Diabetes affects an estimated 23.6 million people in the US (90 percent to 95 percent have type 2 diabetes) - 17.9 million have been diagnosed, but 5.7 million are unaware they have the disease. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the American Diabetes Association, those affected include:
- 11.5 million US women (10.2 percent of all women age 20 years and older)
- 12 million US men (11.2 percent of all men age 20 years and older)
- 186,300 people under age 20
- 12.2 million adults over age 60
- 3.7 million African Americans (14.7 percent of all African Americans age 20 years and older)
- 2.5 million Hispanic/Latino Americans (9.5 percent of all Hispanic/Latino Americans)
- 14.9 million Caucasian Americans (9.8 percent of all Caucasian Americans age 20 years and older)
According to the most recent statistics, diabetes was the sixth leading cause of death, and the fifth leading cause of death from disease in 2007. Diabetes costs $116 billion annually in direct medical costs. Diabetes costs $58 billion annually in indirect costs (loss of work, disability, loss of life).
Certain ethnic groups tend to be more susceptible to developing type 2 diabetes. Several risk factors contribute to this pattern, including the following:
- genetic background
Certain racial groups tend to share a common genetic factor that may affect their insulin secretion and insulin resistance. For example, African-Americans, Hispanic Americans, Asian Americans, and Pacific Islanders may share a "thrifty gene" left over from their ancestors, which enabled them to survive during "feast and famine" cycles. However, with those cycles phasing out, that same gene may make a person more susceptible to developing type 2 diabetes.
- impaired glucose tolerance (IGT)
Impaired glucose tolerance, when blood glucose levels rise higher than normal after meals, may be more prevalent in certain groups. IGT may be an early stage of diabetes.
- gestational diabetes
Women who develop gestational diabetes during pregnancy may have a 50 percent chance of developing type 2 diabetes within 20 years of the pregnancy. The prevalence of gestational diabetes is higher among certain groups.
- hyperinsulinemia and insulin resistance
Hyperinsulinemia, or higher than normal levels of fasting insulin, may lead to diabetes. Certain ethnic groups tend to have higher insulin levels.
Obesity is a major risk factor for type 2 diabetes. Obesity is more prevalent in certain races.
- physical inactivity
Lack of physical activity can lead to diabetes. Certain groups have higher levels of physical inactivity than others.
African Americans are two times more likely to develop diabetes than Caucasian Americans. Obesity tends to be one of the major risk factors for developing diabetes in African Americans, especially African-American women. Other facts about African Americans and diabetes include the following:
- African Americans also are more likely to suffer from higher incidences of diabetes complications and disability.
- African Americans are more likely to undergo lower-extremity amputations than Caucasian Americans or Hispanic/Latino Americans.
- African Americans with diabetes experience kidney failure about four times more often than diabetic Caucasian Americans.
- African Americans have a 40 percent to 50 percent higher risk for developing diabetic retinopathy, partly because this population also has a higher rate of hypertension.
- Gestational diabetes may be 50 percent to 80 percent more likely among African-American women than among Caucasian women.
Approximately 10 percent of all Hispanic/Latino Americans (2 million) have diabetes. Hispanic/Latino Americans are twice as likely to have diabetes then are Caucasian Americans. Other Hispanic/Latino Americans are twice as likely to have diabetes then are non-Hispanic whites. Other facts about Hispanic/Latino Americans and diabetes include the following:
- Diabetes is twice as common among Mexican Americans and Puerto Rican Americans then among Caucasian Americans.
- Obesity and physical inactivity are the main risk factors for diabetes among Hispanic/Latino Americans.
- Although Hispanic/Latino Americans have higher rates of diabetic retinopathy and kidney disease, they have lower rates of heart disease from diabetes than Caucasian Americans.
American Indians and Alaska Natives are more than twice as likely to develop diabetes as are Caucasian Americans. Other facts about American Indians and Alaska Natives and diabetes include the following:
- Approximately 15 percent of American Indian adults have diabetes, although rates vary considerably among different tribes.
- Type 2 diabetes prevalence is increasing among American Indian and Alaska Native children and adolescents.
- Obesity is a major risk factor in the development of diabetes among American Indians and Alaska Natives. For example, the majority (95 percent) of Pima Indians with diabetes are overweight.
Data concerning diabetes prevalence among Asian Americans and Pacific Islander Americans is limited. Some groups among Asian Americans and Pacific Islander Americans appear to be at higher risk for developing type 2 diabetes compared with their non-Hispanic white counterparts. For example, one study showed that Native Hawaiians were 2.5 times as likely to develop diabetes than non-Hispanic white Hawaiians. Other facts about Asian Americans and Pacific Islander Americans and diabetes include the following:
- Diabetes is the fifth leading cause of death among Asian Americans and Pacific Islander Americans ages 45 to 64.
- Asian Americans and Pacific Islander Americans are at increased risk for developing type 2 diabetes compared with Caucasian Americans.