Chapter 2. Effectiveness: Diabetes
Importance and Measures
There are three forms of diabetes. All forms of diabetes are characterized by elevated blood glucose, which can cause a number of complications over time if not controlled1.
Prevalence and Incidence
- In 2003, the number of adults with diagnosed diabetes was 13 million. With the addition of 5.2 million undiagnosed cases, the total prevalence of diabetes was 6.3%.
- According to the Centers for Disease Control and Prevention (CDC), in 2002 the number of new cases of diabetes in adults was 1.3 million.
- The number of cases of diagnosed diabetes is projected to increase 165% between 2000 and 2050, from 12 million to 39 million2.
Morbidity and Mortality
- Diabetes is the leading cause of blindness, nontraumatic lower extremity amputation, and end stage renal disease and increases the risk of complications with pregnancy.
- Diabetes was the sixth leading cause of death in the United States in 20013.
- People with diabetes are generally at twice the risk of death and are two to four times more likely to die from heart disease or stroke than those without diabetes1.
Cost
- In 2002, costs of diabetes totaled $132 billion, including about $92 billion in direct medical expenditures and about $40 billion in lost productivity and premature death4.
Measures
The NHQR diabetes measures include five recommended diabetes interventions and measures of associated outcomes (such as cholesterol and blood pressure levels and diabetes-related complications and hospital admissions). Measures highlighted in this section include:
- Receipt of recommended interventions for diabetes management
- State variation in HbA1c testing
- Hospital admission rates for long-term diabetes complications (renal, eye, neurological, circulatory, or complications not otherwise specified, excluding pregnancy-related diabetes)