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Lawrence JM, Casagrande SS, Herman WH, et al., editors. Diabetes in America [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); 2023-.
Sociodemographic Characteristics of Youth and Adults With Diabetes
Sarah S. Casagrande, PhD and Tiffany L. Gary-Webb, PhD, MHS.
Author Information and Affiliations
1 and Initial Posting: December 9, 2024.
Summary
This article describes the sociodemographic characteristics of youth and adults with diabetes in the United States, overall and by diabetes type when available, and compares their characteristics to persons without diagnosed diabetes based on national data from the National Health Interview Survey (NHIS). In the NHIS 2021–2022, the age distribution of all persons with diagnosed diabetes was older than persons without diagnosed diabetes (mean age 61.2 years vs. 37.6 years). Adults with type 1 diabetes were younger than adults with type 2 diabetes (mean age 47.1 years vs. 62.5 years). For the race and ethnicity distribution, a higher proportion of adults with diagnosed diabetes were non-Hispanic Black persons and a lower proportion were non-Hispanic White persons compared to those without diabetes (15.7% vs. 11.4% and 57.3% vs. 64.3%, respectively). The proportion of non-Hispanic White persons was highest for adults with type 1 diabetes compared to those with type 2 diabetes and those without diabetes (75.3% vs. 56.6% and 64.3%, respectively). Among adults with diagnosed diabetes, a higher proportion of non-Hispanic White persons and a lower proportion of non-Hispanic Black persons were men (54.3% vs. 45.7% women and 42.7% vs. 57.3% women, respectively).
In the NHIS 2021–2022, the majority of adults with or without diagnosed diabetes lived in metropolitan counties (83.5% and 86.7%, respectively), but compared to those without diabetes, slightly more adults with diagnosed diabetes lived in nonmetropolitan counties (16.5% vs. 13.3%, respectively) and in the South (42.6% vs. 37.6%, respectively).
The level of attained education was lower in adults with diagnosed diabetes compared to those without diabetes (21.2% vs. 38.4% graduated with bachelor’s degree or higher), and this difference persisted when stratified by age group. Hispanic persons with diagnosed diabetes had the highest prevalence of having less than a high school education compared to persons with diabetes of all other race/ethnicity groups (40.5% vs. 10.4%–19.4%). Compared to adults without diabetes, persons with diagnosed diabetes were more often: living below the poverty threshold (poverty income ratio <1.00: 13.1% vs. 9.3%), food insecure (11.0% vs. 6.5%), receiving Supplemental Nutrition Assistance Program benefits (food stamps; 18.6% vs. 12.2%), and receiving rental assistance (20.5% vs. 8.5%); these differences persisted when stratified by age group. Among adults that reported not working in the past week, those with diagnosed diabetes more often reported being disabled as the main reason for not working compared to persons without diabetes (25.2% vs. 14.3%), and this difference persisted regardless of age.
National data from the National Health and Nutrition Examination Surveys (NHANES) 2015–March 2020 were used to compare characteristics among adults with diagnosed diabetes, undiagnosed diabetes, prediabetes, and no diabetes and among youth with diagnosed diabetes, prediabetes, and no diabetes. Adults with prediabetes were younger (37.6% age 20–44 years) than those with undiagnosed diabetes or diagnosed diabetes (21.6% and 12.7% age 20–44 years, respectively), but the distributions of sex and race/ethnicity were similar for these diabetes status groups. Among youth with prediabetes, there were more males than females, and the majority were non-Hispanic White persons (52.0%), followed by Hispanic persons (27.2%).
Introduction
Understanding the sociodemographic characteristics of people with diabetes in the United States is important for public health efforts, including health care planning, guidance for federal assistance programs, interventions related to diabetes management and care, and promotion of policy change and resource allocation to address inequities. In addition, assessing the sociodemographic characteristics of persons with diabetes aligns with the Social Determinants of Health framework, which outlines social determinants that have a major impact on a person’s health and well-being (1). For example, knowing the race and ethnicity, educational attainment, and income levels of adults living in the United States with diabetes could guide culturally relevant nutrition and physical activity strategies at appropriate educational levels that are accessible at various income levels. Identifying employment patterns of population subgroups with diabetes may provide guidance to improve educational assistance or vocational training. Finally, estimating the future number of persons who may apply for Social Security, the Supplemental Nutrition Assistance Program, or other government benefits requires knowing the age distribution of people with diabetes and their current use of these benefits, along with the prevalence of diabetes in these subgroups. The content herein is an update of the Diabetes in America, 3rd edition, chapter Sociodemographic Characteristics of Persons With Diabetes (2).
Sources and Limitations of National Data on Sociodemographic Characteristics of Persons With Diabetes
The majority of data in this article utilize the National Health Interview Survey (NHIS), which is a cross-sectional household interview survey that uses a complex sampling design and has been conducted annually since 1957. In the NHIS 2021–2022 survey cycles, participants self-reported their diabetes status and several sociodemographic characteristics (age, sex, race/ethnicity, education, poverty income ratio [PIR], diabetes duration, place of residence, marital status, family size, home ownership, food insecurity, employment, and social and health benefits). Data on Asian American subgroups and Hispanic subgroups, other than Mexican American persons, were not publicly available for analysis. Diagnosed diabetes is determined if participants answer “yes” to the following question: “(If female, other than during pregnancy) Have you ever been told by a doctor or health professional that you have diabetes or sugar diabetes?” Although the questionnaire items in the NHIS are comprehensive, a limitation is that the data are self-reported and persons with undiagnosed diabetes cannot be identified. Defining type of diabetes in survey data is challenging due to the lack of a gold standard or antibody testing. While type 1 diabetes has previously been considered a disease of the young, evidence is accumulating that many type 1 diabetes cases are diagnosed at older ages (3), and type 2 diabetes is an increasing proportion of diabetes in youth (4). Several studies have shown utility in defining diabetes type using common questionnaire items that are included in the NHIS (5,6).
Sociodemographic estimates are presented for adults age ≥20 years with (1.) any diagnosed diabetes, (2.) type 2 diabetes (defined as self-report of diagnosed diabetes and not defined as type 1), (3.) type 1 diabetes (defined as self-report of type 1 diabetes and continuous insulin use within 1 year of diagnosis), and (4.) no diagnosed diabetes. For youth age <20 years, sociodemographic estimates are presented for diagnosed diabetes and no diabetes; information used to define diabetes type and age at diabetes diagnosis was not collected for youth. Two additional years of data from the NHIS (2019–2022) were utilized for adults with type 1 diabetes (n=434) and youth (n=140) to increase sample size. In spite of these additional years of data, stratification levels are limited for these subgroups.
The other national data source used in this report is the National Health and Nutrition Examination Survey (NHANES), a cross-sectional, national probability sample that has been conducted periodically since 1971 and continuously since 1999. Data from the NHANES 2015–March 2020 (the 2020 survey year included data from January–March only due to the start of the COVID-19 [coronavirus disease of 2019] pandemic) are used to assess current estimates in demographic characteristics (age, sex, race/ethnicity, PIR) among people with diagnosed diabetes, undiagnosed diabetes, prediabetes, and normal glycemia. Participants self-reported diagnosed diabetes status, based on the question of “Other than during pregnancy, have you ever been told by a doctor or health professional that you have diabetes or sugar diabetes?” An advantage of the NHANES is that the survey includes a health exam in a mobile examination center where laboratory measures are collected. Thus, the NHANES has laboratory test results for glycated hemoglobin (A1C) and fasting plasma glucose (FPG) that could be used to determine undiagnosed diabetes (A1C ≥6.5% [≥48 mmol/mol] or FPG ≥126 mg/dL [≥6.99 mmol/L; fast 8–<24 hours] and no self-report of diagnosed diabetes) and prediabetes (A1C 5.7%–<6.5% [39–<48 mmol/mol] or FPG 100–<126 mg/dL [5.55–<6.99 mmol/L; fast 8–<24 hours]). The NHANES does not include a question on diabetes type; therefore, no distinction is made between type 1 and type 2 diabetes.
Statistical Methods
Since the NHIS and NHANES use complex survey designs with oversampling of some population subgroups to improve survey reliability, estimates for each survey were weighted separately, except sample sizes, to produce nationally representative estimates of the noninstitutionalized population in the United States. Weighted standard errors (SE) are provided for estimates in tables, and weighted 95% confidence intervals are provided in figures. Percent estimates were considered significantly different if 95% confidence intervals prepared with weighted standard errors did not overlap. The relative standard error (RSE = [SE/estimate]*100) is provided in tables and figures for estimates that are likely unreliable due to sample size. Estimates with RSE >50% are censored. Unless stated otherwise, adults refer to persons age ≥20 years (with a coding cap at age 85 years), and youth refers to persons age <20 years at the time of the survey. Race and ethnicity are combined into one variable, race/ethnicity, by categorizing everyone with Hispanic ethnicity as Hispanic, regardless of race, and then categorizing everyone with non-Hispanic ethnicity based on their race.
The content herein describes the sociodemographic characteristics of persons with diabetes with comparisons by diabetes type and to those without diabetes. Prevalence of diabetes and risk factors for diabetes by sociodemographic characteristics are not presented.
Demographic Characteristics
Age Distribution
In the NHIS 2021–2022, the age distribution of all persons with diagnosed diabetes (youth and adults combined) was older than the age distribution of the total U.S. population (Figure 1). Nearly 60% (59.4%) of persons with diagnosed diabetes were age ≥60 years compared to a quarter (23.8%) of persons in the total U.S. population.
FIGURE 1.
Age Distribution Among Persons With Diagnosed Diabetes and the Total U.S. Population, U.S., 2021–2022. All data are self-reported.
In the NHIS 2021–2022, the age distribution of all persons with diagnosed diabetes was older than persons without diagnosed diabetes (mean age 61.2 years vs. 37.6 years) (Appendix Table A1). The highest percentage of persons with diabetes was in the 45–64-year age group (~43%), with 18.2% age ≥75 years. In contrast, the highest percentage of persons without diabetes were age <45 years (~62%).
Among adults age ≥20 years, the mean age was 61.9 years for persons with diagnosed diabetes, 62.5 years for persons with type 2 diabetes, 47.1 years for persons with type 1 diabetes, and 47.7 years for persons without diabetes (Appendix Table A2). The proportion of adults age ≥65 years was 45.6% for persons with diagnosed diabetes, 46.8% for persons with type 2 diabetes, 16.8% for persons with type 1 diabetes, and 20.4% for persons without diabetes.
In the NHIS 2019–2022, among youth age <20 years, the mean age was 12.4 years for those with diagnosed diabetes and 9.7 years for those without diabetes (Appendix Table A3).
Sex Distribution
In the NHIS 2021–2022, among all ages, a higher percentage of persons with diabetes were male (51.2%) compared to persons without diabetes (48.9%) (Appendix Table A1). Among adults with diagnosed diabetes, the proportion of men among non-Hispanic White persons was higher (54.3%) than the proportion of men among non-Hispanic Black (42.7%) and non-Hispanic American Indian/Alaska Native (36.7%) persons; the sex distribution within other races/ethnicities was similar to that for non-Hispanic White persons (Figure 2, Appendix Table A2). For adults, the sex distribution was similar by diabetes type.
FIGURE 2.
Sex Distribution Among Adults Age ≥20 Years, by Diabetes Status and Race/Ethnicity, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
In the NHIS 2019–2022, among youth, the distribution of sex was similar by diabetes status, with 55.5% male among youth with diagnosed diabetes and 51.0% male for youth without diabetes (Appendix Table A3).
Age Distribution by Sex
Among adults with diagnosed diabetes, nearly 90% were age ≥45 years compared to 50%–55% of adults with type 1 diabetes or adults without diabetes (Appendix Table A4). Fewer men and women with type 2 diabetes were age 20–44 years (9.2% and 10.3%, respectively) compared to men and women with type 1 diabetes (43.9% and 49.8%, respectively) or without diabetes (49.1% and 46.0%, respectively). The age distributions among adults with diagnosed diabetes across the age categories 20–44, 45–64, and ≥65 years were 10.5%, 45.8%, and 43.6% for men and 11.8%, 40.6%, and 47.7% for women, respectively.
Race and Ethnicity Distribution
In the NHIS 2021–2022, among all persons with diagnosed diabetes, non-Hispanic White persons comprised the largest race/ethnicity subgroup (57.1%), followed by Hispanic (18.8%), non-Hispanic Black (15.8%), non-Hispanic Asian (6.3%), and non-Hispanic American Indian/Alaska Native (2.0%) persons (Figure 3). The race/ethnicity distribution of people without diabetes was 61.3%, 19.5%, 11.9%, 5.8%, and 1.5%, respectively. Among all ages, the proportion of non-Hispanic Black persons was higher among persons with diabetes compared to those without diabetes (15.8% vs. 11.9%, respectively), while the prevalence of other race/ethnicity groups was similar by diabetes status. Mexican Americans were the largest population subgroup among Hispanic persons and comprised a similar percentage among persons with or without diabetes (Appendix Table A1).
FIGURE 3.
Distribution of Race/Ethnicity of All Persons, by Diabetes Status, U.S., 2021–2022. All data are self-reported.
Compared to adults with type 1 diabetes, a lower proportion of adults with type 2 diabetes were non-Hispanic White persons (56.6% vs. 75.3%) and a higher proportion were Hispanic persons (19.2% vs. 8.4%) (Figure 4). In 2019–2022, among adults with type 1 diabetes, the majority were non-Hispanic White persons (75.3%), followed by non-Hispanic Black (10.4%), Hispanic (8.4%), non-Hispanic Asian (4.2%), and non-Hispanic American Indian/Alaska Native (1.7%) persons. In the NHIS 2019–2022, among youth age <20 years, the distribution of race/ethnicity was similar for youth with or without diabetes. Among youth with diagnosed diabetes, 52.4% were non-Hispanic White, 11.3% were non-Hispanic Black, and 34.2% were Hispanic persons (Appendix Table A3).
FIGURE 4.
Distribution of Race/Ethnicity Among Adults Age ≥20 Years, by Diabetes Status, U.S., 2019–2022. All data are self-reported.
Age Distribution by Race and Ethnicity
Across all age and race/ethnicity groups, persons with diabetes were older than those without diabetes (Figure 5, Appendix Table A1). Among those with diagnosed diabetes, a higher proportion of Hispanic persons were age <65 years (65.0%) compared to non-Hispanic White (50.4%), non-Hispanic Black (58.7%), and non-Hispanic Asian (50.4%) persons.
FIGURE 5.
Age Distribution of All Persons, by Diabetes Status and Race/Ethnicity, U.S., 2021–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Similarly, adults with diabetes were older than adults without diabetes in every race/ethnicity group examined (Figure 6, Appendix Table A4). In all race/ethnicity groups, more than 80% of adults with diagnosed diabetes were age ≥45 years in 2021–2022 compared to 38%–58% of adults without diabetes. A larger percentage of Hispanic persons with diagnosed diabetes were age 20–44 years (15.2%) compared to non-Hispanic White (9.4%) and non-Hispanic Black (11.2%) persons with diagnosed diabetes. The percentage of adults age ≥65 years with diagnosed diabetes was 50.2% for non-Hispanic White, 42.0% for non-Hispanic Black, 35.7% for Hispanic, 50.0% for non-Hispanic Asian, and 29.1% for non-Hispanic American Indian/Alaska Native persons.
FIGURE 6.
