Over the past 45 years, the U.S. Public Health Service has conducted surveys to assess the health and disease status of the U.S. population. These studies, complemented by those of the National Diabetes Data Group, document the growing impact of diabetes on the nation's public health. Over this period the prevalence of diabetes has increased tenfold.
At present, virtually one in every 40 Americans, or almost six million persons, have been told by a doctor that they have diabetes. About 600,000 are newly diagnosed each year. An additional five million persons have been diagnosed as having borderline, pre- or potential diabetes or have had abnormal glucose tolerance tests. Further, another four to five million persons have undiagnosed diabetes.
In the U.S., diabetes causes almost 50% of amputations of the foot and leg among adults. It causes about 20% of all cases of kidney failure and 15% of all blindness. About 25% of diabetics have heart disease.
Diabetics have twice as much disability as nondiabetics and spend twice as many days in the hospital as persons without the disease. Over 25% of diabetics require hospitalization each year. Further, about 2% of all deaths in the U.S. are directly attributable to diabetes, and an additional 5% to its complications.
Diabetes also places a major drain on health resources. Over 19 million visits to physicians are made each year by diabetics. It is the fourth leading cause of visits to general and family practice physicians. Diabetes accounts for over two million hospitalizations annually (7% of all hospitalizations) and over 21 million hospital days (10% of all hospital days). One in every seven patients in nursing homes has diabetes.
The cost of diabetes has been mounting steadily. In the past six years, the cost of medical care for diabetics and the losses due to disability and premature mortality have almost doubled. In 1982, the economic impact of diabetes stands at approximately $12 billion. Since 40% of diabetics are age 65 years and older and many diabetics are poor, much of this economic burden falls on public sources such as our Medicare and Medicaid programs.