North Carolina Diabetes Prevention and Control Branch: Small Steps. Big Rewards

Fact & Figures

Diabetes: Surveillance and Epidemiology

Implementation and evaluation of diabetes prevention and control programs depends on reliable data. The following data sources are used to find out how many people in North Carolina are estimated to have diabetes and the groups most affected by the disease. This data assist in focusing prevention efforts on high-risk populations.

The Diabetes prevention and Control Branch develops epidemiological reports on diabetes incidence, prevalence, morbidity, and mortality in North Carolina. The data utilized in these reports are from the North Carolina Behavioral Risk Factor Surveillance System (BRFSS), which conducts annual statewide telephone surveys.  The estimation of diabetes burden in North Carolina is based on responses to BRFSS questions regarding the disease and its risk factors. Data from these and other sources are collected and analyzed in the burden report below:

The Burden of Diabetes in North Carolina: Prevalence, Complications and Costs 2008 pdf

A 50-page report highlighting prevalence and risk factor data from the North Carolina BRFSS, mortality data, complications-specific data, prevention of complications, diabetes cost and diabetes among children in the state. The Diabetes Program updates this report periodically as data collection occurs and data is verified for publication.

The North Carolina Diabetes Fact Sheets offers at-a-glance diabetes prevalence, risk factors, preventive care and mortality statistics:

County-level Powerpoint presentations may be found here: Diabetes county-level stastical presentations

Impact of Diabetes

  • Diabetes is a disease in which the body does not produce or properly use insulin (insulin resistance). Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity (particularly central adiposity - apple shape) and lack of physical activity appear to play roles.
  • There are three main forms of diabetes.
  • Type 1 Diabetes, also known as juvenile-onset diabetes, is a chronic condition in which the pancreas produces little or no insulin. People with type 1 diabetes must 1inject insulin every day to live.  It generally develops in children and young people under the age of 30. The highest prevalence of type 1 diabetes is seen mainly in non-Hispanic white people. Type 1 diabetes comprises about five to ten percent of all diabetes cases.
  • Type 2 diabetes, also known as adult-onset diabetes, generally occurs after the age of 30; now increasingly seen among youth and young adults. The major modifiable risk factors for type 2 diabetes are obesity, physical inactivity and lack of healthy diet. The highest prevalence of type 2 diabetes is among ethnic minority people like African Americans, Native Americans and people of Hispanic origin. Type 2 diabetes is controlled with diet, exercise, and pills that reduce blood-sugar levels. Type 2 diabetes accounts for majority of diabetes cases, from 90 to 95 percent. 
  • Gestational Diabetes (GD) occurs in some pregnant women who never had diabetes before but experience high glucose levels during pregnancy. Although gestational diabetes goes away after the baby is born, 50 to 60 percent of women develop type 2 diabetes in next five to ten years. Highest gestational diabetes prevalence is seen among ethnic minority women. The risk factors to gestational diabetes are similar to type 2 diabetes; obesity, family history of diabetes and age. Gestational diabetes affects four to nine percent of all pregnant women.
  • Complications: Heart attack and stroke are the number one killers of people with diabetes. Diabetes is the leading cause of blindness and kidney failure. People with diabetes are at increased risk for amputations, depression, nerve damage and periodontal disease.
  • The good news is that landmark studies in 1993 (Diabetes Control and Complications - DCCT - Trial in the US for type 1) and 1998 (United Kingdom Prospective Diabetes Study -UKPDS for newly diagnosed type 2) showed that, if we can decrease the average blood sugar level (A1c - a simple blood test) even by one percent, we can reduce the risk of the devastating complications including blindness, kidney disease, and amputations.
  • Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes (between 111 and 125mg/dl).  Fifty-seven million Americans have pre-diabetes. A landmark study in the US demonstrated that minimal weight loss (five to ten percent) through physical activity, good nutrition and self-management education, can reduce the risk of developing type 2 diabetes by 58 percent for those with pre-diabetes (Diabetes Prevention Program, 2002).
  • Diabetes is on the rise in the U.S. in 2009. 11.3 percent of U.S. adults or 22 million people had diabetes in the U.S. (Source: ADA). 
  • In North Carolina, 643,000 adults had diagnosed diabetes and another 376,000 adults have pre-diabetes. It is more prevalent in ethnic minorities where they live in the Northeastern and Southeastern portions of the state. In the state, the highest prevalence is seen in African Americans at 15.6 percent. One in every five adults, age 65 and older, had diabetes in the state. Adults with less than high school education and with household incomes less than $15,000 had higher rates of diabetes in the state.
  • In 2008, North Carolina ranked 17th highest for adults diabetes prevalence in the nation. The national average was 8.3 percent, and the prevalence in North Carolina was 9.3 percent.
  • Children: In North Carolina, we have also seen alarming new trends among children who are developing type 2. The causes for these increasing diabetes trends are increasing obesity and sedentary lifestyles. The CDC estimates that for children born in 2000, one in three will develop type 2 diabetes in their lifetime.
  • In North Carolina, Diabetes is the seventh leading cause of death. It is the fourth leading cause of death among African Americans and fifth among Native Americans.
  • In 2006, the total direct and indirect costs were $5.3 billion in North Carolina, which translates into 3.6 billion dollars in direct medical costs and 1.7 billion in indirect costs such as disability, work loss and premature mortality.
  • North Carolina supports a strong Diabetes Advisory Council and strategic plan to address these issues through community, health systems and policy initiatives.