Age Distribution Among Adults Age ≥20 Years, by Diabetes Status and Race/Ethnicity, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Race and Ethnicity Distribution by Sex
In the NHIS 2021–2022, among all males, the distribution of race/ethnicity was similar for those with diagnosed diabetes compared to those without diabetes (Appendix Table A1). For males with diagnosed diabetes, the race/ethnicity distribution was 60.2% non-Hispanic White, 13.3% non-Hispanic Black, 19.0% Hispanic, 6.1% non-Hispanic Asian, and 1.4% non-Hispanic American Indian/Alaska Native (vs. 62.1%, 11.2%, 19.7%, 5.6%, and 1.4% for those without diabetes, respectively). Among all females with diagnosed diabetes, a lower proportion were non-Hispanic White (53.8%) and a higher proportion were non-Hispanic Black (18.6%) compared to females without diabetes (60.8% and 12.5%, respectively).
Among adult men with type 2 diabetes, a lower proportion were non-Hispanic White (59.9%) and a higher proportion were non-Hispanic Black (13.1%) compared to men with type 1 diabetes (78.2% and 9.0%) or without diabetes (65.4% and 10.6%) (Appendix Table A2). Among adult men with type 2 diabetes, a higher proportion were Hispanic compared to men with type 1 diabetes (19.2% vs. 8.1%). Similar race/ethnicity distributions were found for adult woman with type 2 diabetes compared to their counterparts with type 1 diabetes or no diabetes.
Sex Distribution by Race and Ethnicity
In the NHIS 2021–2022, among all persons with diagnosed diabetes, the proportion of males was highest among non-Hispanic White persons (54.1%) and lowest for non-Hispanic American Indian/Alaska Native (36.7%) and non-Hispanic Black (42.9%) persons (Appendix Table A1). The proportion of males was higher for those with diagnosed diabetes compared to those without diabetes for non-Hispanic White persons (54.1% vs. 49.3%, respectively) and lower for non-Hispanic Black persons (42.9% vs. 46.2%, respectively); a similar proportion of persons with diagnosed diabetes were male compared to those with no diabetes among Hispanic, non-Hispanic Asian, and non-Hispanic American Indian/Alaska Native persons.
For non-Hispanic White adults with type 2 diabetes, a higher proportion were men (54.4%) compared to adults with type 1 diabetes or no diabetes (50.2% and 48.9%, respectively) (Appendix Table A2). For non-Hispanic Black adults with type 2 diabetes a similar proportion were men (42.4%) compared to those with type 1 diabetes (41.8%) or no diabetes (44.5%). Among Hispanic adults, a higher proportion with type 2 diabetes were men compared to those with no diabetes (51.3% vs. 48.3%, respectively).
Sexual Orientation
The majority of adults self-identified as straight (or heterosexual) regardless of diabetes status (90%–92%), and the prevalences of gay/lesbian, bisexual, or other and unknown orientation were similar by diabetes status (Figure 7). For adults with diagnosed diabetes, the prevalence of identifying as straight was lowest for adults age 20–44 years (83.7%) compared to those ages 45–64 (92.5%) or ≥65 (92.6%) years, but there were no differences by sex or race/ethnicity (Appendix Table A5). Adults age 20–44 years more often identified as bisexual compared to the older age groups, regardless of diabetes status (6.6% and 4.2% with and without diagnosed diabetes, respectively).
FIGURE 7.
Sexual Orientation Among Adults Age ≥20 Years, by Diabetes Status, U.S., 2019–2022. All data are self-reported.
Diabetes Characteristics
Age at Diagnosis of Diabetes
In the NHIS 2021–2022, the mean and median ages at diagnosis of diabetes were 47.7 years and 49.2 years for all adults with diagnosed diabetes (Figure 8, Appendix Table A6). For adults with type 2 diabetes, mean and median ages of diagnosis were similar by sex but slightly older for non-Hispanic White persons compared to persons of other races/ethnicities.
FIGURE 8.
Mean Age of Diagnosis Among Adults Age ≥20 Years, by Race/Ethnicity, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
In the NHIS 2019–2022, the mean and median ages of diagnosis for adults with type 1 diabetes were 23.5 and 19.8 years, respectively. For adults with type 1 diabetes, the mean and median ages of diagnosis were older for Hispanic and non-Hispanic Black persons compared to non-Hispanic White persons.
Duration of Diabetes
In the NHIS 2021–2022, among adults with diagnosed diabetes, the mean duration of diabetes was 14.1 years and the median duration was 10.1 years (Appendix Table A7). The mean duration of diabetes differed slightly by sex (13.6 years for men vs. 14.6 years for women) and race/ethnicity (range 12.9–15.8 years) among those with diagnosed diabetes. Adults with type 2 diabetes had a shorter mean duration of diabetes than adults with type 1 diabetes (13.6 years vs. 23.5 years, respectively). Among those age ≥65 years, the mean and median durations of diabetes were higher for adults with type 1 diabetes (mean, 35.3 years; median 35.0 years) compared to their counterparts with type 2 diabetes (mean, 17.3 years; median, 14.2 years). The mean duration of diabetes for adults with type 1 diabetes was similar by sex and highest for non-Hispanic White persons (25.7 years) and lowest for Mexican American persons (11.9 years).
Among all adults with diagnosed diabetes, 27.0% had a duration of diabetes ≥20 years compared to 55.0% of adults with type 1 diabetes (Figure 9). Further, 16.5% of adults with diagnosed diabetes had a duration of diabetes of ≥25 years compared to 43.7% of adults with type 1 diabetes (Appendix Table A8). For each type of diabetes, the distribution of duration of diabetes was similar by sex and race/ethnicity.
FIGURE 9.
Distribution of Duration of Diabetes Among Adults Age ≥20 Years, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Place of Residence
Urban-Rural County-Level Residence
In the NHIS 2021–2022, the majority of adults with and without diabetes lived in urban counties; 51.4% of adults with diagnosed diabetes lived in large metropolitan counties (that is, large central metro or large fringe metro areas) compared to 56.7% of adults without diabetes (Figure 10). The percentage living in nonmetropolitan counties was higher among adults with diagnosed diabetes compared to adults without diabetes (16.5% vs. 13.3%, respectively). There were no significant differences by type of diabetes.
FIGURE 10.
Urban-Rural County-Level Classification of Residence Among Adults Age ≥20 Years, by Diabetes Status, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Among adults with diabetes, non-Hispanic White persons more often lived in a nonmetropolitan area than non-Hispanic Black and Hispanic persons (22.4% vs. 10.5% and 5.4%, respectively) (Appendix Table A9). There was no difference in urbanicity by age or sex among adults with diagnosed diabetes.
Region of the United States
The regional distribution of adults with diagnosed diabetes was 15.9% in the Northeast, 20.9% in the Midwest, 42.6% in the South, and 20.7% in the West (Figure 11). More adults with diagnosed diabetes lived in the South (42.6%) and fewer in the West (20.7%) compared to adults without diabetes (37.6% and 24.1%, respectively). Overall, the distribution of region of residence was similar for adults with type 2 diabetes and type 1 diabetes.
FIGURE 11.
Region of Residence Among Adults Age ≥20 Years, by Diabetes Status, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Among adults with diagnosed diabetes, there was no difference in region of residence by age or sex (Appendix Table A10). The regions of the United States where adults with diabetes lived varied by race/ethnicity, and these regional distributions were similar to those without diabetes. Among adults with diagnosed diabetes, fewer non-Hispanic Black persons lived in the West compared to non-Hispanic White, Hispanic, and non-Hispanic Asian persons (7.2% vs. 15.9%, 37.2%, 41.7%, respectively). Non-Hispanic Black persons with diabetes predominately resided in the South (66.8%) compared to persons of all other race/ethnicity groups (range 24.8%–42.3%), and non-Hispanic Asian persons more often resided in the West (41.7%) compared to persons of all other race/ethnicity groups (range 7.2%–37.2%).
Among adults age 20–44 years with type 2 diabetes, a higher proportion lived in the South (46.7%) and a lower proportion lived in the Northeast (10.5%) compared with those age 20–44 years without diabetes (37.3% and 16.9%, respectively) (Appendix Table A10). Among adults age ≥65 years, the region of residence was similar for those with type 2 diabetes and no diabetes with only slightly more older adults with type 2 diabetes living in the South compared to those without diabetes (41.4% vs. 37.0%, respectively).
Years Living in the United States, Among Immigrants
In 2021–2022, immigrant adults with diagnosed diabetes lived in the United States longer than immigrant adults without diabetes. A higher percentage of immigrant adults with diagnosed diabetes lived in the United States ≥15 years (90.1%) compared to immigrant adults without diabetes (70.3%) (Figure 12). Given that adults with diabetes tend to be older, the percentage having lived in the United States ≥15 years was lower for adults age 20–44 years compared to those ages 45–64 or ≥65 years (71.2% vs. 91.5% and 92.5%, respectively) (Appendix Table A11). Among immigrant adults with diabetes, there were no significant sex or race/ethnicity differences for the number of years living in the United States.
FIGURE 12.
Years Living in the United States Among Immigrant Adults Age ≥20 Years, by Diabetes Status, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Socioeconomic Characteristics
Marital Status
In the NHIS 2021–2022, a higher percentage of adults with diagnosed diabetes were ever married (currently married, divorced/separated, or widowed) and a lower percentage were never married or currently living with a partner compared to adults without diabetes (Figure 13). A larger percentage of adults age 20–44 years with diagnosed diabetes were divorced or separated than adults without diabetes (8.9% vs. 4.8%) (Appendix Table A12). A larger percentage of men with diagnosed diabetes were married (63.1%) compared to women with diabetes (48.5%) or men without diabetes (54.8%). A higher percentage of women with diagnosed diabetes were widowed (19.2%) or divorced/separated (15.7%) compared to men with diabetes (6.3% and 12.2%) or women without diabetes (7.9% and 11.3%). Among adults with diagnosed diabetes, the percentage married ranged from 40.8% among non-Hispanic Black persons to 71.0% among non-Hispanic Asian persons.
FIGURE 13.
Marital Status Among Adults Age ≥20 Years, by Diabetes Status, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
In 2019–2022, adults with type 1 diabetes were more likely to have never been married compared to those with type 2 diabetes (26.4% vs. 11.7%, respectively) or adults without diabetes (22.3%), especially among adults age <45 years.
Family Composition
In the NHIS 2021–2022, 77.9% of adults with diagnosed diabetes lived with others (with another adult, with children, or both), which was similar to adults without diabetes (81.0%) (Figure 14). Given that adults with diabetes tend to be older, fewer adults with diabetes lived with children (18.6% vs. 33.2% without diabetes) and more lived with one other adult but no children (41.2% vs. 32.5% without diabetes). Among adults with diagnosed diabetes, more adults age 20–44 years lived in a household with two adults and children compared to those ages 45–64 or ≥65 years (30.2% vs. 8.8% and 1.4%, respectively) (Appendix Table A13). Men with diagnosed diabetes less often lived by themselves compared to women with diabetes (19.7% vs. 24.7%). Among adults with diagnosed diabetes, non-Hispanic White and non-Hispanic Black persons more often lived alone compared to Hispanic and non-Hispanic Asian persons (23.7% and 31.1% vs. 13.3% and 10.2%, respectively). For all race/ethnicity groups and for both men and women, adults with diagnosed diabetes more often lived without children compared to those without diabetes.
FIGURE 14.
Family Composition Among Adults Age ≥20 Years, by Diabetes Status, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Education
In the NHIS 2021–2022, adults age ≥25 years with diagnosed diabetes had lower educational attainment than adults of similar age without diabetes (Figure 15). Adults with type 2 diabetes were more likely to have less than a high school education (18.3%) compared to their counterparts with type 1 diabetes (9.9%) or without diabetes (9.0%) and less likely to have a bachelor’s degree or above (20.6% vs. 37.1% and 38.4%, respectively). Differences between adults with and without diabetes for all age groups were most pronounced for achieving less than a high school education and obtaining a bachelor’s degree but were more similar for completing high school or some college (Appendix Table A14). Non-Hispanic Asian adults had the highest level of education attained regardless of diabetes status, followed by non-Hispanic White, non-Hispanic Black, and Hispanic persons (39.9% vs. 23.9%, 19.4%, 8.4% for adults with diagnosed diabetes and a bachelor’s degree or above, respectively).
FIGURE 15.
Level of Attained Education Among Adults Age ≥25 Years, by Diabetes Status, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals. GED, general equivalency diploma.
In 2019–2022, adults age ≥25 years with type 1 diabetes had a higher level of education attainment than adults with type 2 diabetes and similar levels of education as adults without diabetes.
Poverty Income Ratio
The PIR is defined as total family income divided by the poverty threshold for the family’s size (7). Ratios below 1.00 indicate living below the poverty threshold; ratios greater than 1.00 indicate living above the poverty threshold (e.g., PIR 2.00 refers to a family living two times above the poverty threshold).
In the NHIS 2021–2022, a higher percentage of adults with diagnosed diabetes were below or near the poverty threshold compared to adults without diabetes (Figure 16). For adults with diagnosed diabetes, 36.8% had a PIR <2.00 compared to 26.2% of adults without diabetes, and fewer adults with diabetes were in the most economically advantaged PIR category (≥4.00) compared to adults without diabetes (31.0% vs. 44.9%). Adults with type 1 diabetes were more often in the most economically advantaged PIR category compared to adults with type 2 diabetes (43.7% vs. 30.5%).
FIGURE 16.
Family Poverty Income Ratio Among Adults Age ≥20 Years, by Diabetes Status, U.S., 2019–2022. The poverty income ratio (PIR) is defined as family income divided by the federal poverty threshold. All data are self-reported. Error bars represent (more...)
Among adults with diagnosed diabetes, those ages 20–44 and 45–64 years were more often living below the poverty threshold (PIR <1.00) compared to those age ≥65 years (17.0% and 15.3% vs. 10.1%, respectively), and a higher percentage of women compared to men were below the poverty threshold (16.0% vs. 10.4%, respectively) (Appendix Table A15). Among adults with or without diabetes, the age group 20–44 years had the highest percentage below poverty (PIR <1.00), and the age group 45–64 years had the highest percentage in the most economically advantaged PIR category (≥4.00). Non-Hispanic Black and Hispanic persons had a higher percentage below the poverty threshold compared to non-Hispanic White or non-Hispanic Asian persons, regardless of diabetes status.
Home Ownership
In the NHIS 2021–2022, among adults with diagnosed diabetes, 72.7% owned a home, 24.9% rented, and 2.3% had another arrangement (Figure 17). Slightly more adults with diagnosed diabetes owned a home (72.7%) and fewer rented (24.9%) compared to those without diabetes (69.3% and 28.7%, respectively) (Appendix Table A16). Among adults with diabetes, half of adults age 20–44 years owned a home (54.0%) compared to 70.5% and 79.5% of adults ages 45–64 and ≥65 years, respectively (Appendix Table A16). For adults with diabetes, home ownership was higher for men (75.0%) compared to women (70.4%) and for non-Hispanic White (79.9%) and non-Hispanic Asian (73.3%) persons compared to non-Hispanic Black (58.2%) and Hispanic (63.3%) persons. Home ownership was similar for adults age 20–44 years with diagnosed diabetes compared to their counterparts without diabetes (54.0% vs. 56.7%, respectively), but home ownership was lower for adults ages 45–64 or ≥65 years with diagnosed diabetes compared to their counterparts without diabetes. Overall, adults with type 1 diabetes were more likely to rent (32.5%) compared to adults with type 2 diabetes (24.7%), but the proportion renting was similar when stratified by age.
