Twenty-Year Secular Trend of Diabetes Comorbidities in the United States, 1997-2016

Abstract

Diabetes affected over 30 million U.S. adults in 2015, and its comorbidities remained among the leading causes of premature death and reduced quality of life. However, little is known about the secular trend of diabetes comorbidities in the last 20 years. Sample-weighted prevalence of twelve common comorbidities of diabetes was estimated using data from 52,842 adults aged ≥18 years who had diabetes in the National Health Interview Survey from 1997 through 2016, with age-standardized to the 2000 U.S. population. We ranked the prevalence [% (SE)] of twelve diabetes comorbidities, and the top five were hypertension [53.7(3.1)], arthritis [33.2(3.1)], asthma [17.2(2.9)], coronary heart disease [CHD: 14.4(2.3)]), and chronic obstructive pulmonary disease [COPD: 9.1(2.3)]. From 1997 to 2016, the estimated prevalence (%) of diabetes comorbidities including hypertension (47.8 to 59.7), asthma (13.2 to 21.0), cancer (7.6 to 10.4), and liver cirrhosis (3.0 to 4.1) continuingly increased (P<0.05), while CHD (15.4 to 13.4), COPD (10.1 to 8.0), and hepatitis (5.5 to 2.9) declined (P<0.05). Such trends were similar among subgroups stratified by gender or by race. In the past two decades, along with continuing increase of diabetes, the rates of its comorbidities including hypertension, asthma, cancer, and liver cirrhosis showed increasing trends, whereas the rates of CHD, COPD, and hepatitis exhibited decreasing trends in the U.S. adults. Disclosure D. Sun: None. T. Zhou: None. X. Li: None. Y. Heianza: None. X. Shang: None. V. Fonseca: Consultant; Self; Abbott. Board Member; Self; American Association of Clinical Endocrinologists. Consultant; Self; Eli Lilly and Company. Stock/Shareholder; Self; Amgen Inc.. Consultant; Self; Asahi Kasei Corporation, AstraZeneca, Novo Nordisk Inc., ADOCIA, Intarcia Therapeutics, Inc., Sanofi-Aventis. L. Qi: None.

Association between type 2 diabetes and long-term outcomes in middle-aged and older trauma patients

“…Comorbidities commonly associated with T2D include obesity, hypertension, depression, arthritis, asthma, coronary heart disease, and chronic obstructive pulmonary disease. 10,11 Adverse hospital outcomes may also be associated with an increased risk of complications secondary to poor hyperglycemic control. Poor hyperglycemic control has previously been associated with adverse outcomes in trauma patients, including increased mortality, greater hospital length of stay, increased risk of ICU admission, and increased risk of complications.…”

“…These findings may be associated with the higher level of comorbidity among trauma patients with diabetes. Comorbidities commonly associated with T2D include obesity, hypertension, depression, arthritis, asthma, coronary heart disease, and chronic obstructive pulmonary disease 10,11 . Adverse hospital outcomes may also be associated with an increased risk of complications secondary to poor hyperglycemic control.…”

“…8,9 In addition, there has been an increase in comorbidities closely associated with T2D, including obesity, cardiovascular disease, and osteoarthritis. 10,11 Diabetes and these associated conditions are also expected to increase in trauma patients in coming years, potentially impacting on trauma recovery in the short and long terms. 8,12,13 Previous research has investigated the impact of diabetes (both type 1 diabetes [T1D] and T2D) on trauma patients during their hospital admission.…”

“…Obesogenic environments, urbanization, and the aging population have led to an increased prevalence of T2D in Australia and worldwide 8,9 . In addition, there has been an increase in comorbidities closely associated with T2D, including obesity, cardiovascular disease, and osteoarthritis 10,11 . Diabetes and these associated conditions are also expected to increase in trauma patients in coming years, potentially impacting on trauma recovery in the short and long terms 8,12,13 …”