1 / 30

Healthy People 2010 Focus Area 5

Healthy People 2010 Focus Area 5. Diabetes Progress Review December 18, 2002. Diabetes Model. Prevention of Diabetes. Prevention of Diabetes-Related Complications. Physical Activity Nutrition Healthy Weight Access. General Population. Pre-diabetes (16 million persons) .

sidone
Télécharger la présentation

Healthy People 2010 Focus Area 5

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Healthy People 2010Focus Area 5 Diabetes Progress Review December 18, 2002

  2. Diabetes Model Prevention of Diabetes Prevention of Diabetes-Related Complications Physical Activity Nutrition Healthy Weight Access General Population Pre-diabetes (16 million persons) Diagnosed Diabetes Undiagnosed Diabetes Self-management of Diabetes Provider Services Increase risk for: Acute Complications Amputations Birth Defects Blindness/Eye Disease Dental Disease Flu & Pneumonia-Related Deaths Heart Disease High Blood Pressure Kidney Disease Pregnancy Complications Nervous System Damage Stroke Societal Costs Related Deaths Per Year: 200,000 + Reduced Life Expectancy: 5-15 years Medicare: 25% of Costs Estimated Annual Costs: ~ $100 billion (direct and indirect)

  3. 5-3. Diagnosed Diabetes Prevalence, 2000 Persons with diabetes in the U.S.: 17 million (11.1 million diagnosed + 5.9 million undiagnosed) Age-adjusted rate per 1,000 standard population 2010 Target American Indian/ Alaska Native Asian/Pacific Islander White, not Hispanic Hispanic Black, not Hispanic Total I 95% confidence interval. Source: National Health Interview Survey (NHIS), CDC, NCHS.

  4. 5-3. Prevalence of Diagnosed Diabetes by Age: United States, 1980-1999 160 140 65-74 Years 120 75+ Years 100 80 45-64 Years 60 Total 40 20 0-44 Years Note: Data are three-year averages. Data from 1997 and later years my not be comparable with earlier years due to a redesign of the NHIS in 1997. Source: National Health Interview Survey (NHIS), CDC, NCHS. www.cdc.gov/diabetes/statistics/prev/national/Table8.htm.

  5. 5-3. Prevalence of Diagnosed Diabetes by Age: United States, 1980-1999 Percent change (1980-1996) (1997-1999) 160 65-74 years 140 120 75+ years 100 45-64 years 80 60 Total 40 20 0-44 years Note: Data are three-year averages. Data from 1997 and later years my not be comparable with earlier years due to a redesign of the NHIS in 1997. Source: National Health Interview Survey (NHIS), CDC, NCHS. www.cdc.gov/diabetes/statistics/prev/national/Table8.htm.

  6. 5-3. Prevalence of Diagnosed Diabetes by Race/Ethnicity and Gender 80 Hispanic males 70 Black females 60 Hispanic females 50 Black males Age-adjusted rate per 1,000 standard population 40 White males 30 White females 20 10 Note: Data are three-year averages. Data from 1997 and later years my not be comparable with earlier years due to a redesign of the NHIS in 1997. Source: National Health Interview Survey (NHIS), CDC, NCHS. www.cdc.gov/diabetes/statistics/prev/national/fig4data.htm.

  7. 5-3. Prevalence of Diagnosed Diabetes by Race/Ethnicity and Gender Percent Change 1980-96 1997-99 80 Hispanic males 70 Black females 60 Hispanic females 50 Black males 40 Age-adjusted rate per 1,000 standard population White males White females 30 20 10 Note: Data are three-year averages. Data from 1997 and later years my not be comparable with earlier years due to a redesign of the NHIS in 1997. Source: National Health Interview Survey (NHIS), CDC, NCHS. www.cdc.gov/diabetes/statistics/prev/national/fig4data.htm.

  8. 5-3. Prevalence of Diagnosed Diabetes, Adults 18 years and over, by State, United States 1994 2000 Age-adjusted percent <4% 4-4.9% 5-5.9% 6+% Note: 1994: 3-Year Average; 2000: 2-Year Average.Source: Behavioral Risk Factor Surveillance Survey (BRFSS), CDC, NCCDPHP. www.cdc.gov/diabetes/statistics/prev/state/fig61994and2000.htm

  9. 5-2. Diagnosed Diabetes Incidence*: Adults Age 18-84, by Race/Ethnicity, 1998-2000 Age-adjusted rate per 1,000 standard population ** 2010 Target Total Black, not Hispanic American Indian/ Alaska Native Asian/Pacific Islander Hispanic White, not Hispanic **Unreliable estimate, relative standard error >30%. I 95% confidence interval. *Note: Diagnosed incidence derived from algorithm using age at interview and age at diagnosis. Source: National Health Interview Survey (NHIS), CDC, NCHS.

