What NIH Statistics Reveal About Diabetes Prevalence

By John Steinberg, DPM

How Common Are Complications?
Emphasizing prevention efforts is more critical than ever when you consider the array of diabetes-related complications. Heart disease, for example, is the leading cause of diabetes-related deaths. Adults with diabetes have heart disease death rates about two to four times higher than in adults without diabetes. The risk for stroke is two to four times higher among people with diabetes. About 73 percent of adults with diabetes have blood pressure greater than or equal to 130/80 mm Hg or use prescription medications for hypertension.
Diabetes is the leading cause of new cases of blindness among adults 20 to 74 years old. Diabetic retinopathy causes between 12,000 to 24,000 new cases of blindness each year.
Diabetes is the leading cause of treated end-stage renal disease, accounting for 43 percent of new cases, according to NIH statistics. In 1999, 38,160 people with diabetes began treatment for end-stage renal disease. The same year, a total of 114,478 people with diabetes underwent dialysis or kidney transplantation.
About 60 to 70 percent of people with diabetes have mild to severe forms of nervous system damage. The results of such damage include impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome and other nerve problems.
Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations. More than 60 percent of nontraumatic lower-limb amputations in the United States occur among people with diabetes. From 1997 to 1999, about 82,000 nontraumatic lower-limb amputations were performed each year among people with diabetes.

Final Notes
In 1999, approximately 450,000 deaths occurred among people with diabetes age 25 and older, representing about 19 percent of all deaths in the United States of that age group, according to NIH statistics.
Overall, the risk for death among people with diabetes is about two times that of people without diabetes. However, the increased risk associated with diabetes is greater for younger people (3.6 times the risk for people age 25 to 44 versus 1.5 times the risk for those age 65 to 74) and women (2.7 times the risk for women age 45 to 64 versus two times the risk for men in that age group).
Diabetes is the sixth leading cause of death in the U.S. Diabetes was listed as a contributing cause of death on an additional 141,265 death certificates. However, these numbers may be underestimated. According to NIH estimates, diabetes is listed on only about 35 to 40 percent of the death certificates of people with diabetes and only about 10 to 15 percent have it listed as the underlying cause of death.

Dr. Steinberg (pictured) is an Assistant Professor in the Department of Orthopedics/Podiatry Service at the University of Texas Health Science Center.

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