FIGURE 17.
Home Ownership Among Adults Age ≥20 Years, by Diabetes Status, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Food Security
In the NHIS 2021–2022, food insecurity was based on a set of 10 questions developed by the U.S. Department of Agriculture that measures a family’s food situation based on the past 30 days (8). Items measure the extent of worrying that food would run out or perish before there was money to buy more, affordability of balanced meals, reduced or skipped meals, or went hungry or lost weight because there was not enough money for food.
The prevalence of marginal food security and low/very low food security was higher among adults with diagnosed diabetes compared to adults without diabetes (8.1% and 11.0% vs. 5.8% and 6.5%, respectively) (Figure 18). Among adult with diabetes, low/very low food security was highest among those age 20–44 years (17.6% vs. 7.4% age ≥65 years), women compared to men (12.8% vs. 9.3%), and non-Hispanic Black and Hispanic persons compared to non-Hispanic White and non-Hispanic Asian persons (Appendix Table A17). Food security status was similar for adults with type 1 diabetes and adults with type 2 diabetes, with 10.6% and 11.0%, respectively, having low/very low food security.
FIGURE 18.
Food Security Among Adults Age ≥20 Years by Diabetes Status, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Employment Characteristics
Employment Status in Prior Week
In the NHIS 2021–2022, adults with diagnosed diabetes were less likely to work in the past week compared to adults without diabetes overall and within age strata (overall, 39.6% vs. 65.8% reported working in the prior week) (Figure 19). The magnitude in the difference between adults with diabetes who worked in the prior week compared to adults without diabetes diminished with increasing age, likely due to adults with diabetes tending to be older and therefore more often retired or disabled. Among adults with diabetes, the percentage who did not work in the past week increased by age group (31.9% age 20–44, 41.0% age 45–64, and 85.9% age ≥65 years), was higher for women than for men (65.7% vs. 55.4%), and ranged from 55.1% for Hispanic persons to 67.1% for non-Hispanic American Indian/Alaska Native persons (Appendix Table A18). Similar prevalence estimates for employment status by age, sex, and race/ethnicity were found for adults without diabetes. Adults with type 1 diabetes were more likely to work in the past week compared to adults with type 2 diabetes (58.7% vs. 38.9%).
FIGURE 19.
Prevalence of Working in the Past Week Among Adults Age ≥20 Years, by Diabetes Status and Age, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Main Reason for Not Working in Prior Week
In the NHIS 2021–2022, among the 60.4% of adults with diagnosed diabetes who reported not working in the prior week, retirement (64.3%) and disability (25.2%) were the main reasons for not working in the prior week (Figure 20). Among adults without diabetes, the main reasons were retirement (51.7%), other reasons (19.4%), such as unemployment or attending school, and caring for the family or home (14.5%). Women, regardless of a diabetes diagnosis, were more likely to report caring for the family or home as the main reason for not working compared to men (Appendix Table A19). Disability as a reason for not working in the prior week among adults with diabetes was highest among non-Hispanic American Indian/Alaska Native (44.2%) and Hispanic (31.2%) persons and lowest among non-Hispanic Asian persons (15.7%). For adults without diabetes, disability as a reason for not working in the prior week was highest for non-Hispanic Black persons (24.1%) and lowest for non-Hispanic Asian persons (6.6%).
FIGURE 20.
Main Reason for Not Working in Prior Week Among Adults Age ≥20 Years, by Diabetes Status, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Type of Employer
In the NHIS 2020–2021, among those who were employed in the past 12 months (which includes 40.1% of persons with diabetes and 68.9% without diabetes), type of employer was similar by diabetes status (Figure 21). Among adults with diabetes, the majority worked at a private company (71.3%), followed by being self-employed (13.1%), working at a state or local government (12.5%), and working for the federal government (3.1%) (Appendix Table A20). A higher percentage of women with diabetes worked in state and local government than men with diabetes (16.1% vs. 10.1%, respectively), which was similar to the pattern for women and men without diabetes (14.9% vs. 9.4%, respectively). Men, regardless of diabetes status, were more often self-employed. Within each race/ethnicity group, employer type was similar regardless of diabetes status.
FIGURE 21.
Type of Employer Among Adults Age ≥20 Years, by Diabetes Status, U.S., 2020–2021. All data are self-reported. Estimates are for the 40.1% of persons with diabetes and 68.9% of persons without diabetes who were employed in the past 12 months (more...)
Hours Worked When Employed
Among employed adults, the number of hours worked in the prior week was similar for adults with or without diabetes (Figure 22). Approximately 50% of people who worked in the prior week reported working 40–49 hours, regardless of diabetes status. Among adults with diabetes, women were more likely to work <40 hours in the prior week compared to men with diabetes (37.7% vs. 18.9%, respectively) (Appendix Table A21). Hours worked were similar by race/ethnicity groups, regardless of diabetes status. Adults age ≥65 years worked fewer hours in the prior week (50.4% with diabetes and 51.0% without diabetes worked <40 hours in the prior week).
FIGURE 22.
Hours Worked in Prior Week Among Employed Adults Age ≥20 Years, by Diabetes Status, U.S., 2019–2022. All data are self-reported. Error bars represent 95% confidence intervals.
Veteran Status
In the NHIS 2021–2022, adults with diabetes had a higher prevalence of military veterans compared to adults without diabetes. Overall, 12.1% of adults with diabetes were military veterans compared with 7.3% of adults without diabetes (Figure 23). The prevalence of military veterans increased with age, regardless of diabetes status. Among adults with diagnosed diabetes, 2.2% age 20–44 years, 8.2% age 45–64 years, and 18.2% age ≥65 years were military veterans compared to 3.8%, 6.7%, and 16.5%, respectively, for adults without diabetes. Among adults with diabetes, men were more often military veterans than women (21.7% vs. 1.9%), and non-Hispanic White persons were more often veterans compared to persons of all other race/ethnicity groups (Appendix Table A22).
FIGURE 23.
Prevalence of Veterans Among Adults Age ≥20 Years by Diabetes Status and Age, U.S., 2019–2022. Veterans are defined as adults who report ever serving in active-duty military. All data are self-reported. Error bars represent 95% confidence (more...)
Social and Health Benefits
Reported Health Insurance
In the NHIS 2021–2022, the percentage reporting health insurance coverage was higher among adults with diabetes than adults without diabetes (94.8% vs. 89.6%, respectively) (Appendix Table A23). The percentage having health insurance was similar for men and women with diabetes; however, among adults without diabetes, a higher percentage of women compared to men had health insurance. Differences in insurance coverage by race/ethnicity existed among all adults, regardless of diabetes status, and the differences were more pronounced in adults without diabetes. Among adults with diabetes, 85.4% of Hispanic persons with diabetes reported having health insurance coverage, which was lower than the 90.0% or higher reported by persons of other race/ethnicity groups. In the NHIS 2019–2022, 97.6% of adults with type 1 diabetes had health insurance. More detailed information on health insurance status can be found in the Diabetes in America article Health Insurance and Diabetes (9).
Federal Benefit Programs
Federal benefits include income from Social Security or Railroad Retirement benefits, Supplemental Security Income (SSI) or Social Security Disability Income (SSDI), Supplemental Nutrition Assistance Program (SNAP), also known as food stamps, Supplemental Nutrition Program for Women, Infants, and Children (WIC), and rental assistance, where the federal, state, or local government pays for part of the cost of housing rent.
Social Security or Railroad Retirement Benefits
Receipt of Social Security or Railroad Retirement benefits was more common among adults with diabetes than among adults without diabetes (53.0% versus 26.9%) (Appendix Table A24). Receipt of these benefits was similar for adults age ≥65 years by diabetes status (87.8% with diagnosed diabetes vs. 87.4% without diabetes), but adults age 20–44 years with diagnosed diabetes had a twofold higher prevalence of receiving Social Security or Railroad Retirement benefits compared to adults age 20–44 years without diabetes (17.9% vs. 7.9%, respectively). A larger percentage of non-Hispanic White adults with diabetes received Social Security or Railroad Retirement benefits compared with adults with diabetes in other race/ethnicity groups.
In the NHIS 2019–2022, adults with type 1 diabetes were less likely to receive these benefits compared to adults with type 2 diabetes (31.6% vs. 53.8%), but receiving these benefits was similar for adults age ≥65 years (89.9% for type 1 diabetes and 87.8% for type 2 diabetes).
Supplemental Security Income or Social Security Disability Income
Receipt of SSI or SSDI was higher among adults with diagnosed diabetes (18.8%) than among adults without diabetes (8.2%) (Appendix Table A24). The percentage receiving SSI/SSDI benefits varied by race/ethnicity among adults with diabetes and ranged from 14.7% for non-Hispanic Asian adults to 34.3% for non-Hispanic American Indian/Alaska Native adults. The prevalence of SSI/SSDI benefits was similar for adults with type 1 diabetes and those with type 2 diabetes.
Supplemental Nutrition Assistance Program (SNAP)
A larger percentage of adults with diabetes received SNAP, also known as food stamps, compared to adults without diabetes, including: 30.3% versus 15.1% in the 20–44-years age group; 19.9% versus 10.8% in the 45–64-years age group; and 14.5% versus 7.8% in the ≥65-years age group (Appendix Table A24). Women more often received SNAP than men (23.5% vs. 14.0% among adults with diabetes); a similar association was seen for adults without diabetes, although the magnitude of the difference was smaller. Receiving SNAP varied by race/ethnicity among adults with diabetes and included 12.7% of non-Hispanic White persons, 28.7% of non-Hispanic Black persons, 26.8% of Hispanic persons, 18.9% of non-Hispanic Asians persons, and 35.0% of non-Hispanic American Indian/Alaska Native persons.
Women, Infants, and Children (WIC) Benefits
Among adults eligible for WIC benefits, the percentage of adults receiving WIC benefits was similar by diabetes status (6.8% with diabetes vs. 6.1% without diabetes) (Appendix Table A24). Among adults with diabetes, the prevalence of WIC benefits was similar by sex and higher for Hispanic persons compared with non-Hispanic Black and non-Hispanic White persons (10.5% vs. 7.7% and 4.3%, respectively). Among adults with type 1 diabetes, the prevalence of WIC benefits was lower compared to adults with type 2 diabetes (2.9% vs. 7.0%).
Rental Assistance
The percentage of adults receiving rental assistance (paying lower rent because the federal, state, or local government is paying for part of the cost) was twice as high for those with diagnosed diabetes compared to those without diabetes (20.5% vs. 8.5%) (Appendix Table A24). Among adults with diabetes, the percentage receiving rental assistance increased with age from 12.8% in the 20–44-years age group to 17.7% in the 45–64-years age group and 29.2% in the ≥65-years age group. Women more often received rental assistance than men (27.0% vs. 13.0%), and rental assistance was higher for non-Hispanic Black (27.3%) and Hispanic (21.0%) adults compared to non-Hispanic White (15.9%) and non-Hispanic Asian (17.2%) adults. The percentage receiving rental assistance was similar for adults with type 1 diabetes compared to those with type 2 diabetes.
Age-Standardized Sociodemographic Characteristics of Adults With Diabetes
Some differences in sociodemographic characteristics between adults with and without diabetes may be attributed to age, as noted in previous sections, given that adults with diabetes tend to be older than adults without diabetes. However, understanding the sociodemographic characteristics of persons with diabetes, regardless of age, is important for public health initiatives, interventions, and policy development. To provide additional information, Appendix Table A25 shows selected age-standardized sociodemographic characteristics by diabetes status.
Demographic Characteristics of People With Undiagnosed Diabetes and Prediabetes
The NHANES includes laboratory tests and results. Results from A1C and FPG tests were used to determine undiagnosed diabetes (A1C ≥6.5% or FPG ≥126 mg/dL [fast 8–<24 hours]) and prediabetes (A1C 5.7%–<6.5% or FPG 100–<126 mg/dL [fast 8–<24 hours]) among participants with no self-report of diagnosed diabetes.
Demographic Characteristics of Adults With Undiagnosed Diabetes and Prediabetes
Using the NHANES 2015–March 2020, adults with undiagnosed diabetes were generally younger than those with diagnosed diabetes (30.1% vs. 42.9% age ≥65 years, respectively) (Appendix Table A26). Adults with prediabetes tended to be younger than adults with undiagnosed diabetes (37.6% vs. 21.6% age 20–44 years, respectively). The distributions of sex and race/ethnicity were similar among adults with diagnosed diabetes, undiagnosed diabetes, and prediabetes. Adults with prediabetes more often obtained a college or higher degree and more often had a PIR well above the poverty threshold (≥4.00) compared to adults with diagnosed diabetes (32.0% vs. 21.7% and 38.6% vs. 31.7%, respectively). The distributions of education level and PIR were relatively similar for adults with undiagnosed diabetes and diagnosed diabetes.
Demographic Characteristics of Youth With Prediabetes
The distributions of sex, race/ethnicity, and PIR among youth in the NHANES 2015–March 2020 are shown in Appendix Table A27. Due to the small sample size for total diabetes (diagnosed and undiagnosed, n=31), estimates are imprecise such that conclusions by demographic characteristics cannot be determined. Among youth with prediabetes, there were more males than females (62.3% vs. 37.7%), the majority were non-Hispanic White persons (52.0%), followed by Hispanic persons (27.2%), and one-fifth (20.8%) had a PIR below the poverty threshold (<1.00). Compared to youth without diabetes, youth with prediabetes were more often male but had similar race/ethnicity and PIR distributions.
Conclusions
There are many differences in the sociodemographic characteristics of persons with diabetes in the United States compared with persons without diabetes. In 2021–2022, adults with diagnosed diabetes were older, more often men, and more often non-Hispanic Black compared to adults without diabetes. In addition, adults with diabetes disproportionately resided in nonmetropolitan counties and in the South, had a lower level of educational achievement, more often lived below the poverty threshold, had more food insecurity, and were more likely to be beneficiaries of federal programs compared to adults without diabetes. Adults with type 1 diabetes were younger, more often non-Hispanic White and less often non-Hispanic Black or Hispanic, had a longer duration of diabetes, and achieved higher levels of education compared to adults with type 2 diabetes. While the small number of youth with diabetes makes sociodemographic comparisons difficult, the race/ethnicity and PIR distributions of youth with prediabetes were similar to those without diabetes; however, more males than females had prediabetes. Public health efforts, including health care planning and interventions for diabetes management, should be developed with consideration to these sociodemographic characteristics. Given the increasing prevalence of diabetes, including at younger ages, public health programs designed to effectively alleviate the burden of diabetes in the United States will be crucial.
List of Abbreviations and Definitions
- A1C
glycated hemoglobin
- FPG
fasting plasma glucose
- NHANES
National Health and Nutrition Examination Survey
- NHIS
National Health Interview Survey
- PIR
poverty income ratio, defined as family income divided by the federal poverty threshold
- SNAP
Supplemental Nutrition Assistance Program, also known as food stamps
- SSDI
Social Security Disability Income
- SSI
Supplemental Security Income
- WIC
Supplemental Nutrition Program for Women, Infants, and Children
Conversions
A1C: (% x 10.93) - 23.50 = mmol/mol
Glucose: mg/dL x 0.0555 = mmol/L
Acknowledgment
This is an update of: Eberhardt MS, Casagrande S, Cowie C: Sociodemographic Characteristics of Persons with Diabetes. Chapter 8 in Diabetes in America, 3rd ed. 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, Eds. Bethesda, MD, National Institutes of Health, NIH Pub No. 17-1468, 2018, p. 8.1–8.67.
