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Diabetes, Pre-diabetes and DSMES Program

More than 30 million Americans have diabetes. Another 84 million US adults have prediabetes, a serious health condition in which blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. A person with prediabetes is at high risk of type 2 diabetes, heart disease, and stroke.

Fast Facts: More than 30 million people in the United States have diabetes, and 1 in 4 of them don’t know they have it.

Diabetes also increases the risk of heart disease and stroke and can lead to other serious complications, such as kidney failure, blindness, and amputation of a toe, foot, or leg. People with diabetes spend more on health care, have fewer productive years, and miss more workdays compared to people who don’t have diabetes. In 2017, the total estimated cost of diagnosed diabetes was $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity.

Fast Facts: More than 84 million US adults—1 in 3—have prediabetes, and 90% of them don’t know they have it.

Some people are at higher risk of type 2 diabetes because they:

  • Are overweight or have obesity.
  • Are age 45 or older.
  • Have a parent, brother, or sister with type 2 diabetes.
  • Are physically active less than 3 times a week.
  • Had gestational diabetes (diabetes during pregnancy) or gave birth to a baby who weighed more than 9 pounds.
  • Are African American, Hispanic or Latino, American Indian, Alaska Native, Pacific Islander, or Asian American.

Some risk factors for type 2 diabetes can’t be modified, such as age and family history, but some can, such as having prediabetes, being overweight, eating unhealthy food, being inactive, and smoking. Working on these risk factors can prevent or delay developing type 2 diabetes and improve their overall health. This will also lead to improving the quality of life of all people with diabetes. Central to those efforts are helping them prevent or reduce the severity of diabetes complications, including heart disease (the leading cause of early death among people with diabetes), kidney disease, blindness, and nerve damage that can lead to lower-limb amputations.

Fast Facts: Prediabetes is a risk factor for type 2 diabetes. Being overweight, being age 45 or older, and being physically active less than 3 times a week are risk factors for prediabetes and type 2 diabetes.

Diabetes self-management education and support (DSMES) programs help people meet the challenges of self-care by providing them with the knowledge and skills to deal with daily diabetes management: eating healthy food, being active, checking their blood sugar, and managing stress. These programs have been shown to reduce A1C levels (average blood sugar over the last 2 to 3 months), reduce the onset and severity of diabetes complications, improve quality of life, and lower health care costs.

Fast Facts: In 2017, the total estimated cost of diagnosed diabetes was $327 billion.

Diabetes is about 17% more prevalent in rural areas than urban ones, but 62% of rural counties do not have a DSMES program. The use of telehealth (delivery of the program by phone, Internet, or videoconference) may allow more patients in rural areas to benefit from DSMES and the National DPP lifestyle change program.


Diabetes and Prediabetes


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