As the number of individuals diagnosed with diabetes continues to increase, a new report has revealed that close to half the country's adult population – 40 percent – is expected to develop type 2 diabetes at some point during their lifetime. Published Aug. 13 in The Lancet Diabetes & Endocrinology, the study combed through 26 years of data – from 1985 to 2011 – from nationally representative U.S. population interviews and death certificates from approximately 600,000 adults to estimate trends in the lifetime risk of diabetes and years of life lost to the disease.

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In just over a quarter century's time, the lifetime risk of developing type 2 diabetes for the average American 20-year-old rose from 20 percent for men and 27 percent for women in 1985-1989, to 40 percent for men and 39 percent for women in 2000-2011. Worse off were those in ethnic minority groups such as Hispanic men and women, as well as non-Hispanic black women, whose lifetime risk now measures over 50 percent. The study also found that the number of life-years lost to diabetes when diagnosed at age 40 decreased from 7.7 years in 1990-1999 to 5.8 years in 2000-2011 in men and from 8.7 years to 6.8 years in women over the same period.

"Soaring rates of diabetes since the late 1980s and longer overall life expectancy in the general population have been the main drivers of the striking increase in the lifetime risk of diabetes over the last 26 years," says Edward Gregg, MD, lead author of the study and chief of the Epidemiology and Statistics Branch, Division of Diabetes Translation at the Centers for Disease Control and Prevention. "At the same time, a large reduction in death rates in the U.S. population with diabetes has reduced the average number of years lost to the disease. However, the overwhelming increase in diabetes prevalence has resulted in an almost 50 percent increase in the cumulative number of years of life lost to diabetes for the population as a whole: years spent living with diabetes have increased by 156 percent in men and 70 percent in women. As the number of diabetes cases continue to increase and patients live longer there will be a growing demand for health services and extensive costs. More effective lifestyle interventions are urgently needed to reduce the number of new cases in the U.S. and other developed nations."

In a commenting editorial, Lorraine Lipscombe, PhD, Women's College Hospital and the University of Toronto, Toronto, Canada, argues that the trends reported by Gregg and his colleagues are likely to be quite similar across the rest of the developed world where a large increase in diabetes prevalence has been surveyed. "Primary prevention strategies are urgently needed," writes Lipscombe. "Excellent evidence has shown that diabetes can be prevented with lifestyle changes. However, provision of these interventions on an individual basis might not be sustainable. Only a population-based approach to prevention can address a problem of this magnitude. Prevention strategies should include optimisation of urban planning, food-marketing policies, and work and school environments that enable individuals to make healthier lifestyle choices. With an increased focus on interventions aimed at children and their families, there might still be time to change the fate of our future generations by lowering their risk of type 2 diabetes."

Keywords: Life Style, Life Expectancy, Social Responsibility, Death Certificates, Diabetes Mellitus, Type 2, Hispanic Americans, Marketing, Primary Prevention, Centers for Disease Control and Prevention, U.S., Minority Groups, Prevalence, Developed Countries

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