Article History
Received in final form on August 22, 2024.
References
- 1.
- Hill-Briggs F, Adler NE, Berkowitz SA, et al. Social determinants of health and diabetes: a scientific review. Diabetes Care. 2020;44(1):258-279. doi:10.2337/dci20-0053 [PMC free article: PMC7783927] [PubMed: 33139407] [CrossRef]
- 2.
- Eberhardt MS, Casagrande SS, Cowie CC. Sociodemographic Characteristics of Persons With Diabetes. In: Cowie CC, Casagrande SS, Menke A, et al, eds. Diabetes in America. 3rd ed. National Institutes of Health; 2018. https://www
.ncbi.nlm .nih.gov/books/NBK567995/ - 3.
- Thomas NJ, Jones SE, Weedon MN, Shields BM, Oram RA, Hattersley AT. Frequency and phenotype of type 1 diabetes in the first six decades of life: a cross-sectional, genetically stratified survival analysis from UK Biobank. Lancet Diabetes Endocrinol. 2018;6(2):122-129. doi:10.1016/S2213-8587(17)30362-5 [PMC free article: PMC5805861] [PubMed: 29199115] [CrossRef]
- 4.
- Wagenknecht LE, Lawrence JM, Isom S, et al. Trends in incidence of youth-onset type 1 and type 2 diabetes in the USA, 2002–18: results from the population-based SEARCH for Diabetes in Youth study. Lancet Diabetes Endocrinol. 2023;11(4):242-250. doi:10.1016/S2213-8587(23)00025-6 [PMC free article: PMC10091237] [PubMed: 36868256] [CrossRef]
- 5.
- Bullard KM, Cowie CC, Lessem SE, et al. Prevalence of diagnosed diabetes in adults by diabetes type—United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(12):359-361. doi:10.15585/mmwr.mm6712a2 [PMC free article: PMC5877361] [PubMed: 29596402] [CrossRef]
- 6.
- Casagrande SS, Lessem SE, Orchard TJ, et al. Comparison of several survey-based algorithms to ascertain type 1 diabetes among US adults with self-reported diabetes. BMJ Open Diabetes Res Care. 2020;8(2):e001917. doi:10.1136/bmjdrc-2020-001917 [PMC free article: PMC7733112] [PubMed: 33298431] [CrossRef]
- 7.
- United States Census Bureau. How the census bureau measures poverty. Updated June 15, 2023. https://www
.census.gov /topics/income-poverty /poverty/guidance/poverty-measures .html - 8.
- Weeks JD, Mykyta L, Madans JH. Adults living in families experiencing food insecurity in the past 30 days: United States, 2021. NCHS Data Brief. 2023;(465):1-8. doi:10.15620/cdc:125707 [PubMed: 37093588] [CrossRef]
- 9.
- Casagrande SS, Park J, Herman WH, Bullard KM. Health Insurance and Diabetes. In: Lawrence JM, Casagrande SS, Herman WH, Wexler DJ, Cefalu WT, eds. Diabetes in America. eBook. National Institutes of Health; 2023. https://www
.ncbi.nlm .nih.gov/pubmed/38117923
Appendices
APPENDIX TABLE A1.
Distribution of All Persons, by Diabetes Status, Age, Sex, and Race/Ethnicity, U.S., 2021–2022
| CHARACTERISTICS | DIAGNOSED DIABETES | NO DIABETES |
|---|---|---|
| Age (years), mean | 61.2 (0.3) | 37.6 (0.2) |
| Percent (Standard Error) | ||
| Age (years) | ||
| <20 | 1.5 (0.2) | 26.7 (0.2) |
| 20–44 | 11.0 (0.5) | 34.8 (0.3) |
| 45–64 | 42.6 (0.8) | 23.6 (0.2) |
| 65–74 | 26.7 (0.6) | 8.9 (0.1) |
| ≥75 | 18.2 (0.6) | 6.0 (0.1) |
| Sex | ||
| Male | 51.2 (0.8) | 48.9 (0.2) |
| Female | 48.8 (0.8) | 51.1 (0.2) |
| Sex, age (years) | ||
| Male | ||
| <20 | 1.6 (0.3) | 27.8 (0.3) |
| 20–44 | 10.4 (0.7) | 35.4 (0.4) |
| 45–64 | 45.1 (1.1) | 23.2 (0.3) |
| 65–74 | 26.4 (0.9) | 8.4 (0.2) |
| ≥75 | 16.5 (0.7) | 5.1 (0.1) |
| Female | ||
| <20 | 1.5 (0.3) | 25.6 (0.3) |
| 20–44 | 11.6 (0.7) | 34.2 (0.3) |
| 45–64 | 40.0 (1.1) | 23.9 (0.3) |
| 65–74 | 27.0 (0.8) | 9.4 (0.2) |
| ≥75 | 20.0 (0.9) | 6.8 (0.2) |
| Race/ethnicity | ||
| Non-Hispanic White | 57.1 (1.1) | 61.3 (0.8) |
| Non-Hispanic Black | 15.8 (0.8) | 11.9 (0.4) |
| Hispanic | 18.8 (1.0) | 19.5 (0.7) |
| Mexican American* | 11.7 (0.9) | 11.4 (0.6) |
| Non-Hispanic Asian | 6.3 (0.5) | 5.8 (0.2) |
| Non-Hispanic American Indian/Alaska Native | 2.0 (0.4) | 1.5 (0.2) |
| Race/ethnicity, age (years) | ||
| Non-Hispanic White | ||
| <20 | 1.3 (0.2) | 22.7 (0.3) |
| 20–44 | 9.3 (0.7) | 32.2 (0.3) |
| 45–64 | 39.8 (1.0) | 25.7 (0.3) |
| 65–74 | 29.0 (0.8) | 11.4 (0.2) |
| ≥75 | 20.7 (0.7) | 8.0 (0.2) |
| Non-Hispanic Black | ||
| <20 | 1.6 (0.7) | 28.7 (0.6) |
| 20–44 | 11.0 (1.3) | 38.1 (0.7) |
| 45–64 | 46.1 (2.1) | 22.8 (0.6) |
| 65–74 | 25.0 (1.5) | 6.6 (0.3) |
| ≥75 | 16.3 (1.3) | 3.9 (0.2) |
| Hispanic | ||
| <20 | 2.1 (0.5) | 36.0 (0.5) |
| 20–44 | 14.9 (1.4) | 39.0 (0.5) |
| 45–64 | 48.0 (2.0) | 18.8 (0.5) |
| 65–74 | 23.6 (1.6) | 3.9 (0.2) |
| ≥75 | 11.4 (1.4) | 2.4 (0.2) |
| Non-Hispanic Asian | ||
| <20 | 0.7 (0.5) | 21.9 (0.6) |
| 20–44 | 11.4 (2.1) | 41.7 (1.0) |
| 45–64 | 38.3 (3.2) | 25.0 (0.8) |
| 65–74 | 26.4 (2.8) | 7.4 (0.5) |
| ≥75 | 23.2 (3.1) | 4.1 (0.4) |
| Non-Hispanic American Indian/Alaska Native | ||
| <20 | 1 | 35.0 (1.7) |
| 20–44 | 16.8 (4.7) | 33.9 (1.5) |
| 45–64 | 54.1 (5.2) | 20.4 (1.4) |
| 65–74 | 11.7 (2.9) | 7.0 (0.7) |
| ≥75 | 17.4 (3.4) | 3.7 (0.6) |
| Race/ethnicity, sex | ||
| Non-Hispanic White | ||
| Male | 54.1 (0.9) | 49.3 (0.3) |
| Female | 45.9 (0.9) | 50.7 (0.3) |
| Non-Hispanic Black | ||
| Male | 42.9 (1.9) | 46.2 (0.7) |
| Female | 57.1 (1.9) | 53.8 (0.7) |
| Hispanic | ||
| Male | 51.8 (2.0) | 49.3 (0.6) |
| Female | 48.2 (2.0) | 50.7 (0.6) |
| Mexican American* | ||
| Male | 52.9 (2.6) | 50.2 (0.7) |
| Female | 47.1 (2.6) | 49.8 (0.7) |
| Non-Hispanic Asian | ||
| Male | 49.9 (3.2) | 47.4 (0.9) |
| Female | 50.1 (3.2) | 52.6 (0.9) |
| Non-Hispanic American Indian/Alaska Native | ||
| Male | 36.7 (7.6) | 45.6 (1.9) |
| Female | 63.3 (7.6) | 54.4 (1.9) |
| Sex, race/ethnicity | ||
| Male | ||
| Non-Hispanic White | 60.2 (1.4) | 62.1 (0.8) |
| Non-Hispanic Black | 13.3 (0.9) | 11.2 (0.4) |
| Hispanic | 19.0 (1.2) | 19.7 (0.7) |
| Mexican American* | 12.0 (1.0) | 11.7 (0.6) |
| Non-Hispanic Asian | 6.1 (0.6) | 5.6 (0.3) |
| Non-Hispanic American Indian/Alaska Native | 1.4 (0.3) | 1.4 (0.2) |
| Female | ||
| Non-Hispanic White | 53.8 (1.4) | 60.8 (0.8) |
| Non-Hispanic Black | 18.6 (1.0) | 12.5 (0.5) |
| Hispanic | 18.6 (1.2) | 19.2 (0.7) |
| Mexican American* | 11.3 (1.0) | 11.1 (0.6) |
| Non-Hispanic Asian | 6.4 (0.6) | 5.9 (0.3) |
| Non-Hispanic American Indian/Alaska Native | 2.5 (0.7) | 1.6 (0.3) |
All data are self-reported.
- *
Mexican American is a subset of Hispanic.
- 1
Estimate is too unreliable to present; ≤1 case or relative standard error >50%.
SOURCE: National Health Interview Surveys 2021–2022
APPENDIX TABLE A2.
Distribution of Adults Age ≥20 Years, by Diabetes Status, Age, Sex, and Race/Ethnicity, U.S., 2019–2022
| CHARACTERISTICS | DIAGNOSED DIABETES* | TYPE 2 DIABETES* | TYPE 1 DIABETES† | NO DIABETES* |
|---|---|---|---|---|
| Age (years), mean | 61.9 (0.2) | 62.5 (0.2) | 47.1 (1.0) | 47.7 (0.1) |
| Percent (Standard Error) | ||||
| Age (years) | ||||
| 20–44 | 11.1 (0.5) | 9.7 (0.5) | 47.0 (3.0) | 47.5 (0.4) |
| 45–64 | 43.3 (0.8) | 43.5 (0.8) | 36.3 (2.7) | 32.2 (0.3) |
| ≥65 | 45.6 (0.8) | 46.8 (0.8) | 16.8 (1.9) | 20.4 (0.3) |
| Sex | ||||
| Men | 51.3 (0.8) | 51.3 (0.8) | 48.1 (3.0) | 48.1 (0.3) |
| Women | 48.7 (0.8) | 48.7 (0.8) | 51.9 (3.0) | 51.9 (0.3) |
| Sex, age (years) | ||||
| Men | ||||
| 20–44 | 10.5 (0.7) | 9.2 (0.7) | 43.9 (4.1) | 49.1 (0.5) |
| 45–64 | 45.8 (1.1) | 46.0 (1.1) | 39.7 (3.9) | 32.1 (0.4) |
| ≥65 | 43.6 (1.0) | 44.9 (1.1) | 16.4 (2.5) | 18.8 (0.3) |
| Women | ||||
| 20–44 | 11.8 (0.7) | 10.3 (0.7) | 49.8 (4.2) | 46.0 (0.4) |
| 45–64 | 40.6 (1.1) | 40.9 (1.1) | 33.0 (3.7) | 32.2 (0.3) |
| ≥65 | 47.7 (1.1) | 48.8 (1.1) | 17.1 (2.8) | 21.9 (0.3) |
| Race/ethnicity | ||||
| Non-Hispanic White | 57.3 (1.1) | 56.6 (1.2) | 75.3 (2.8) | 64.3 (0.8) |
| Non-Hispanic Black | 15.7 (0.8) | 15.9 (0.8) | 10.4 (1.8) | 11.4 (0.4) |
| Hispanic | 18.7 (1.0) | 19.2 (1.0) | 8.4 (1.8) | 16.9 (0.6) |
| Mexican American‡ | 11.6 (0.9) | 12.0 (0.9) | 4.7 (1.4) | 9.7 (0.5) |
| Non-Hispanic Asian | 6.2 (0.5) | 6.3 (0.5) | 4.2 (1.6) | 6.1 (0.3) |
| Non-Hispanic American Indian/Alaska Native | 2.0 (0.4) | 2.0 (0.4) | 1.7 (0.8) | 1.3 (0.2) |
| Race/ethnicity, age (years) | ||||
| Non-Hispanic White | ||||
| 20–44 | 9.4 (0.7) | 7.5 (0.7) | 46.4 (3.3) | 41.6 (0.4) |
| 45–64 | 40.4 (1.0) | 40.4 (1.0) | 37.4 (3.1) | 33.3 (0.3) |
| ≥65 | 50.2 (1.0) | 52.2 (1.0) | 16.2 (2.0) | 25.1 (0.3) |
| Non-Hispanic Black | ||||
| 20–44 | 11.2 (1.3) | 10.2 (1.3) | 45.9 (8.8) | 53.4 (0.9) |
| 45–64 | 46.9 (2.1) | 47.2 (2.1) | 33.3 (7.9) | 31.9 (0.8) |
| ≥65 | 42.0 (1.9) | 42.6 (1.9) | 20.8 (6.0) | 14.7 (0.6) |
| Hispanic | ||||
| 20–44 | 15.2 (1.4) | 14.8 (1.4) | 47.8 (11.3) | 60.9 (0.8) |
| 45–64 | 49.0 (2.0) | 49.2 (2.0) | 35.7 (11.0)1 | 29.3 (0.7) |
| ≥65 | 35.7 (2.0) | 36.0 (2.0) | 16.5 (8.0)2 | 9.7 (0.4) |
| Mexican American‡ | ||||
| 20–44 | 16.9 (1.8) | 16.4 (1.9) | 57.8 (15.6) | 63.2 (1.0) |
| 45–64 | 50.7 (2.6) | 50.9 (2.6) | 36.1 (15.8) | 28.6 (0.9) |
| ≥65 | 32.4 (2.4) | 32.7 (2.4) | 3 | 8.2 (0.5) |
| Non-Hispanic Asian | ||||
| 20–44 | 11.5 (2.1) | 10.0 (1.8) | 49.0 (19.0)1 | 53.3 (1.2) |
| 45–64 | 38.5 (3.2) | 39.5 (3.2) | 3 | 32.0 (1.0) |
| ≥65 | 50.0 (3.5) | 50.5 (3.5) | 3 | 14.7 (0.8) |
| Non-Hispanic American Indian/Alaska Native | ||||
| 20–44 | 16.8 (4.7) | 16.1 (4.4) | 48.2 (21.8)2 | 52.2 (2.1) |
| 45–64 | 54.1 (5.2) | 53.8 (5.3) | 47.0 (23.3)2 | 31.3 (1.9) |
| ≥65 | 29.1 (4.9) | 30.1 (5.0) | 3 | 16.4 (1.3) |
| Race/ethnicity, sex | ||||
| Non-Hispanic White | ||||
| Men | 54.3 (0.9) | 54.4 (0.9) | 50.2 (3.2) | 48.9 (0.3) |
| Women | 45.7 (0.9) | 45.6 (0.9) | 49.8 (3.2) | 51.1 (0.3) |
| Non-Hispanic Black | ||||
| Men | 42.7 (1.8) | 42.4 (1.9) | 41.8 (8.1) | 44.5 (0.8) |
| Women | 57.3 (1.8) | 57.6 (1.9) | 58.2 (8.1) | 55.5 (0.8) |
| Hispanic | ||||
| Men | 51.6 (2.0) | 51.3 (2.0) | 46.5 (11.2) | 48.3 (0.7) |
| Women | 48.4 (2.0) | 48.7 (2.0) | 53.5 (11.2) | 51.7 (0.7) |
| Mexican American‡ | ||||
| Men | 53.2 (2.6) | 52.7 (2.7) | 60.7 (15.2) | 49.3 (1.0) |
| Women | 46.8 (2.6) | 47.3 (2.7) | 39.3 (15.2)1 | 50.7 (1.0) |
| Non-Hispanic Asian | ||||
| Men | 50.7 (3.3) | 51.7 (3.2) | 41.9 (18.2)2 | 46.2 (1.1) |
| Women | 49.3 (3.3) | 48.3 (3.2) | 58.1 (18.2)1 | 53.8 (1.1) |
| Non-Hispanic American Indian/Alaska Native | ||||
| Men | 36.7 (7.6) | 38.0 (7.8) | 3 | 44.9 (2.2) |
| Women | 63.3 (7.6) | 62.0 (7.8) | 70.9 (23.3)1 | 55.1 (2.2) |
| Sex, race/ethnicity | ||||
| Men | ||||
| Non-Hispanic White | 60.6 (1.4) | 59.9 (1.4) | 78.2 (3.6) | 65.4 (0.8) |
| Non-Hispanic Black | 13.1 (0.8) | 13.1 (0.9) | 9.0 (2.1) | 10.6 (0.4) |
| Hispanic | 18.8 (1.2) | 19.2 (1.2) | 8.1 (2.4) | 16.9 (0.7) |
| Mexican American‡ | 12.1 (1.0) | 12.3 (1.1) | 5.9 (2.3) | 9.9 (0.5) |
| Non-Hispanic Asian | 6.2 (0.6) | 6.3 (0.6) | 3.7 (1.7) | 5.9 (0.3) |
| Non-Hispanic American Indian/Alaska Native | 1.4 (0.3) | 1.5 (0.3) | 1.0 (1.0) | 1.2 (0.2) |
| Women | ||||
| Non-Hispanic White | 53.9 (1.4) | 53.1 (1.4) | 72.5 (4.0) | 63.3 (0.8) |
| Non-Hispanic Black | 18.5 (1.0) | 18.9 (1.1) | 11.7 (2.7) | 12.2 (0.5) |
| Hispanic | 18.6 (1.2) | 19.3 (1.3) | 8.6 (2.5) | 16.8 (0.7) |
| Mexican American‡ | 11.2 (1.0) | 11.6 (1.1) | 3.6 (1.7) | 9.4 (0.5) |
| Non-Hispanic Asian | 6.3 (0.6) | 6.2 (0.6) | 4.7 (2.6) | 6.3 (0.3) |
| Non-Hispanic American Indian/Alaska Native | 2.6 (0.8) | 2.5 (0.8) | 2.4 (1.2) | 1.4 (0.2) |
All data are self-reported.
