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Diabetes Care. 2017 Sep;40(9):1139-1143. doi: 10.2337/dc16-2442.

Declines in the Incidence of Diabetes in the U.S.-Real Progress or Artifact?

Author information

1
Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD eselvin@jhu.edu.
2
Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, and Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA.

Abstract

National surveillance data show a sustained decline in the incidence rate of diagnosed diabetes, which has been heralded as a success in the battle against diabetes in the U.S. In this Perspective, we take a closer look at these data and provide additional insights to help interpret these trends. We examine multiple sources of data on the prevalence and incidence of diabetes in the U.S. as well as data on trends in diabetes risk factors to provide context for these national surveillance findings. Although some of the incidence decline may represent real progress against diabetes, it is likely that there are also nonbiological factors at play, especially changes in diagnostic criteria for diabetes. We present and discuss data that suggest improved detection and changes in screening and diagnostic practices may have resulted in the depletion of the "susceptible population." Providing this context for the recent declines in new diabetes diagnoses observed in national data is critical to help avoid misinterpretation. We argue that it is premature to declare victory against the epidemic of diabetes in the U.S. and discuss how we might better focus current public health efforts, including a specific emphasis to address prediabetes.

Comment in

PMID:
28830954
PMCID:
PMC5566279
DOI:
10.2337/dc16-2442
[Indexed for MEDLINE]
Free PMC Article

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