks WR, Thomas A, Spiegelhalter DJ: A language and program for complex Bayesian modeling. The Statistician 1994,43(1):169-178. 10.2307/2348941

Bartholomew DJ: Stochastic Models for Social Processes. 3rd edition. New York, NY: John Wiley & Sons; 1982.

Sandefur JT: Discrete Dynamical Modeling. New York, NY: Oxford University Press; 1993.

Aptech Systems Inc: GAUSS Mathematical and Statistical System version 9.0. Maple Valley, WA: Aptech Systems Inc; 2008.

Saydah SH, Loria CM, Eberhardt MS, Brancati FL: Subclinical states of glucose intolerance and risk of death in the U.S. Diabetes Care 2001,24(3):447-453. 10.2337/diacare.24.3.447

Wild S, Roglic G, Green A, Sicree R, King H: Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004,27(5):1047-1053. 10.2337/diacare.27.5.1047

Mainous AG, Baker R, Koopman J, Saxena S, Diaz VA, Everett CJ, Majeed A: Impact of the population at risk of diabetes on projections of diabetes burden in the United States: an epidemic on the way. Diabetologia 2007,50(5):934-940. 10.1007/s00125-006-0528-5

Magliano DJ, Barr EL, Zimmet PZ, Cameron AJ, Dunstan DW, Colagiuri S, Jolley D, Owen N, Phillips P, Tapp RJ, Welborn TA, Shaw JE: Glucose indices, health behaviors, and incidence of diabetes in Australia: the Australian Diabetes, Obesity and Lifestyle Study. Diabetes Care 2008,31(2):267-272. 10.2337/dc07-0912

Gregg EW, Gu Q, Cheng YJ, Narayan KMV, Cowie CC: Mortality trends in men and women with diabetes, 1971 to 2000. Ann Intern Med 2007,147(3):149-155.

Harris MI, Klein R, Welborn TA, Knuiman MW: Onset of NIDDM occurs at least4–7yr before clinical diagnosis. Diabetes Care 1992,15(7):815-819. 10.2337/diacare.15.7.815

Cowie CC, Rust KF, Ford ES, Eberhardt MS, Byrd-Holt DD, Li C, Williams DE, Gregg EW, Bainbridge KE, Saydah SH, Heiss LS: Full accounting of diabetes and pre-diabetes in the U.S. population in 1988-1994 and 2005-2006. Diabetes Care 2009,32(2):287-294. 10.2337/dc08-1296

Gerstein HC, Santaguida P, Raina P, Morrison KM, Balion C, Hunt D, Yazdi H, Booker L: Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: a systematic overview and meta-analysis of prospective studies. Diabetes Res Clin Pract 2007,78(3):305-312. 10.1016/j.diabres.2007.05.004

Santaguida PL, Balion C, Hunt D, Morrison K, Gerstein H, Raina P, Booker L, Yazdi H: Diagnosis, prognosis, and treatment of impaired glucose tolerance and impaired fasting glucose. Evid Rep Technol Assess.(Summ.) 2005, 128: 1-11.

Engberg S, Vistiesen D, Lau C, Glumer C, Jorgensen T, Pedersen O, Borch-Johnsen K: Progression to impaired glucose regulation and diabetes in the population-based inter99 study. Diabetes Care 2009,32(4):606-611. 10.2337/dc08-1869

Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Meigs JB, Bonadonna RC, Muggeo M: Population-based incidence rates and risk factors for type 2 diabetes in white individuals: the Bruneck study. Diabetes 2004,53(7):1782-1789. 10.2337/diabetes.53.7.1782

Maskarinec G, Erber E, Grandinetti A, Verheus M, Oum R, Hopping BN, Schmidt MM, Uchinda A, Juarez DT, Hodges K, Kolonel LN: Diabetes incidence based on linkages with health plans: the multiethnic cohort. Diabetes 2009,58(8):1732-1738. 10.2337/db08-1685

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Population Health Metrics

Tập 8 Số 1

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