- *
Data on diagnosed diabetes, type 2 diabetes, and no diabetes are from 2021–2022.
- †
Type 1 diabetes is based on self-report of type 1 diabetes and continuous insulin use within 1 year of diagnosis; data are from 2019–2022.
- ‡
Mexican American is a subset of Hispanic.
- 1
Relative standard error >30%–40%
- 2
Relative standard error >40%–50%
- 3
Estimate is too unreliable to present; ≤1 case or relative standard error >50%.
SOURCE: National Health Interview Surveys 2019–2022
APPENDIX TABLE A3.
Distribution of Sex and Race/Ethnicity Among Youth Age <20 Years, by Diabetes Status, U.S., 2019–2022
| CHARACTERISTICS | DIAGNOSED DIABETES | NO DIABETES |
|---|---|---|
| Age (years), mean | 12.4 (0.63) | 9.7 (0.04) |
| Percent (Standard Error) | ||
| Sex | ||
| Male | 55.5 (5.1) | 51.0 (0.4) |
| Female | 44.5 (5.1) | 49.0 (0.4) |
| Race/ethnicity | ||
| Non-Hispanic White | 52.4 (5.6) | 53.7 (0.9) |
| Non-Hispanic Black | 11.3 (4.0)1 | 13.2 (0.5) |
| Hispanic | 34.2 (5.4) | 26.7 (0.9) |
| Mexican American* | 21.4 (4.5) | 16.2 (0.8) |
| Non-Hispanic Asian | 2 | 4.7 (0.2) |
| Non-Hispanic American Indian/Alaska Native | 2 | 1.7 (0.3) |
All data are self-reported.
- *
Mexican American is a subset of Hispanic.
- 1
Relative standard error >30%–40%
- 2
Estimate is too unreliable to present; ≤1 case or relative standard error >50%.
SOURCE: National Health Interview Surveys 2019–2022
APPENDIX TABLE A4.
Distribution of Age Among Adults ≥20 Years, by Diabetes Status, Sex, and Race/Ethnicity, U.S., 2019–2022
| CHARACTERISTICS | PERCENT (STANDARD ERROR) | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Diagnosed Diabetes* | Type 2 Diabetes* | Type 1 Diabetes† | No Diabetes* | |||||||||
| Age (Years) | ||||||||||||
| 20–44 | 45–64 | ≥65 | 20–44 | 45–64 | ≥65 | 20–44 | 45–64 | ≥65 | 20–44 | 45–64 | ≥65 | |
| Total | 11.1 (0.5) | 43.3 (0.8) | 45.6 (0.8) | 9.7 (0.5) | 43.5 (0.8) | 46.8 (0.8) | 47.0 (3.0) | 36.3 (2.7) | 16.8 (1.9) | 47.5 (0.4) | 32.2 (0.3) | 20.4 (0.3) |
| Sex | ||||||||||||
| Men | 10.5 (0.7) | 45.8 (1.1) | 43.6 (1.0) | 9.2 (0.7) | 46.0 (1.1) | 44.9 (1.1) | 43.9 (4.1) | 39.7 (3.9) | 16.4 (2.5) | 49.1 (0.5) | 32.1 (0.4) | 18.8 (0.3) |
| Women | 11.8 (0.7) | 40.6 (1.1) | 47.7 (1.1) | 10.3 (0.7) | 40.9 (1.1) | 48.8 (1.1) | 49.8 (4.2) | 33.0 (3.7) | 17.1 (2.8) | 46.0 (0.4) | 32.2 (0.3) | 21.9 (0.3) |
| Race/ethnicity, sex | ||||||||||||
| Non-Hispanic White | 9.4 (0.7) | 40.4 (1.0) | 50.2 (1.0) | 7.5 (0.7) | 40.4 (1.0) | 52.2 (1.0) | 46.4 (3.3) | 37.4 (3.1) | 16.2 (2.0) | 41.6 (0.4) | 33.3 (0.3) | 25.1 (0.3) |
| Men | 8.6 (0.9) | 43.3 (1.3) | 48.1 (1.2) | 6.8 (0.9) | 43.2 (1.3) | 50.0 (1.3) | 45.4 (4.6) | 37.5 (4.3) | 17.1 (2.9) | 44.0 (0.6) | 33.0 (0.5) | 23.0 (0.4) |
| Women | 10.3 (1.0) | 36.9 (1.4) | 52.8 (1.4) | 8.3 (0.9) | 37.0 (1.5) | 54.8 (1.5) | 47.4 (4.8) | 37.2 (4.5) | 15.4 (2.8) | 39.3 (0.5) | 33.5 (0.4) | 27.2 (0.4) |
| Non-Hispanic Black | 11.2 (1.3) | 46.9 (2.1) | 42.0 (1.9) | 10.2 (1.3) | 47.2 (2.1) | 42.6 (1.9) | 45.9 (8.8) | 33.3 (7.9) | 20.8 (6.0) | 53.4 (0.9) | 31.9 (0.8) | 14.7 (0.6) |
| Men | 9.0 (1.9) | 54.7 (3.1) | 36.2 (2.7) | 8.3 (1.9) | 54.9 (3.1) | 36.8 (2.8) | 26.1 (11.1)2 | 53.3 (12.8) | 20.6 (8.8)2 | 53.4 (1.3) | 33.2 (1.1) | 13.4 (0.8) |
| Women | 12.7 (1.9) | 41.0 (2.5) | 46.3 (2.4) | 11.6 (1.8) | 41.5 (2.5) | 46.9 (2.5) | 60.1 (10.9) | 19.0 (7.9) | 20.9 (8.4)2 | 53.4 (1.2) | 30.9 (1.0) | 15.7 (0.7) |
| Hispanic | 15.2 (1.4) | 49.0 (2.0) | 35.7 (2.0) | 14.8 (1.4) | 49.2 (2.0) | 36.0 (2.0) | 47.8 (11.3) | 35.7 (11.0)1 | 16.5 (8.0)2 | 60.9 (0.8) | 29.3 (0.7) | 9.7 (0.6) |
| Men | 15.9 (2.2) | 50.0 (2.7) | 34.1 (2.7) | 15.1 (2.1) | 50.4 (2.7) | 34.6 (2.8) | 40.6 (15.4)1 | 48.7 (16.3)1 | 3 | 61.1 (1.1) | 29.7 (1.0) | 9.2 (0.5) |
| Women | 14.5 (1.9) | 48.0 (3.0) | 37.5 (2.9) | 14.6 (1.9) | 48.0 (3.0) | 37.4 (2.9) | 54.1 (15.4) | 24.4 (12.1)2 | 3 | 60.8 (1.0) | 28.9 (0.8) | 10.3 (0.6) |
| Mexican American‡ | 16.9 (1.8) | 50.7 (2.6) | 32.4 (2.4) | 16.4 (1.9) | 50.9 (2.6) | 32.7 (2.5) | 57.8 (15.6) | 36.1 (15.8)2 | 3 | 63.2 (1.0) | 28.6 (0.9) | 8.2 (0.5) |
| Men | 17.0 (2.8) | 50.1 (3.5) | 32.9 (3.4) | 16.1 (2.8) | 50.5 (3.5) | 33.4 (3.4) | 44.2 (19.5)2 | 49.5 (20.3)2 | 3 | 62.9 (1.3) | 29.0 (1.2) | 8.1 (0.7) |
| Women | 16.7 (2.5) | 51.4 (4.0) | 31.8 (3.6) | 16.7 (2.5) | 51.4 (4.0) | 31.8 (3.6) | 78.7 (16.3) | 3 | 3 | 63.6 (1.2) | 28.1 (1.1) | 8.3 (0.6) |
| Non-Hispanic Asian | 11.5 (2.1) | 38.5 (3.2) | 50.0 (3.2) | 10.0 (1.8) | 39.5 (3.2) | 50.5 (3.5) | 49.0 (19.0)1 | 3 | 3 | 53.3 (1.2) | 32.0 (1.0) | 14.7 (0.8) |
| Men | 12.9 (2.8) | 38.5 (4.6) | 48.7 (4.9) | 12.0 (2.7) | 39.0 (4.6) | 49.0 (4.9) | 3 | 48.7 (23.6)2 | 3 | 55.6 (1.7) | 30.3 (1.5) | 14.1 (1.1) |
| Women | 10.0 (3.1)1 | 38.6 (4.5) | 51.4 (5.2) | 7.8 (2.1) | 40.0 (4.7) | 52.1 (5.0) | 3 | 3 | 3 | 51.4 (1.5) | 33.4 (1.3) | 15.2 (1.1) |
| Non-Hispanic American Indian/Alaska Native | 16.8 (4.7) | 54.1 (5.2) | 29.1 (4.9) | 16.1 (4.4) | 53.8 (5.3) | 30.1 (5.0) | 48.2 (21.8)2 | 47.0 (23.3)2 | 3 | 52.2 (2.1) | 31.3 (1.9) | 16.4 (1.3) |
| Men | 3 | 51.6 (9.9) | 34.7 (8.9) | 3 | 51.6 (9.9) | 34.7 (8.9) | 3 | 3 | 3 | 51.1 (3.0) | 35.0 (3.0) | 13.9 (1.9) |
| Women | 18.6 (5.5) | 55.6 (5.6) | 25.8 (5.2) | 17.6 (4.7) | 55.1 (5.7) | 27.3 (5.3) | 3 | 3 | 3 | 53.1 (3.0) | 28.4 (2.6) | 18.5 (1.8) |
All data are self-reported.
- *
Data on diagnosed diabetes, type 2 diabetes, and no diabetes are from 2021–2022.
- †
Type 1 diabetes is based on self-report of type 1 diabetes and continuous insulin use within 1 year of diagnosis; data are from 2019–2022.
- ‡
Mexican American is a subset of Hispanic.
- 1
Relative standard error >30%–40%
- 2
Relative standard error >40%–50%
- 3
Estimate is too unreliable to present; ≤1 case or relative standard error >50%.
SOURCE: National Health Interview Surveys 2019–2022
APPENDIX TABLE A5.
