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March 2011 eNewsletter
The Diabetes 2025 Forecasting Data
In This Issue:
New data forecast the prevalence, morbidity, and economic burden of diabetes through 2025, with regional and demographic analyses
Diabetes has become an epidemic in the United States. The CDC reports that almost 26 million Americans have diabetes already—1 in 10 adults, 3 in 10 seniors—and another 79 million have “prediabetes,” blood glucose or A1C higher than normal but not high enough to be classified as diabetes.1 The overall cost of prediabetes and diabetes in the United States was estimated at $218 billion in 2007 and is expected to rise dramatically in coming years. 2,3 As more patients experience disease progression and require clinical care, the health care system, and health care providers, will feel the effects.
Meeting this increased need for care will require careful planning. To better understand the scope of the problem, Novo Nordisk commissioned the Institute for Alternative Futures (IAF) to forecast the prevalence, morbidity, and cost of diabetes in 2015 and 2025, based on current trends and CDC projections. Data from the study, United States' Diabetes Crisis: Today and Future Trends, reveal several important epidemiologic trends1-4*:
The total number of US adults with diabetes (diagnosed and undiagnosed) may double by 2025, to approximately 53 million1,3,4
The proportion of patients with diabetes who are undiagnosed is projected to decrease between now and 2025, from 37% in 2011 to 27% in 20253
The annual total cost of diabetes is expected to reach $514 billion by 2025—a cost equivalent to the total Medicare budget for 20103
These forecasts go beyond any available national data by providing data for each state and 13 metropolitan regions, including analyses for people of various ethnic backgrounds and for seniors. The study identifies ten states in particular as "diabetes hot spots"; by 2025, these states will account for more than 50% of the diabetes population and will bear most of the direct and indirect costs of diabetes care. These results underscore the urgency of the diabetes epidemic—and can help policy makers, the medical community, and the public work together to change the course of the disease and create a better future.
You can access the data and briefing papers for each state by visiting
view data from Diabetes 2025
To raise public awareness of the findings, Novo Nordisk worked with Denver artist Mark Cline to represent the data as a chalk-art map of the United States. Cline created the 400-square-foot map in Union Station in Washington, DC, and the process was recorded in a time-lapse video.
Chalk image
Watch Mark Cline draw the data map >
*Estimates are based on national data and population projections. they assume a steady but conservative reduction in cases of undiagnosed diabetes, due to heightened awareness of the risks, earlier screening and intervention, and more effective therapies. for details on data, sources, and methodology go to research funding supported by Novo Nordisk.
Novo Nordisk is exploring the potential impact of diabetes over the next 15 years.
"Picture This: Diabetes" forums bring together experts and policy makers in Seattle and Philadelphia
The news and entertainment media are increasingly influential in building awareness of important public health issues. With that in mind, in 2010 Novo Nordisk joined with the nonprofit Entertainment Industries Council (EIC) and top-rated broadcast stations in Seattle and Philadelphia to create the "Picture This: Diabetes" forums. These forums brought together local media and diabetes experts to discuss ways to improve media coverage of issues relating to diabetes.
Actor James Avery speaks at a "Picture This: Diabetes" forum in Seattle
Participants worked to identify communication challenges and explore strategies to strengthen understanding about diabetes through news media and community affairs programs. Speakers included local reporters, policy makers, and celebrities living with diabetes, such as James Avery from the hit television show The Fresh Prince of Bel-Air.
Collaboration with the EIC will continue in 2011, with additional
"Picture This: Diabetes" forums and further community engagement.
Learn more through WPVI-TV (Philadelphia) and KING-5-TV (Seattle).
