Diabetes affects approximately 26 million Americans or 8.3% of the U.S. population (1). In recent years there has been a sharp increase in the disease’s prevalence. The number of people diagnosed with diabetes has drastically risen since 1958 in which 1.5 million Americans had diabetes (1).  In 2010 alone, about 1.9 million people aged 20 years or older were newly diagnosed with diabetes (1).

Diabetes refers to a group of diseases characterized by high blood glucose levels that result from defects in the body's ability to produce and/or use insulin (2). When diabetes is not controlled, glucose and fats remain in the blood and can over time damage vital organs (3). Type 1 diabetes, previously called juvenile-onset diabetes, usually occurs among children and young adults and accounts for approximately 5% of all diagnosed cases of diabetes (4). Type 2 diabetes, or adult-onset diabetes, accounts for 90-95% of all diagnosed cases of diabetes and is associated with older age, obesity, family history of diabetes, physical inactivity, and race/ethnicity (3). Today, type 2 diabetes in adolescents, while less prevalent, is being diagnosed more frequently.

Diabetes is associated with many complications including heart, dental, and nervous system disease (4). Diabetes is also the leading cause of kidney failure, limb amputations, and new cases of blindness among adults and is the seventh leading cause of death in the United States (4). Diabetes is also a costly disease. Total health care and related costs of diabetes is $174 billion annually; direct medical costs (hospitalizations, treatment supplies) account for approximately $116 billion of these total costs and indirect costs (related to disability, work loss) account for $58 billion (1). In addition, people diagnosed with diabetes have medical expenditures that are approximately 2.3 times higher than for people without diabetes (3).

In recognition of November as American Diabetes Month, this article presents information on the prevalence of diabetes and risk factors among adults in Southeastern Pennsylvania from PHMC’s Community Health Data Base 2010 Southeastern Pennsylvania Household Health Survey.

Demographic and Socioeconomic Profile of Adults Diagnosed with Diabetes

• Approximately 11% of adults ages 18 and over in SEPA have ever been diagnosed with diabetes, representing approximately 325,700 adults in the region. Over the past 20 years, there has been a steady increase in diabetes among adults (Figure 1).
• The likelihood of having diabetes increases with age. For example, 2.4% of adults 18-39 have been diagnosed with diabetes compared to 20.8% of adults 60-74.
• Racial and ethnic disparities exist in regards to the prevalence of diabetes. Non-Latino Black adults (16.3%) are more likely to be diagnosed with diabetes than Latinos (9.6%), Whites (9.5%), and Asians (8.9%). (Figure 2)
• Adults living in poverty are more likely to have diabetes; approximately 17% of adults living below 100% of the federal poverty level have diabetes compared to 10% of non-poor adults. This breakdown stays consistent for those living below 150% and 200% of the federal poverty level.
• Adults with higher education are less likely to have diabetes; 6.5% of college graduates have diabetes compared to 23% of adults with less than a high school education.
• Obesity and high blood pressure are associated with diabetes. Adults who are obese are nearly five times more likely to have diabetes than those with a normal weight (21.4% compared to 4.3%, respectively). Similarly, adults with high blood pressure are five times more likely to have diabetes compared with adults who do not have high blood pressure (24.1% compared to 4.8%, respectively).

Health Care Among Adults with Diabetes

• Adults in the region who are in fair or poor health are significantly more likely to have diabetes than those who are in good, very good, or excellent health (28.9% compared to 7.4%, respectively).
• Among adults between the ages of 18 and 64 who have diabetes, 94.7% are insured.
• The majority of adults with diagnosed diabetes have a regular source of care (93.0%). This is a higher percentage than adults without diabetes (89.1%).
• However, adults diagnosed with diabetes are less likely to go to a doctor’s office for regular source of care (81%) compared to adults who do not have diabetes (87%). Adults with diabetes are more likely to go to a community health center (7.5%), hospital outpatient clinic (7.2%), or emergency room (7.2%) than adults without diabetes.
• Of uninsured adults, those diagnosed with diabetes are more likely to have visited an emergency room in the last year than uninsured adults who do not have diabetes (55.3% compared to 44.7%).

Conclusion

The large number of adults diagnosed with diabetes in Southeastern Pennsylvania illustrates how diabetes has quickly become a rising regional and nationwide health concern. The demographic and socioeconomic disparities among those diagnosed with diabetes also illustrates the need for targeted prevention efforts among poor, Black, and Latino populations. While most adults with diabetes in Southeastern Pennsylvania are insured and have a primary source of care, in order to treat the disease and maintain health additional measures such as behavior modification, self-care, and patient education are critical.

For more information about these findings, please contact Amy Clark at aclark@phmc.org.

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