Diabetes rates appear finally to be falling in the United States, according to the latest official figures. That will come as a big relief to health experts after an exponential climb in the numbers from 1991 to the peak in 2009, from 573,000 new cases a year to 1.7 million, taking a huge toll in devastating health consequences including amputations and blindness as well as early death.
According to the Centers for Disease Control and Prevention (CDC), the steady downward curve on the graph since then is not just a blip. The latest figure for new diagnoses in 2014 is 1.4 million and health professionals will be hoping that trend continues.
In one way, the good news is not so surprising, because type 2 diabetes, which accounts for 90% to 95% of the cases, is linked mostly to obesity – and the obesity figures have also slowed. Obesity prevalence remained stable between 2003-04 and 2009-10, according to more data from the CDC, published in the Journal of the American Medical Association, and childhood obesity appears to be dropping.
The good news is that the US diet is improving, according to the Harvard School of Public Health. A lot of that is down to consumers choosing to avoid trans fats, but there has also been an increase in the amount of fruit, vegetables and nuts that Americans eat. So some of the health messages and the alarm bells over sugar have probably had an effect.
But that same Harvard study said the quality of the American diet remains poor, and a closer look at both the diabetes and the obesity figures reveals that it is only some of the population who are getting healthier. Diabetes affects Hispanic and black American populations considerably more than white Americans. Obesity is greatest in the most disadvantaged communities. The danger is that in celebrating progress, we will be celebrating only the progress of the better-off.
There are now 22 million people living with diabetes in the US, who need care and treatment and lifestyle advice if they are to stay well. Diabetes care is hugely expensive – the International Diabetes Federation says the US was responsible for most of the $348bn spent in the North American and Caribbean regions on caring for people with the condition in 2015, even though countries like Mexico and Belize have a very heavy burden too.
The rest of the world, struggling with rising rates of diabetes and rising healthcare costs as well, will be hoping the US trend is permanent and that it will be replicated elsewhere. The US led the rise in rates and maybe it will lead a universal downturn. But not yet. In the UK, diagnoses have gone up 65% in a decade and are still rising, costing the NHS 9% of its budget. Rates have doubled in Canada from 1.2 million in 2000 to 2.4 million in 2010 and have yet to show signs of any decline.