Sexual Orientation of Adults Age ≥20 Years, by Diabetes Status, Age, Sex, and Race/Ethnicity, U.S., 2019–2022
| CHARACTERISTICS | PERCENT (STANDARD ERROR) | |||
|---|---|---|---|---|
| Diagnosed Diabetes* | Type 2 Diabetes* | Type 1 Diabetes† | No Diabetes* | |
| Total | ||||
| Straight | 91.6 (0.5) | 91.7 (0.5) | 91.2 (1.8) | 89.5 (0.2) |
| Gay/lesbian | 1.1 (0.1) | 1.1 (0.1) | 1.9 (0.8)2 | 2.0 (0.1) |
| Bisexual | 1.2 (0.2) | 1.1 (0.2) | 2.6 (1.2)2 | 2.3 (0.1) |
| Other/do not know | 1.9 (0.3) | 1.9 (0.3) | 1.3 (0.6)2 | 1.7 (0.1) |
| Unknown | 4.2 (0.3) | 4.2 (0.3) | 3.1 (1.1)1 | 4.5 (0.1) |
| Age (years) | ||||
| 20–44 | ||||
| Straight | 83.7 (2.0) | 83.7 (2.1) | 87.4 (3.2) | 86.0 (0.3) |
| Gay/lesbian | 1.2 (0.5) | 1.3 (0.6) | 3 | 2.5 (0.1) |
| Bisexual | 6.6 (1.4) | 6.0 (1.5) | 5.3 (2.5)2 | 4.2 (0.2) |
| Other/do not know | 3.5 (1.0) | 3.8 (1.1) | 3 | 2.4 (0.1) |
| Unknown | 4.9 (1.1) | 5.3 (1.2) | 3 | 4.8 (0.2) |
| 45–64 | ||||
| Straight | 92.5 (0.7) | 92.5 (0.7) | 93.8 (2.2) | 92.1 (0.3) |
| Gay/lesbian | 1.5 (0.3) | 1.5 (0.3) | 2.3 (1.2) | 1.8 (0.1) |
| Bisexual | 0.9 (0.3) | 0.9 (0.3) | 3 | 0.8 (0.1) |
| Other/do not know | 1.5 (0.3) | 1.6 (0.3) | 0.9 (0.9) | 1.0 (0.1) |
| Unknown | 3.6 (0.4) | 3.5 (0.4) | 3.0 (1.6) | 4.3 (0.2) |
| ≥65 | ||||
| Straight | 92.6 (0.6) | 92.6 (0.7) | 95.9 (2.0) | 93.3 (0.3) |
| Gay/lesbian | 0.7 (0.1) | 0.7 (0.1) | 3 | 1.1 (0.1) |
| Bisexual | 0.2 (0.1) | 0.2 (0.1) | 3 | 0.3 (0.0) |
| Other/do not know | 1.9 (0.4) | 1.9 (0.4) | 3 | 1.2 (0.1) |
| Unknown | 4.6 (0.5) | 4.6 (0.5) | 3 | 4.1 (0.2) |
| Sex | ||||
| Men | ||||
| Straight | 91.9 (0.6) | 92.2 (0.6) | 91.4 (2.5) | 90.6 (0.2) |
| Gay/lesbian | 1.4 (0.2) | 1.4 (0.2) | 3 | 2.4 (0.1) |
| Bisexual | 0.8 (0.2) | 0.6 (0.2) | 3 | 1.2 (0.1) |
| Other/do not know | 1.8 (0.4) | 1.7 (0.4) | 3 | 1.5 (0.1) |
| Unknown | 4.1 (0.4) | 4.0 (0.4) | 3.4 (1.4)2 | 4.3 (0.2) |
| Women | ||||
| Straight | 91.2 (0.7) | 91.1 (0.7) | 91.0 (2.5) | 88.4 (0.3) |
| Gay/lesbian | 0.8 (0.2) | 0.8 (0.2) | 3 | 1.7 (0.1) |
| Bisexual | 1.7 (0.4) | 1.6 (0.4) | 3 | 3.4 (0.2) |
| Other/do not know | 2.0 (0.3) | 2.1 (0.4) | 3 | 1.9 (0.1) |
| Unknown | 4.3 (0.5) | 4.4 (0.5) | 3 | 4.6 (0.2) |
| Race/ethnicity | ||||
| Non-Hispanic White | ||||
| Straight | 92.1 (0.6) | 92.4 (0.6) | 90.7 (2.1) | 90.2 (0.2) |
| Gay/lesbian | 1.4 (0.2) | 1.4 (0.2) | 2.2 (1.0)2 | 2.1 (0.1) |
| Bisexual | 1.6 (0.3) | 1.3 (0.3) | 3.4 (1.6)2 | 2.5 (0.1) |
| Other/do not know | 1.3 (0.2) | 1.3 (0.2) | 3 | 1.5 (0.1) |
| Unknown | 3.7 (0.4) | 3.6 (0.4) | 2.9 (1.2)2 | 3.7 (0.2) |
| Non-Hispanic Black | ||||
| Straight | 92.9 (1.0) | 92.8 (1.0) | 93.2 (3.7) | 86.6 (0.6) |
| Gay/lesbian | 3 | 3 | 3 | 2.0 (0.2) |
| Bisexual | 3 | 3 | 3 | 2.0 (0.2) |
| Other/do not know | 3 | 3 | 3 | 1.9 (0.2) |
| Unknown | 5.3 (0.8) | 5.3 (0.8) | 3 | 7.5 (0.5) |
| Hispanic | ||||
| Straight | 89.0 (1.3) | 89.0 (1.3) | 85.8 (8.0) | 89.1 (0.5) |
| Gay/lesbian | 1.1 (0.4)1 | 1.2 (0.4)1 | 3 | 1.7 (0.2) |
| Bisexual | 1.0 (0.4)1 | 1.0 (0.4)2 | 3 | 2.0 (0.2) |
| Other/do not know | 4.0 (0.9) | 3.9 (0.9) | 3 | 2.0 (0.2) |
| Unknown | 4.8 (0.9) | 4.9 (0.9) | 3 | 5.2 (0.4) |
| Mexican American‡ | ||||
| Straight | 88.5 (1.7) | 88.6 (1.7) | 87.1 (8.9) | 89.3 (0.7) |
| Gay/lesbian | 3 | 1.1 (0.5)2 | 3 | 1.7 (0.2) |
| Bisexual | 1.5 (0.6)2 | 1.5 (0.6)2 | 3 | 1.7 (0.2) |
| Other/do not know | 5.3 (1.2) | 5.2 (1.2) | 3 | 2.2 (0.3) |
| Unknown | 3.6 (0.9) | 3.6 (0.9) | 3 | 5.0 (0.5) |
| Non-Hispanic Asian | ||||
| Straight | 93.2 (1.7) | 93.0 (1.7) | 3 | 91.1 (0.6) |
| Gay/lesbian | 3 | 3 | 3 | 1.2 (0.2) |
| Bisexual | 3 | 3 | 3 | 0.8 (0.2) |
| Other/do not know | 3 | 3 | 3 | 1.9 (0.3) |
| Unknown | 1 | 3.2 (1.1)1 | 3 | 4.9 (0.4) |
| Non-Hispanic American Indian/Alaska Native | ||||
| Straight | 88.9 (3.3) | 88.5 (3.5) | 3 | 85.6 (1.5) |
| Gay/lesbian | 3 | 3 | 3 | 3.4 (1.1)1 |
| Bisexual | 3 | 3 | 3 | 4.4 (1.1) |
| Other/do not know | 3 | 3 | 3 | 2.3 (0.6) |
| Unknown | 1 | 8.2 (3.2)1 | 3 | 4.3 (1.2) |
All data are self-reported.
- *
Data on diagnosed diabetes, type 2 diabetes, and no diabetes are from 2021–2022.
- †
Type 1 diabetes is based on self-report of type 1 diabetes and continuous insulin use within 1 year of diagnosis; data are from 2019–2022.
- ‡
Mexican American is a subset of Hispanic.
- 1
Relative standard error >30%–40%
- 2
Relative standard error >40%–50%
- 3
Estimate is too unreliable to present; ≤1 case or relative standard error >50%.
SOURCE: National Health Interview Surveys 2019–2022
APPENDIX TABLE A6.
Mean and Median Ages of Diagnosis Among Adults Age ≥20 Years, by Diabetes Status, Sex, and Race/Ethnicity, U.S., 2019–2022
| CHARACTERISTICS | AGE (YEARS) | |||||
|---|---|---|---|---|---|---|
| Diagnosed Diabetes* | Type 2 Diabetes* | Type 1 Diabetes† | ||||
| Mean (SE) | Median (SE) | Mean (SE) | Median (SE) | Mean (SE) | Median (SE) | |
| Total | 47.7 (0.3) | 49.2 (0.1) | 48.7 (0.3) | 49.5 (0.1) | 23.5 (0.8) | 19.8 (1.4) |
| Sex | ||||||
| Men | 48.0 (0.3) | 49.3 (0.2) | 48.9 (0.3) | 49.5 (0.1) | 24.8 (1.3) | 20.0 (1.8) |
| Women | 47.3 (0.4) | 49.2 (0.3) | 48.4 (0.4) | 49.5 (0.2) | 22.3 (1.1) | 19.7 (2.0) |
| Race/ethnicity | ||||||
| Non-Hispanic White | 49.3 (0.3) | 50.0 (0.4) | 50.8 (0.3) | 51.4 (0.5) | 21.4 (0.9) | 16.7 (1.3) |
| Non-Hispanic Black | 45.7 (0.6) | 47.3 (1.0) | 46.2 (0.7) | 47.6 (0.9) | 29.5 (2.7) | 26.9 (3.5) |
| Hispanic | 45.2 (0.6) | 44.6 (0.8) | 45.4 (0.6) | 44.7 (0.8) | 31.7 (3.0) | 26.9 (4.8) |
| Mexican American‡ | 44.1 (0.8) | 43.4 (1.3) | 44.3 (0.8) | 43.7 (1.3) | 30.9 (3.7) | 25.8 (5.5) |
| Non-Hispanic Asian | 46.9 (1.2) | 47.8 (1.4) | 47.6 (1.2) | 48.7 (1.6) | 26.2 (3.7) | 25.3 (6.2) |
| Non-Hispanic American Indian/Alaska Native | 44.2 (1.6) | 44.2 (1.9) | 44.4 (1.5) | 44.1 (1.7) | 33.9 (9.2) | 1 |
All data are self-reported. SE, standard error.
- *
Data on diagnosed diabetes and type 2 diabetes are from 2021–2022.
- †
Type 1 diabetes is based on self-report of type 1 diabetes and continuous insulin use within 1 year of diagnosis; data are from 2019–2022.
- ‡
Mexican American is a subset of Hispanic.
- 1
Estimate is too unreliable to present; ≤1 case or relative standard error >50%.
SOURCE: National Health Interview Surveys 2019–2022
APPENDIX TABLE A7.
Mean and Median Durations of Diabetes Among Adults Age ≥20 Years, by Diabetes Status, Sex, and Race/Ethnicity, U.S., 2019–2022
| CHARACTERISTICS | DIABETES DURATION (YEARS) | |||||
|---|---|---|---|---|---|---|
| Diagnosed Diabetes* | Type 2 Diabetes* | Type 1 Diabetes† | ||||
| Mean (SE) | Median (SE) | Mean (SE) | Median (SE) | Mean (SE) | Median (SE) | |
| Total | 14.1 (0.2) | 10.1 (0.2) | 13.6 (0.2) | 9.9 (0.2) | 23.5 (0.9) | 20.1 (1.3) |
| Age (years) | ||||||
| 20–44 | 8.4 (0.4) | 5.1 (0.5) | 7.0 (0.4) | 4.0 (0.5) | 15.8 (0.9) | 15.0 (1.2) |
| 45–64 | 11.9 (0.3) | 8.2 (0.4) | 11.3 (0.3) | 7.9 (0.3) | 28.1 (1.5) | 28.6 (2.0) |
| ≥65 | 17.6 (0.3) | 14.3 (0.3) | 17.3 (0.3) | 14.2 (0.3) | 35.3 (2.0) | 35.0 (2.6) |
| Sex | ||||||
| Men | 13.6 (0.3) | 9.7 (0.2) | 13.2 (0.3) | 9.5 (0.2) | 22.6 (1.1) | 19.5 (1.8) |
| Women | 14.6 (0.3) | 10.8 (0.4) | 14.1 (0.3) | 10.5 (0.3) | 24.2 (1.3) | 21.6 (1.7) |
| Race/ethnicity | ||||||
| Non-Hispanic White | 13.9 (0.2) | 10.1 (0.2) | 13.2 (0.2) | 9.7 (0.2) | 25.7 (1.0) | 23.8 (1.6) |
| Non-Hispanic Black | 15.1 (0.6) | 10.9 (0.7) | 14.9 (0.6) | 10.8 (0.6) | 18.6 (2.0) | 15.4 (2.8) |
| Hispanic | 13.2 (0.5) | 9.6 (0.6) | 13.2 (0.5) | 9.6 (0.6) | 15.7 (2.5) | 13.7 (3.1) |
| Mexican American‡ | 12.9 (0.6) | 9.7 (0.7) | 13.0 (0.6) | 9.7 (0.7) | 11.9 (2.1) | 12.9 (3.3) |
| Non-Hispanic Asian | 15.8 (1.1) | 10.6 (1.3) | 15.8 (1.1) | 10.4 (1.3) | 17.8 (4.5) | 2 |
| Non-Hispanic American Indian/Alaska Native | 13.5 (1.1) | 10.0 (1.4) | 13.4 (1.2) | 10.1 (1.5) | 15.0 (5.3)1 | 2 |
All data are self-reported. SE, standard error.
- *
Data on diagnosed diabetes and type 2 diabetes are from 2021–2022.
- †
Type 1 diabetes is based on self-report of type 1 diabetes and continuous insulin use within 1 year of diagnosis; data are from 2019–2022.
- ‡
Mexican American is a subset of Hispanic.
- 1
Relative standard error >30%–40%
- 2
Estimate is too unreliable to present; ≤1 case or relative standard error >50%.
SOURCE: National Health Interview Surveys 2019–2022
APPENDIX TABLE A8.
