Diabetes affects an estimated 25.6 million adults in the United States with another 79 million being classified as pre-diabetic. Factoring in those under age 20 with diabetes, a total of 25.8 million Americans, or 8.3 percent of the nation’s population, are diabetic and another 35 percent are at high risk of developing the chronic condition.

Diabetes is the seventh leading cause of death listed on U.S. death certificates. Cardiovascular disease is the leading cause of death among diabetics with approximately 68 percent dying from heart disease or stroke. The overall risk of death is nearly double for diabetics compared to those without the disease.

Source: National Institute of Diabetes and Digestive and Kidney Diseases.

Diabetic Populations

By Gender

13 million men have diabetes (11.8 percent of men 20 and older) 12.6 million women have diabetes (10.8 percent of women 20 and older)

By Age

25.6 million Americans 20 and older have diabetes (11.3 percent of age group) 10.9 million Americans 65 and older have diabetes (26.9 percent of age group) 215,000 Americans younger than age 20 have diabetes, predominantly type 1 (less than 1 percent of age group)

By Race/Ethnicity

Non-Hispanic Whites: 10.2 percent of the adult population has diagnosed or undiagnosed diabetes (7.1 percent diagnosed, 3.1 percent undiagnosed). African-American: 18.7 percent of non-Hispanic black adults has diagnosed or undiagnosed diabetes (12.6 percent diagnosed, 6.1 percent undiagnosed). Hispanics/Latinos: 11.8 percent of the larger adult Hispanic/Latino population has diagnosed diabetes. Within the population, diabetes prevalence rates are 7.6 percent for Cubans and those from Central and South America, 13.3 percent for Mexican Americans, and 13.8 percent for Puerto Ricans. Asian Americans: 8.4 percent of the adult population has diagnosed diabetes. Native Americans: 16.1 percent of this population served by the Indian Health Service has diagnosed diabetes. However, the prevalence varies greatly by region from 5.5 percent among Alaska Natives to 33.5 percent of American Indians in southern Arizona.

Source: National Diabetes Education Program, NIDDK.

Gestational Diabetes & Possible Later Link to Heart Disease

A study released last month in the Journal of the American Heart Association found pregnant women might face an increased risk of early heart disease when they develop gestational diabetes, which usually disappears when the pregnancy ends.

The condition is known to increase the risk the mother will develop diabetes later and is managed with meal planning, activity and sometimes insulin or other medications. In the recently released 20-year study, researchers found that a history of gestational diabetes also might be a risk factor for early atherosclerosis in women during midlife before the onset of diabetes and metabolic diseases.

 “Our research shows that just having a history of gestational diabetes elevates a woman’s risk of developing early, sub-clinical atherosclerosis before she develops type 2 diabetes or the metabolic syndrome,” said Erica P. Gunderson, PhD, MS, MPH, lead author of the study and senior research scientist in the Division of Research at Kaiser Permanente Northern California.

Researchers measured risk factors for heart disease before pregnancy among 898 women, ages 18-30, who later had one or more births. The women were periodically tested for diabetes and metabolic conditions before and after their pregnancies throughout the 20-year period. Carotid artery wall thickness was measured on average 12 years after pregnancy when women were ages 38-50. The study controlled for age, race, number of births and pre-pregnancy body mass index, plus fasting blood glucose, insulin, lipids, and blood pressure.

Participants were divided into women who developed gestational diabetes and those who didn’t. Overall, 119 women (13 percent) reported they had developed gestational diabetes (7.6 per 100 deliveries).

Carotid artery media thickness is an early measure of sub-clinical atherosclerosis and predicts heart attack and stroke in women. Researchers used ultrasound studies to image the carotid artery, with four measurements from the near and far wall thickness.

Among the women who did not go on to develop diabetes or the metabolic syndrome during the 20-year follow up, they found a 0.023 mm larger average carotid artery intima-media thickness in those who had gestational diabetes compared to those who didn’t, and the difference was not attributed to obesity or elevated glucose before pregnancy.

Gunderson said it’s important to recognize reproductive characteristics that might contribute to disease risk in women and could inform early prevention efforts.