  10. 5-5. Diabetes-Related Death Rates*: 2000 Age-adjusted death rate per 100,000 standard population 2010 Target White, not Hispanic American Indian/ Alaska Native Asian/ Pacific Islander Hispanic Black, not Hispanic Total *Any mention of diabetes on death certificate as underlying or contributing cause. Source: National Vital Statistics System-Mortality, (NVSS-M), CDC, NCHS.

  11. 5-7. Cardiovascular Disease Death Rates Among Persons with Diabetes, 2000 All Cause Deaths in Persons with Diabetes 820 per 100,000 Age-adjusted death rate per 100,000 standard population 2010 Target Total Hispanic Black, not Hispanic White, not Hispanic Females Males Note: Data for American Indian/Alaska Native and Asian/Pacific Islander are not shown due to small cell sizes. Source: National Vital Statistics System (NVSS-M), CDC, NCHS.

  12. Projected Increase in Total Heart Disease Deaths Related to Increased Diabetes Prevalence Proportion of heart disease deaths due to diabetes Heart Disease Deaths (thousands) 883 29% 724 21% . Source: Unpublished estimates from the National Heart, Lung, and Blood Institute, October 18, 2002.

  13. Projected Increase in Total Heart Disease Deaths, U.S. Population Heart Disease Deaths (thousands) Diabetes Mellitus Prevalence Unchanged Diabetes Mellitus Prevalence Increases Source: Unpublished estimates from the National Heart, Lung, and Blood Institute, October 18, 2002.

  14. 5-10. Lower Extremity Amputations Among Persons with Diabetes, 1998-2000 Age-adjusted rate per 1,000 standard population 2010 Target Total Black White Female Male < 65 65-74 75+ Age (not adjusted) I 95% confidence interval. Note: Data for American Indians/Alaska Natives, Asian/Pacific Islanders and Hispanics are not shown due to small cell sizes. Source: National Hospital Discharge Survey (NHDS) and National Health Interview Survey (NHIS), CDC, NCHS.

  15. Diabetes-Related Complications: Provider Services For Adults with Diabetes Age-adjusted percent Most recent level 2010 Target Direction desired 90% 90% 75% 75% 75% * 60% 60% 60% 68% ** 65% 61% 61% 60% 51% 60% 55% 36% 23% Age 18-64 Age 65+ Age 18-64 Age 65+ 2 x year Annual exam Annual Influenza vaccination Pneumococcal Vaccination (ever) 2001 2000 1999 1988-94 2000 Sources: CDC: Behavioral Risk Factor Surveillance Survey (BRFSS), NCCDPHP; National Health Interview Survey (NHIS), National Health and Nutrition Examination Survey (NHANES), NCHS. * Target-to-be-determined. **Exceeds total population target (50%).

  16. 5-12. A1C Tests: Persons with Diabetes, 2001* Age-adjusted percent receiving two or more tests in the past year** White, not Hispanic American Indian/ Alaska Native Asian/Pacific Islander Total Black, not Hispanic Hispanic *41 reporting States and D.C. I 95% confidence interval. **Target-to-be-determined. Source: Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.

  17. 5-13. Annual Dilated Eye Examinations: Persons with Diabetes, by Race/Ethnicity 1998 1999 2010 Target Age-adjusted percent American Indian/ Alaska Native Hispanic Black, not Hispanic White, not Hispanic Total I 95% confidence interval. Note: Data for American Indians/Alaska Natives are for IHS Service Areas. Asian/Pacific Islander data are not shown due to small cell sizes. Sources: National Health Interview Survey (NHIS), CDC, NCHS, and Indian Health Service.

  18. 5-14. Annual Foot Examinations: Persons with Diabetes, 2001* Age-adjusted percent 2010 Target American Indian/ Alaska Native Total Asian/Pacific Islander Black, not Hispanic White, not Hispanic Hispanic *41 reporting States and D.C. I 95% confidence interval. Source: Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.

  19. Provider Services Utilization: Persons with Diabetes by Education Level Age-adjusted percent Less than high school At least some college Eye Diabetes Education (1999) Foot Dental A1C Test 2 x year Annual Exam (2001) (2001) (2000) (1999) I 95% confidence interval Sources: CDC: Behavioral Risk Factor Surveillance Survey (BRFSS), NCCDPHP; National Health Interview Survey (NHIS), National Health and Nutrition Examination Survey (NHANES), NCHS.