Distribution of Duration of Diabetes Among Adults Age ≥20 Years, by Diabetes Status, Sex, and Race/Ethnicity, U.S. 2019–2022
| DIABETES DURATION (YEARS) | PERCENT (STANDARD ERROR) | ||
|---|---|---|---|
| Diagnosed Diabetes* | Type 2 Diabetes* | Type 1 Diabetes† | |
| Total | |||
| <10 | 44.0 (0.8) | 44.9 (0.9) | 21.2 (2.5) |
| <5 | 25.1 (0.7) | 25.6 (0.7) | 10.0 (1.9) |
| 5–<10 | 19.0 (0.7) | 19.3 (0.7) | 11.2 (2.0) |
| 10–<20 | 29.0 (0.7) | 29.2 (0.7) | 23.8 (2.6) |
| 10–<15 | 16.8 (0.6) | 17.0 (0.6) | 12.9 (2.1) |
| 15–<20 | 12.2 (0.5) | 12.2 (0.5) | 10.9 (1.8) |
| ≥20 | 27.0 (0.7) | 25.8 (0.7) | 55.0 (2.9) |
| 20–<25 | 10.5 (0.5) | 10.5 (0.5) | 11.4 (2.0) |
| 20–<30 | 15.9 (0.5) | 15.8 (0.6) | 23.0 (2.5) |
| ≥25 | 16.5 (0.6) | 15.3 (0.6) | 43.7 (2.9) |
| 30–<40 | 6.2 (0.4) | 5.7 (0.4) | 15.6 (2.0) |
| 40–<50 | 2.4 (0.2) | 2.1 (0.2) | 8.8 (1.4) |
| 50–<60 | 1.5 (0.2) | 1.3 (0.2) | 6.0 (1.1) |
| ≥60 | 0.9 (0.2) | 0.9 (0.2) | 1.5 (0.5)1 |
| 60–<70 | 0.5 (0.1) | 0.5 (0.1) | 1.2 (0.5)2 |
| ≥70 | 0.4 (0.1) | 0.4 (0.1) | 3 |
| Sex | |||
| Men | |||
| <10 | 45.9 (1.1) | 46.9 (1.1) | 21.2 (3.3) |
| <5 | 25.6 (0.9) | 26.3 (1.0) | 9.4 (2.2) |
| 5–<10 | 20.3 (0.9) | 20.6 (0.9) | 11.8 (2.8) |
| 10–<20 | 28.3 (1.0) | 28.4 (1.0) | 25.4 (3.8) |
| 10–<15 | 17.0 (0.8) | 17.1 (0.9) | 14.2 (3.3) |
| 15–<20 | 11.4 (0.7) | 11.3 (0.7) | 11.3 (2.5) |
| ≥20 | 25.8 (1.0) | 24.6 (1.0) | 53.3 (4.0) |
| ≥60 | 0.9 (0.2) | 0.9 (0.2) | 3 |
| Women | |||
| <10 | 42.0 (1.2) | 42.8 (1.2) | 21.2 (3.8) |
| <5 | 24.4 (1.0) | 24.9 (1.0) | 10.5 (3.0) |
| 5–<10 | 17.6 (0.9) | 18.0 (0.9) | 10.7 (2.8) |
| 10–<20 | 29.7 (1.0) | 30.1 (1.0) | 22.2 (3.5) |
| 10–<15 | 16.7 (0.8) | 16.9 (0.8) | 11.8 (2.6) |
| 15–<20 | 13.1 (0.7) | 13.2 (0.8) | 10.5 (2.5) |
| ≥20 | 28.3 (1.0) | 27.1 (1.0) | 56.6 (4.2) |
| ≥60 | 1.0 (0.2) | 0.9 (0.2) | 2.9 (1.0)1 |
| Race/ethnicity | |||
| Non-Hispanic White | |||
| <10 | 43.5 (1.0) | 45.1 (1.0) | 16.1 (2.6) |
| <5 | 24.9 (0.9) | 25.8 (0.9) | 7.8 (1.8) |
| 5–<10 | 18.6 (0.8) | 19.3 (0.8) | 8.3 (2.0) |
| 10–<20 | 29.5 (0.9) | 29.8 (0.9) | 23.2 (3.0) |
| 10–<15 | 17.7 (0.7) | 18.0 (0.7) | 13.6 (2.6) |
| 15–<20 | 11.8 (0.6) | 11.8 (0.6) | 9.7 (1.9) |
| ≥20 | 27.0 (0.9) | 25.1 (0.9) | 60.7 (3.3) |
| ≥60 | 0.8 (0.2) | 0.8 (0.2) | 1.8 (0.7)1 |
| Non-Hispanic Black | |||
| <10 | 41.5 (2.1) | 41.9 (2.1) | 29.1 (8.1) |
| <5 | 24.3 (1.8) | 24.6 (1.9) | 12.3 (5.1)2 |
| 5–<10 | 17.3 (1.5) | 17.3 (1.5) | 16.8 (7.3)2 |
| 10–<20 | 29.4 (1.9) | 29.6 (1.9) | 26.7 (7.8) |
| 10–<15 | 16.9 (1.5) | 16.9 (1.5) | 19.4 (7.2)1 |
| 15–<20 | 12.5 (1.3) | 12.6 (1.3) | 3 |
| ≥20 | 29.0 (1.7) | 28.6 (1.8) | 44.2 (8.6) |
| ≥60 | 1.7 (0.7) | 1.7 (0.7)2 | 3 |
| Hispanic | |||
| <10 | 47.6 (2.2) | 47.4 (2.2) | 43.4 (10.9) |
| <5 | 25.6 (1.9) | 25.6 (1.9) | 14.8 (7.0)2 |
| 5–<10 | 21.9 (1.6) | 21.8 (1.6) | 28.6 (9.9)1 |
| 10–<20 | 27.9 (1.8) | 28.0 (1.8) | 26.3 (9.9)1 |
| 10–<15 | 15.0 (1.4) | 15.0 (1.5) | 3 |
| 15–<20 | 13.0 (1.3) | 13.0 (1.3) | 22.9 (9.7)2 |
| ≥20 | 24.5 (1.6) | 24.5 (1.6) | 30.3 (11.0)1 |
| ≥60 | 0.3 (0.1)1 | 0.3 (0.1)1 | 3 |
| Mexican American‡ | |||
| <10 | 47.0 (2.7) | 46.7 (2.7) | 41.0 (14.6)1 |
| <5 | 27.4 (2.2) | 27.3 (2.2) | 3 |
| 5–<10 | 19.6 (1.9) | 19.4 (1.9) | 3 |
| 10–<20 | 29.6 (2.4) | 29.6 (2.4) | 38.9 (15.0)2 |
| 10–<15 | 16.5 (2.0) | 16.5 (2.0) | 3 |
| 15–<20 | 13.0 (1.7) | 13.1 (1.7) | 32.9 (14.7)2 |
| ≥20 | 23.4 (2.0) | 23.7 (2.0) | 3 |
| ≥60 | 0.1 (0.1)1 | 3 | 3 |
| Non-Hispanic Asian | |||
| <10 | 43.1 (3.2) | 43.3 (3.2) | 3 |
| <5 | 28.2 (3.0) | 27.8 (2.9) | 3 |
| 5–<10 | 15.0 (2.1) | 15.5 (2.2) | 3 |
| 10–<20 | 25.8 (2.8) | 25.8 (2.8) | 3 |
| 10–<15 | 12.4 (2.1) | 12.5 (2.1) | 3 |
| 15–<20 | 13.4 (2.3) | 13.3 (2.3) | 3 |
| ≥20 | 31.0 (3.2) | 30.9 (3.3) | 51.7 (19.1)1 |
| ≥60 | 2.0 (1.0)3 | 3 | 3 |
| Non-Hispanic American Indian/Alaska Native | |||
| <10 | 47.4 (5.0) | 46.8 (5.5) | 47.0 (23.3)2 |
| <5 | 24.3 (5.9) | 24.4 (6.1) | 3 |
| 5–<10 | 23.0 (5.8) | 22.3 (5.8) | 3 |
| 10–<20 | 28.1 (4.7) | 29.2 (4.7) | 3 |
| 10–<15 | 18.4 (3.9) | 19.1 (4.0) | 3 |
| 15–<20 | 9.7 (3.1) | 10.1 (3.2)1 | 3 |
| ≥20 | 24.5 (4.4) | 24.1 (4.7) | 3 |
| ≥60 | 1.0 (0.8)3 | 3 | 3 |
All data are self-reported.
- *
Data on diagnosed diabetes and type 2 diabetes are from 2021–2022.
- †
Type 1 diabetes is based on self-report of type 1 diabetes and continuous insulin use within 1 year of diagnosis; data are from 2019–2022.
- ‡
Mexican American is a subset of Hispanic.
- 1
Relative standard error >30%–40%
- 2
Relative standard error >40%–50%
- 3
Estimate is too unreliable to present; ≤1 case or relative standard error >50%.
SOURCE: National Health Interview Surveys 2019–2022
APPENDIX TABLE A9.
Urban-Rural County-Level Classification of Residence Among Adults Age ≥20 Years, by Diabetes Status, Age, Sex, and Race/Ethnicity, U.S., 2019–2022
| CLASSIFICATION OF RESIDENCE* | PERCENT (STANDARD ERROR) | |||
|---|---|---|---|---|
| Diagnosed Diabetes† | Type 2 Diabetes† | Type 1 Diabetes‡ | No Diabetes† | |
| Total | ||||
| Large central metro | 29.2 (1.3) | 29.2 (1.3) | 28.9 (2.9) | 31.8 (1.1) |
| Large fringe metro | 22.2 (1.1) | 22.0 (1.1) | 25.6 (2.8) | 24.9 (1.1) |
| Medium/small metro | 32.1 (1.5) | 32.3 (1.5) | 29.8 (2.9) | 30.0 (1.4) |
| Nonmetropolitan | 16.5 (0.8) | 16.5 (0.8) | 15.7 (2.1) | 13.3 (0.5) |
| Age (years) | ||||
| 20–44 | ||||
| Large central metro | 29.6 (2.6) | 28.4 (2.7) | 34.9 (4.7) | 35.3 (1.2) |
| Large fringe metro | 21.5 (2.4) | 20.6 (2.6) | 24.0 (4.1) | 24.2 (1.1) |
| Medium/small metro | 32.9 (2.8) | 34.4 (3.1) | 28.7 (4.3) | 29.2 (1.5) |
| Nonmetropolitan | 16.0 (1.9) | 16.6 (2.1) | 12.4 (2.9) | 11.3 (0.6) |
| 45–64 | ||||
| Large central metro | 29.4 (1.5) | 29.5 (1.5) | 22.6 (4.0) | 30.1 (1.1) |
| Large fringe metro | 22.1 (1.4) | 22.0 (1.4) | 27.8 (4.3) | 25.9 (1.2) |
| Medium/small metro | 31.9 (1.8) | 31.9 (1.8) | 30.9 (4.2) | 29.5 (1.5) |
| Nonmetropolitan | 16.7 (1.1) | 16.6 (1.1) | 18.7 (3.6) | 14.5 (0.6) |
| ≥65 | ||||
| Large central metro | 29.0 (1.4) | 29.1 (1.4) | 25.6 (5.1) | 26.2 (1.1) |
| Large fringe metro | 22.4 (1.3) | 22.3 (1.3) | 25.6 (6.1) | 24.8 (1.2) |
| Medium/small metro | 32.2 (1.7) | 32.3 (1.7) | 30.3 (5.3) | 33.0 (1.5) |
| Nonmetropolitan | 16.4 (0.9) | 16.3 (0.9) | 18.6 (4.4) | 16.0 (0.6) |
| Sex | ||||
| Men | ||||
| Large central metro | 29.0 (1.4) | 28.8 (1.4) | 35.6 (4.1) | 32.1 (1.2) |
| Large fringe metro | 22.0 (1.3) | 21.9 (1.3) | 21.3 (3.6) | 24.8 (1.2) |
| Medium/small metro | 32.7 (1.7) | 33.0 (1.7) | 25.0 (3.3) | 29.6 (1.4) |
| Nonmetropolitan | 16.3 (0.9) | 16.2 (0.9) | 18.1 (3.1) | 13.4 (0.6) |
| Women | ||||
| Large central metro | 29.4 (1.5) | 29.6 (1.5) | 22.6 (3.8) | 31.4 (1.1) |
| Large fringe metro | 22.3 (1.3) | 22.1 (1.3) | 29.7 (4.1) | 25.0 (1.1) |
| Medium/small metro | 31.6 (1.7) | 31.6 (1.7) | 34.2 (4.3) | 30.4 (1.4) |
| Nonmetropolitan | 16.7 (1.1) | 16.7 (1.1) | 13.5 (2.7) | 13.2 (0.6) |
| Race/ethnicity | ||||
| Non-Hispanic White | ||||
| Large central metro | 18.2 (1.1) | 17.9 (1.1) | 24.6 (3.2) | 23.7 (1.0) |
| Large fringe metro | 23.9 (1.4) | 23.8 (1.3) | 26.4 (3.2) | 26.5 (1.2) |
| Medium/small metro | 35.5 (1.7) | 35.8 (1.8) | 31.8 (3.3) | 32.8 (1.5) |
| Nonmetropolitan | 22.4 (1.1) | 22.6 (1.1) | 17.2 (2.6) | 17.1 (0.7) |
| Non-Hispanic Black | ||||
| Large central metro | 39.3 (2.7) | 39.0 (2.7) | 41.5 (9.1) | 42.5 (1.9) |
| Large fringe metro | 22.3 (2.4) | 22.3 (2.5) | 20.0 (7.6)1 | 23.6 (1.8) |
| Medium/small metro | 27.9 (2.5) | 28.4 (2.6) | 19.4 (6.2)1 | 25.7 (2.0) |
| Nonmetropolitan | 10.5 (2.0) | 10.3 (2.1) | 19.1 (6.8)1 | 8.2 (1.0) |
| Hispanic | ||||
| Large central metro | 49.6 (3.4) | 49.5 (3.4) | 43.8 (10.9) | 47.6 (2.4) |
| Large fringe metro | 15.1 (1.7) | 15.1 (1.7) | 20.2 (9.0)2 | 19.8 (1.4) |
| Medium/small metro | 29.9 (3.6) | 29.9 (3.6) | 34.3 (10.9)1 | 27.7 (2.7) |
| Nonmetropolitan | 5.4 (1.7)1 | 5.5 (1.7)1 | 3 | 4.8 (1.1) |
| Mexican American§ | ||||
| Large central metro | 48.5 (4.5) | 48.6 (4.5) | 42.8 (15.5)1 | 45.5 (3.3) |
| Large fringe metro | 11.3 (2.0) | 11.2 (2.0) | 3 | 15.4 (1.6) |
| Medium/small metro | 33.5 (4.7) | 33.5 (4.8) | 40.8 (15.2)1 | 32.8 (3.9) |
| Nonmetropolitan | 6.6 (2.5)1 | 6.7 (2.6)1 | 3 | 6.4 (1.7) |
| Non-Hispanic Asian | ||||
| Large central metro | 51.4 (4.2) | 51.1 (4.2) | 55.1 (18.7)1 | 54.6 (2.2) |
| Large fringe metro | 30.6 (3.6) | 30.4 (3.6) | 44.9 (18.7)2 | 26.8 (1.9) |
| Medium/small metro | 16.4 (3.8) | 17.0 (3.9) | 3 | 15.9 (1.8) |
| Nonmetropolitan | 3 | 1.6 (1.0)3 | 3 | 2.7 (0.6) |
| Non-Hispanic American Indian/Alaska Native | ||||
| Large central metro | 6.0 (2.2)1 | 6.2 (2.3)1 | 3 | 17.9 (3.2) |
| Large fringe metro | 14.0 (5.5)1 | 14.5 (5.6)1 | 3 | 15.2 (3.0) |
| Medium/small metro | 32.5 (8.5) | 30.1 (8.1) | 58.8 (23.6)2 | 29.9 (5.3) |
| Nonmetropolitan | 47.5 (11.0) | 49.2 (11.0) | 3 | 36.9 (9.1) |
All data are self-reported.
- *
Large central metro are counties in metropolitan statistical areas (MSA) of 1 million or more population that (1.) contain the entire population of the largest principal city of the MSA, (2.) are completely contained in the largest principal city of the MSA, or (3.) contain at least 250,000 residents of any principal city of the MSA. Large fringe metro are counties in MSAs of 1 million or more population that do not qualify as large central. Medium and small metro are counties in MSAs of 250,000–999,999 population or in MSAs <250,000 population. Nonmetropolitan are counties in micropolitan statistical areas and non-core counties.
- †
Data on diagnosed diabetes, type 2 diabetes, and no diabetes are from 2021–2022.
- ‡
Type 1 diabetes is based on self-report of type 1 diabetes and continuous insulin use within 1 year of diagnosis; data are from 2019–2022.
- §
Mexican American is a subset of Hispanic.
- 1
Relative standard error >30%–40%
- 2
Relative standard error >40%–50%
- 3
Estimate is too unreliable to present; ≤1 case or relative standard error >50%.
SOURCE: National Health Interview Surveys 2019–2022
APPENDIX TABLE A10.
