Trends in the Prevalence of Prediabetes Over Time: Differentials by Socioeconomic Status, Age, Period and Cohort
Type 2 diabetes is at epidemic levels in the U.S., with 30.3 million Americans affected and 1-in-3 projected to become diabetic by 2050 (1,2,3). Prediabetes is a modifiable risk factor this disease, but despite its higher prevalence and significance as a diabetes risk factor (4,5), relatively little is known about this condition. This study evaluated the condition's risk factors; the presence of age, period, and cohort effects on historical prediabetes prevalence; and produced special prediabetes projections in an effort to further knowledge about prediabetes and inform diabetes intervention strategies. Key findings: 1) identified educational attainment and household income as risk factors of prediabetes prevalence; 2) supported age, period, and cohort effects in prediabetes prevalence from 1976-1980 through 2013-2014; and 3) projected increasing prediabetes prevalence through 2060. Together, these findings underscored the importance of access to health-promotive resources and environmental conditions for health maintenance and disease avoidance. Vulnerable populations, such as older adults and race/ethnic minorities, historically have less access to these resources and bear a disproportionate burden of poor health outcomes (6,7,8). These groups drive projected prediabetes burden (and diabetes burden) through 2060, suggesting a major future burden on the national healthcare system to the individuals, families, and communities making up these vulnerable groups. The author proposes that diabetes intervention efforts must work in conjunction with policy in other areas of well-being to improve access to resources, environmental conditions, and therefore health outcomes nationally and among those groups projected to drive future disease burden.
Keywords: prediabetes, prevalence, socioeconomic status, cohort, projections.