  20. Diabetes-Related Complications: Self-Management of Diabetes: Adults with Diabetes 2010 Target Most recent level Direction desired Age-adjusted percent 60% 60% 57% 50% 30% 21% 20% 12% Self monitoring blood glucose 1999-2000 1988-1994 2000 2001 Sources: CDC: Behavioral Risk Factor Surveillance System (BRFSS), NCCDPHP; National Health and Nutrition Examination Survey (NHANES), and National Health Interview Survey (NHIS), NCHS.

  21. 5-17. Self-Blood Glucose Monitoring: Persons with Diabetes , 2001* Age-adjusted percent 2010 Target Total American Indian/ Alaska Native Asian/Pacific Islander Hispanic Black, not Hispanic White, not Hispanic *41 reporting States and D.C. I 95% confidence interval. Source: Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.

  22. 5-16. Aspirin Therapy*: Persons with Diabetes, Age 40 years and Over, 1988-94 Age-adjusted percent 2010 Target Mexican American Black, not Hispanic White, not Hispanic Females Males Total I 95% confidence interval. *Took aspirin at least 15 times in past month. Source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

  23. Selected Risk Factors Persons with diabetes Persons without diabetes Age-adjusted percent Obesity High blood pressure Moderate physical activity Healthy weight 2000 1999-2000 1988-94 I 95% confidence interval. Sources: National Health Interview Survey (NHIS), National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

  24. Selected Risk Factors Persons with diabetes Persons without diabetes Age-adjusted percent Obesity High blood pressure Moderate physical activity Healthy weight 2000 1999-2000 1988-94 I 95% confidence interval. Sources: National Health Interview Survey (NHIS), National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

  25. 19-2. Obesity*: Adults Age 20 and Over, by Race/Ethnicity 1988-94 1999-2000 2010 Target Age-adjusted percent Black, not Hispanic White, not Hispanic Mexican American Total I 95% confidence interval. Source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS. *Body Mass Index > 30

  26. Obesity and Diagnosed Diabetes Prevalence Diagnosed Diabetes Obesity Age-adjusted rate per 1,000 standard population Age-adjusted percent Diagnosed Diabetes (All ages) (1999-2000) Obesity (20+ years) (1988-94) (1976-80) 1990 1995 2000 1980 1985 Note: Diagnosed diabetes data are 3-year averages. Obesity is Body Mass Index > 30. Obesity data for 1976-80 are for ages 20-74. Sources: National Health Interview Survey, National Health and Nutrition Examination Survey, CDC, NCHS.

  27. Developmental Objectives • 5-08. Decrease the proportion of pregnant women with gestational diabetes • (future source, National Vital Statistics System-Natality) • 5-09. Reduce frequency of foots ulcers in persons with • diabetes • (future source, National Health and Nutrition Examination Survey) • 5-11. Increase the proportion of persons with diabetes • who obtain an annual urinary albumin • measurement • (proposed source, Behavioral Risk Factor Surveillance System)

  28. Projected Diagnosed Diabetes in the U.S. Projected number of people with diagnosed diabetes (millions) Projected Population growth assumption* High Middle Low Reported 1975 *All population projections assume increasing diabetes prevalence rates. Sources: U.S. Census Bureau, National Health Interview Survey (NHIS), CDC, NCHS. Boyle et al. Diabetes Care, Vol. 24, No.11, November 2001.

  29. Progress review data and slides can be found on the web at: http://www.cdc.gov/nchs/hphome.htm 2010 Target

  30. Data Notes • Objective numbers in the “Provider Services For Adults with Diabetes” slide are as follows: A1C test (5-12), foot (5-14), dental (5-15), eye (5-13), education (5-1), high blood pressure control (12-10), and influenza /pneumococcal vaccination (14-29). • Objective numbers in the “Self-management of Diabetes” slide are as follows: self-monitoring blood glucose (5-17), aspirin use (5-16), healthy weight (19-1), and moderate physical activity (22-2). • Objective numbers in the “Selected Risk Factors” slide are listed above except for high blood pressure (12-9). • Data are age adjusted to the 2000 standard population. • The American Indian/Alaska Native and Asian Pacific Islander categories include persons of Hispanic and non-Hispanic origin. • Persons of Hispanic origin may be of any race.

More Related