Region of Residence Among Adults Age ≥20 Years, by Diabetes Status, Age, Sex, and Race/Ethnicity, U.S., 2019–2022
| REGION | PERCENT (STANDARD ERROR) | |||
|---|---|---|---|---|
| Diagnosed Diabetes* | Type 2 Diabetes* | Type 1 Diabetes† | No Diabetes* | |
| Total | ||||
| Northeast | 15.9 (0.7) | 15.9 (0.7) | 19.1 (2.2) | 17.6 (0.6) |
| Midwest | 20.9 (0.9) | 20.6 (0.9) | 25.9 (2.5) | 20.7 (0.7) |
| South | 42.6 (1.1) | 42.9 (1.1) | 37.4 (3.0) | 37.6 (0.9) |
| West | 20.7 (1.0) | 20.6 (1.0) | 17.6 (2.2) | 24.1 (0.8) |
| Age (years) | ||||
| 20–44 | ||||
| Northeast | 11.1 (1.5) | 10.5 (1.7) | 15.2 (3.2) | 16.9 (0.7) |
| Midwest | 22.6 (2.2) | 21.3 (2.3) | 28.3 (4.1) | 20.4 (0.8) |
| South | 44.5 (2.7) | 46.7 (3.0) | 36.9 (4.7) | 37.3 (1.0) |
| West | 21.8 (2.4) | 21.4 (2.6) | 19.7 (3.6) | 25.3 (1.0) |
| 45–64 | ||||
| Northeast | 15.0 (1.0) | 15.0 (1.0) | 22.7 (3.7) | 18.1 (0.7) |
| Midwest | 20.7 (1.2) | 20.3 (1.2) | 27.9 (4.1) | 20.7 (0.8) |
| South | 43.4 (1.5) | 43.7 (1.5) | 36.8 (4.4) | 38.3 (1.0) |
| West | 20.9 (1.2) | 21.0 (1.3) | 12.7 (2.8) | 22.8 (0.8) |
| ≥65 | ||||
| Northeast | 17.9 (1.0) | 17.7 (1.0) | 22.2 (4.8) | 18.5 (0.7) |
| Midwest | 20.6 (1.0) | 20.8 (1.0) | 15.1 (3.9) | 21.4 (0.7) |
| South | 41.3 (1.3) | 41.4 (1.3) | 40.2 (6.2) | 37.0 (0.9) |
| West | 20.2 (1.1) | 20.1 (1.1) | 22.5 (4.6) | 23.1 (0.9) |
| Sex | ||||
| Men | ||||
| Northeast | 15.7 (0.9) | 15.7 (1.0) | 21.1 (3.0) | 17.6 (0.6) |
| Midwest | 20.9 (1.0) | 20.8 (1.1) | 21.8 (3.1) | 21.0 (0.7) |
| South | 42.4 (1.3) | 42.6 (1.4) | 37.7 (4.2) | 36.6 (0.9) |
| West | 20.9 (1.1) | 20.9 (1.2) | 19.5 (3.0) | 24.8 (0.9) |
| Women | ||||
| Northeast | 16.0 (0.9) | 16.0 (0.9) | 17.2 (3.3) | 17.6 (0.6) |
| Midwest | 20.8 (1.1) | 20.4 (1.1) | 29.7 (3.8) | 20.5 (0.7) |
| South | 42.8 (1.4) | 43.2 (1.4) | 37.2 (4.1) | 38.5 (0.9) |
| West | 20.4 (1.2) | 20.4 (1.3) | 15.9 (3.3) | 23.4 (0.8) |
| Race/ethnicity | ||||
| Non-Hispanic White | ||||
| Northeast | 16.6 (1.0) | 16.6 (1.1) | 20.8 (2.7) | 19.2 (0.8) |
| Midwest | 28.4 (1.2) | 28.2 (1.2) | 30.7 (3.0) | 25.9 (0.9) |
| South | 39.0 (1.3) | 39.5 (1.3) | 31.4 (3.4) | 34.3 (0.9) |
| West | 15.9 (1.0) | 15.8 (1.1) | 17.1 (2.4) | 20.6 (1.0) |
| Non-Hispanic Black | ||||
| Northeast | 13.0 (1.5) | 13.0 (1.6) | 3 | 15.3 (1.1) |
| Midwest | 12.9 (1.5) | 13.2 (1.6) | 3 | 14.4 (1.0) |
| South | 66.8 (2.3) | 66.6 (2.3) | 76.4 (7.7) | 61.8 (1.7) |
| West | 7.2 (1.1) | 7.2 (1.1) | 3 | 8.6 (0.8) |
| Hispanic | ||||
| Northeast | 14.7 (1.7) | 14.7 (1.7) | 22.1 (8.4)1 | 12.8 (1.0) |
| Midwest | 8.5 (1.3) | 8.5 (1.3) | 20.8 (9.7)2 | 8.4 (0.9) |
| South | 39.5 (3.2) | 39.6 (3.2) | 35.5 (11.0)1 | 39.5 (2.3) |
| West | 37.2 (3.1) | 37.2 (3.1) | 21.6 (7.6)1 | 39.3 (2.0) |
| Mexican American‡ | ||||
| Northeast | 2.2 (0.9) | 2.2 (0.9) | 3 | 3.1 (0.5) |
| Midwest | 10.2 (1.8) | 10.0 (1.8) | 36.8 (15.2)2 | 9.8 (1.2) |
| South | 38.6 (4.2) | 38.6 (4.2) | 34.8 (15.5)2 | 35.6 (3.1) |
| West | 49.0 (4.1) | 49.2 (4.2) | 28.4 (11.7)2 | 51.5 (2.9) |
| Non-Hispanic Asian | ||||
| Northeast | 22.6 (3.4) | 23.4 (3.5) | 3 | 22.4 (1.8) |
| Midwest | 10.9 (2.1) | 11.3 (2.2) | 3 | 12.3 (1.1) |
| South | 24.8 (3.1) | 24.3 (3.1) | 39.5 (18.2)2 | 25.0 (1.9) |
| West | 41.7 (4.0) | 41.0 (4.0) | 43.0 (19.4)2 | 40.3 (2.4) |
| Non-Hispanic American Indian/Alaska Native | ||||
| Northeast | 11.1 (4.9)2 | 11.4 (5.1)2 | 3 | 6.4 (1.5) |
| Midwest | 14.7 (4.3) | 15.2 (4.5) | 3 | 19.1 (3.6) |
| South | 42.3 (9.8) | 41.8 (9.8) | 64.6 (21.9)1 | 36.2 (6.0) |
| West | 32.0 (12.7)1 | 31.6 (13.2)2 | 3 | 38.4 (8.9) |
All data are self-reported.
- *
Data on diagnosed diabetes, type 2 diabetes, and no diabetes are from 2021–2022.
- †
Type 1 diabetes is based on self-report of type 1 diabetes and continuous insulin use within 1 year of diagnosis; data are from 2019–2022.
- ‡
Mexican American is a subset of Hispanic.
- 1
Relative standard error >30%–40%
- 2
Relative standard error >40%–50%
- 3
Estimate is too unreliable to present; ≤1 case or relative standard error >50%.
SOURCE: National Health Interview Surveys 2019–2022
APPENDIX TABLE A11.
Years Living in the United States Among Immigrant Adults Age ≥20 Years, by Diabetes Status, Age, Sex, and Race/Ethnicity, U.S., 2019–2022
| YEARS LIVING IN THE UNITED STATES | PERCENT (STANDARD ERROR) | |||
|---|---|---|---|---|
| Diagnosed Diabetes* | Type 2 Diabetes* | Type 1 Diabetes† | No Diabetes* | |
| Total | ||||
| <5 | 1.6 (0.5)1 | 1.6 (0.5)1 | 3 | 7.8 (0.4) |
| 5–<10 | 3.6 (0.8) | 3.5 (0.8) | 3 | 12.5 (0.5) |
| 10–<15 | 4.6 (0.7) | 4.5 (0.7) | 3 | 9.5 (0.4) |
| ≥15 | 90.1 (1.2) | 90.4 (1.2) | 82.8 (6.8) | 70.3 (0.7) |
| Age (years) | ||||
| 20–44 | ||||
| <5 | 7.4 (3.7)3 | 3 | 3 | 12.7 (0.7) |
| 5–<10 | 7.0 (2.8)2 | 5.7 (2.4)2 | 3 | 20.5 (0.8) |
| 10–<15 | 14.4 (4.1) | 14.1 (4.2) | 3 | 14.4 (0.7) |
| ≥15 | 71.2 (5.5) | 72.5 (5.8) | 70.1 (13.1) | 52.4 (1.1) |
| 45–64 | ||||
| <5 | 0.8 (0.6)3 | 3 | 3 | 3.7 (0.5) |
| 5–<10 | 4.1 (1.3)1 | 4.1 (1.3)1 | 3 | 6.0 (0.6) |
| 10–<15 | 3.6 (0.9) | 3.5 (0.9) | 3 | 5.7 (0.5) |
| ≥15 | 91.5 (1.7) | 91.6 (1.7) | 90.1 (7.0) | 84.6 (0.9) |
| ≥65 | ||||
| <5 | 1.3 (0.7)3 | 3 | 3 | 2.1 (0.6) |
| 5–<10 | 2.4 (1.2)2 | 2.4 (1.2)2 | 3 | 2.2 (0.5) |
| 10–<15 | 3.8 (1.1)1 | 3.8 (1.2)1 | 3 | 2.7 (0.7) |
| ≥15 | 92.5 (1.8) | 92.4 (1.8) | 3 | 93.0 (1.1) |
| Sex | ||||
| Men | ||||
| <5 | 0.4 (0.3)3 | 3 | 3 | 8.0 (0.7) |
| 5–<10 | 3.9 (1.4)1 | 3.7 (1.4)1 | 3 | 12.6 (0.7) |
| 10–<15 | 4.3 (1.0) | 4.0 (1.0) | 3 | 8.8 (0.6) |
| ≥15 | 91.4 (1.7) | 91.9 (1.7) | 84.3 (9.1) | 70.6 (1.1) |
| Women | ||||
| <5 | 2.8 (1.1)1 | 2.9 (1.1)1 | 3 | 7.6 (0.5) |
| 5–<10 | 3.3 (0.9) | 3.4 (0.9) | 3 | 12.3 (0.6) |
| 10–<15 | 5.1 (1.1) | 4.9 (1.1) | 3 | 10.1 (0.6) |
| ≥15 | 88.8 (1.8) | 88.8 (1.8) | 80.4 (10.3) | 70.0 (0.9) |
| Race/ethnicity | ||||
| Non-Hispanic White | ||||
| <5 | 0.3 (0.3)3 | 3 | 3 | 5.3 (0.6) |
| 5–<10 | 0.2 (0.2)3 | 0.2 (0.2)3 | 3 | 11.1 (0.9) |
| 10–<15 | 4.1 (1.9)2 | 4.2 (1.9)2 | 3 | 6.7 (0.7) |
| ≥15 | 95.4 (1.9) | 95.6 (1.9) | 86.9 (7.6) | 76.9 (1.3) |
| Non-Hispanic Black | ||||
| <5 | 3 | 3 | 3 | 9.8 (1.6) |
| 5–<10 | 8.9 (2.9)1 | 9.3 (3.1)1 | 3 | 17.2 (1.9) |
| 10–<15 | 3.4 (1.8)3 | 3 | 3 | 13.8 (1.5) |
| ≥15 | 87.7 (3.4) | 87.2 (3.6) | 3 | 59.2 (2.4) |
| Hispanic | ||||
| <5 | 2.3 (0.9)2 | 2.3 (0.9)2 | 3 | 8.0 (0.6) |
| 5–<10 | 2.3 (1.1)2 | 2.3 (1.1)2 | 3 | 11.6 (0.7) |
| 10–<15 | 4.3 (1.1) | 4.0 (1.0) | 3 | 7.1 (0.6) |
| ≥15 | 91.1 (1.8) | 91.4 (1.8) | 85.8 (13.5) | 73.3 (1.1) |
| Mexican American‡ | ||||
| <5 | 1.5 (1.0)3 | 3 | 3 | 5.0 (0.7) |
| 5–<10 | 0.4 (0.4)3 | 3 | 3 | 6.9 (0.7) |
| 10–<15 | 4.7 (1.3) | 4.3 (1.3)1 | 3 | 5.4 (0.6) |
| ≥15 | 93.3 (2.0) | 93.8 (2.0) | 80.5 (18.6) | 82.8 (1.0) |
| Non-Hispanic Asian | ||||
| <5 | 0.8 (0.6)3 | 3 | 3 | 8.7 (0.7) |
| 5–<10 | 5.5 (2.2)1 | 4.9 (2.1)2 | 3 | 13.2 (0.9) |
| 10–<15 | 6.3 (1.7) | 6.1 (1.7) | 3 | 14.1 (0.8) |
| ≥15 | 87.4 (2.7) | 88.1 (2.7) | 66.8 (17.9) | 64.0 (1.3) |
| Non-Hispanic American Indian/Alaska Native | ||||
| <5 | 3 | 3 | 3 | 3 |
| 5–<10 | 3 | 3 | 3 | 3 |
| 10–<15 | 3 | 3 | 3 | 3 |
| ≥15 | 3 | 3 | 3 | 86.0 (9.7) |
All data are self-reported.
- *
Data on diagnosed diabetes, type 2 diabetes, and no diabetes are from 2021–2022.
- †
Type 1 diabetes is based on self-report of type 1 diabetes and continuous insulin use within 1 year of diagnosis; data are from 2019–2022.
- ‡
Mexican American is a subset of Hispanic.
- 1
Relative standard error >30%–40%
- 2
Relative standard error >40%–50%
- 3
Estimate is too unreliable to present; ≤1 case or relative standard error >50%.
SOURCE: National Health Interview Surveys 2019–2022
APPENDIX TABLE A12.
Marital Status Among Adults Age ≥20 Years, by Diabetes Status, Age, Sex, and Race/Ethnicity, U.S., 2019–2022
| MARITAL STATUS | PERCENT (STANDARD ERROR) | |||
|---|---|---|---|---|
| Diagnosed Diabetes* | Type 2 Diabetes* | Type 1 Diabetes† | No Diabetes* | |
| Total | ||||
| Married | 56.0 (0.8) | 56.3 (0.8) | 48.4 (2.9) | 53.2 (0.4) |
| Living with a partner | 5.2 (0.4) | 5.1 (0.4) | 9.1 (1.8) | 9.3 (0.2) |
| Widowed | 12.6 (0.5) | 12.9 (0.5) | 4.9 (1.2) | 5.3 (0.1) |
| Divorced/separated | 13.9 (0.5) | 14.0 (0.5) | 11.0 (1.7) | 9.9 (0.1) |
| Never married | 12.3 (0.5) | 11.7 (0.5) | 26.4 (2.8) | 22.3 (0.3) |
| Age (years) | ||||
| 20–44 | ||||
| Married | 41.9 (2.7) | 42.3 (3.0) | 37.9 (4.5) | 42.6 (0.5) |
| Living with a partner | 10.7 (1.6) | 11.2 (1.8) | 13.3 (3.4) | 14.2 (0.3) |
| Widowed | 1.1 (0.5)2 | 1.4 (0.6)2 | 3 | 0.2 (0.0) |
| Divorced/separated | 8.9 (1.2) | 9.7 (1.4) | 4.3 (1.5)1 | 4.8 (0.2) |
| Never married | 37.4 (2.6) | 35.5 (2.8) | 44.5 (4.8) | 38.2 (0.5) |
| 45–64 | ||||
| Married | 61.1 (1.2) | 61.3 (1.2) | 57.9 (4.5) | 65.5 (0.5) |
| Living with a partner | 5.9 (0.6) | 5.9 (0.6) | 6.3 (2.1) | 6.3 (0.2) |
| Widowed | 4.3 (0.4) | 4.4 (0.5) | 4.3 (1.7)1 | 3.2 (0.1) |
| Divorced/separated | 15.5 (0.8) | 15.3 (0.8) | 17.7 (3.2) | 15.1 (0.3) |
| Never married | 13.2 (0.8) | 13.2 (0.8) | 13.8 (3.0) | 9.9 (0.3) |
| ≥65 | ||||
| Married | 54.5 (1.0) | 54.5 (1.0) | 56.9 (6.0) | 58.3 (0.5) |
| Living with a partner | 3.3 (0.4) | 3.2 (0.4) | 3 | 2.8 (0.2) |
| Widowed | 23.3 (0.9) | 23.3 (0.9) | 19.9 (5.2) | 20.3 (0.4) |
| Divorced/separated | 13.6 (0.7) | 13.6 (0.7) | 15.2 (4.4) | 13.6 (0.3) |
| Never married | 5.4 (0.4) | 5.4 (0.4) | 3 | 5.1 (0.2) |
| Sex | ||||
| Men | ||||
| Married | 63.1 (1.0) | 63.7 (1.0) | 47.4 (4.2) | 54.8 (0.5) |
| Living with a partner | 5.8 (0.5) | 5.6 (0.5) | ||