Impact of Recent Increase in Incidence on Future Diabetes Burden

U.S., 2005–2050

  1. K.M. Venkat Narayan, MD,
  2. James P. Boyle, PHD,
  3. Linda S. Geiss, MA,
  4. Jinan B. Saaddine, MD and
  5. Theodore J. Thompson, MS
  1. From the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
  1. Address correspondence and reprint requests to K.M. Venkat Narayan, MD, Division of Diabetes Translation, Centers for Disease Control and Prevention, 4770 Buford Hwy., NE, MS K-10, Atlanta, GA 30341-3717. E-mail: kav4{at}

In an earlier study, we had forecasted 39 million with diagnosed diabetes in 2050 in the U.S. (1,2). However, since then, national diabetes incidence increased (3) and the relative risk of death among people with diabetes declined (4,5). These changes will impact future forecasts.

Incorporating these changes, we now project 48.3 million people with diagnosed diabetes in the U.S. in 2050. We also present age-, sex-, and race/ethnicity-specific forecasts, with Bayesian CIs, of the number of people with diagnosed diabetes through 2050.


We used a discrete-time (1-year intervals), incidence-based Markov model with three states (no diagnosed diabetes, diagnosed diabetes, and death) (1). In each cycle of the model, projections are developed for 808 population subgroups defined by age, sex, and race/ethnicity.

We estimated the age-, sex-, and race/ethnicity-specific prevalence and incidence of diabetes from the U.S. National Health Interview Survey (6–9) and modeled data for 1984–2004 to improve the precision of 2004 estimates.

Models were fit using Bayesian methods with improper flat priors applied to logistic regression. We assessed adequacy of model fit using posterior predictive P values (10). Estimated prevalence of diagnosed diabetes for 2000 and 2004 were 4.35 and 5.37%, respectively, and estimated incidence were 0.42 and 0.53% per year, respectively. The age-, sex-, and race/ethnicity-specific 2004 prevalence estimates were combined with U.S. population data for 2004 (11 …

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