Visit to learn more about Novo Nordisk's commitment to diabetes care >
Learn more about United States' Diabetes Crisis: Today and Future Trends
Read the press release from Novo Nordisk >
Review the data at the Institute for Alternative Futures website >
What you can do: fight the numbers in your practice
The CDC estimates that 35% of US adults may have elevated blood glucose levels—"prediabetes"—and that about 1 in 4 patients with diagnosable diabetes remain undiagnosed.1 Many of these patients may be asymptomatic, but clinical research has shown that even subthreshold hyperglycemia can cause significant tissue damage (eg, retinopathy) in the years before diagnosis.6-8 The American Diabetes Association (ADA) recommends considering testing for diabetes (A1C, fasting glucose, or 2–hour oral glucose tolerance test) at the age of 45 and in patients who are overweight (BMI ≥25 kg/m2) and have even one additional risk factor, such as physical inactivity, higher-risk ethnicity, or a first-degree relative with diabetes.7 For seniors, Medicare covers diabetes screening, but claims data suggest that this service is underutilized.9

Questioning your patients about their dietary habits and physical activity may help recognize personal or cultural factors (attitudes, beliefs, and practices) that can influence their risk. And connecting them with community-based support groups, such as the YMCA's Diabetes Prevention Program, can help them stay on track with their diet and exercise goals. It's worth the effort; a substantial body of research has shown that lifestyle-based interventions alone can dramatically reduce the risk of progression to frank diabetes.10-19
Review ADA recommendations on diabetes screening
and diagnosis >
This e-mail is just one of the many resources available to registered members of NovoMedLink™.
To find even more relevant information for you and your practice, visit 
Novo Nordisk Disclaimer
These materials are provided "as is" and without warranties of any kind either express or implied. To the fullest extent permissible, pursuant to applicable law, we disclaim all warranties, express or implied, including, but not limited to, implied warranties of merchantability and fitness for a particular purpose. We do not warrant that the functions contained on any Novo Nordisk Inc. site will be uninterrupted or error-free, that defects will be corrected, or that any Novo Nordisk Inc. site or the servers that make such materials available are free of viruses or other harmful components. We do not warrant or make any representations regarding the use or the results of the use of the materials on any Novo Nordisk Inc. site in terms of their correctness.
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US Centers for Disease Control and Prevention. National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States, 2011. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2011.
Dall TM, Zhang Y, Chen YS, et al. The economic burden of diabetes. Health Affairs. 2010;29(2):297-303.
Institute for Alternative Futures.Diabetes 2025. 2011.
Boyle JP, Thompson TJ, Gregg EW, Barker LE, Williamson DF. Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Popul Health Metr. 2010;8:29.
US Department of Health and Human Services. Fiscal Year 2010 Budget in Brief. May 7, 2009.
UKPDS Group. UK Prospective Diabetes Study 6: complications in newly diagnosed type 2 diabetic patients and their association with different clinical and biochemical risk factors. Diabetes Res. 1990;13(1):1-11.
American Diabetes Association. Standards of medical care in diabetes—2011. Diabetes Care.
2011;34(suppl 1):S11-S61.
Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care. 1992;15(7):815-819.
Centers for Medicare and Medicaid Services. Medicare Claims Data.
Tuomilehto H, Peltonen M, Partinen M, et al; Finnish Diabetes Prevention Study Group. Sleep duration, lifestyle intervention, and incidence of type 2 diabetes in impaired glucose tolerance: The Finnish Diabetes Prevention Study. Diabetes Care. 2009;32(11):1965-1971.
Lindström J, Eriksson JG, Valle TT, et al. Prevention of diabetes mellitus in subjects with impaired glucose tolerance in the Finnish Diabetes Prevention Study: results from a randomized clinical trial. J Am Soc Nephrol. 2003;14(7 suppl 2):S108-S113.
Lindström J, Louheranta A, Mannelin M, et al; Finnish Diabetes Prevention Study Group. The Finnish Diabetes Prevention Study (DPS): lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003;26(12):3230-3236.
Lindström J, Absetz P, Hemiö K, Peltomäki P, Peltonen M. Reducing the risk of type 2 diabetes with nutrition and physical activity—efficacy and implementation of lifestyle interventions in Finland. Public Health Nutr. 2010;13(6A):
Tuomilehto J. Nonpharmacologic therapy and exercise in the prevention of type 2 diabetes. Diabetes Care. 2009;32(suppl 2):S189-S193.
Kosaka K, Noda M, Kuzuya T. Prevention of type 2 diabetes by lifestyle intervention: a Japanese trial in IGT males. Diabetes Res Clin Pract. 2005;67(2):152-162.
Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V; Indian Diabetes Prevention Programme (IDPP). The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006;49(2):289-297.
Li G, Zhang P, Wang J, et al. The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. Lancet. 2008;371(9626):1783-1789.
Chiasson JL. Prevention of type 2 diabetes: fact or fiction? Expert Opin Pharmacother. 2007;8(18):3147-3158.
Knowler WC, Barrett-Connor E, Fowler SE, et al; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
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144102     April  2011