Trends and Inequalities in Diabetes-Related Complications Among U.S. Adults, 2000–2020 #ActAgainstAmputation

In the recent study published by Saelee et al. (2024), titled “Trends and Inequalities in Diabetes-Related Complications Among U.S. Adults, 2000–2020,” significant insights are provided into the evolving landscape of diabetes complications over the past two decades. This comprehensive study, published in Diabetes Care, examines the trends in various diabetes-related complications, such as heart failure (HF), myocardial infarction (MI), stroke, end-stage renal disease (ESRD), nontraumatic lower-extremity amputations (NLEA), and hyperglycemic crisis, while highlighting the disparities based on age, sex, and race/ethnicity.

Key Findings:

1. Increasing Complications: After initial declines, the past decade has seen an increase in hospitalizations for heart failure, stroke, and nontraumatic lower-extremity amputations. ESRD incidence has also risen, while hyperglycemic crisis rates have steadily increased since 2000.
2. Persistent Disparities: The study underscores the worsening age, sex, and racial/ethnic inequalities for several complications. Notably, younger adults (18–44 and 45–64 years) and non-Hispanic Black adults are experiencing higher rates of these complications.
3. Sex Inequalities: The data shows increasing hospitalizations for stroke and NLEA among males, contributing to growing sex inequalities.
4. Age Inequalities: While age inequalities have decreased for some complications like heart failure, MI, and stroke due to rising rates among younger age groups, they have increased for hyperglycemic crises.
5. Racial and Ethnic Inequalities: Racial disparities are particularly evident in heart failure and hyperglycemic crisis rates, with non-Hispanic Black adults experiencing significantly higher rates than their Hispanic and non-Hispanic White counterparts.

Implications for Prevention and Policy:

These findings highlight the critical need for targeted secondary prevention efforts. The increase in diabetes-related complications among younger adults and specific racial/ethnic groups indicates a need for tailored interventions that address these disparities. Policymakers and healthcare providers must prioritize these vulnerable populations to mitigate the rising burden of diabetes complications.

The full manuscript provides an in-depth analysis and is available for further reading: Saelee et al., 2024.

Citation:
Saelee R, Bullard KM, Hora IA, Pavkov ME, Pasquel FJ, Holliday CS, Benoit SR. Trends and Inequalities in Diabetes-Related Complications Among U.S. Adults, 2000–2020. Diabetes Care. 2024;47(00):1–11. https://doi.org/10.2337/dci24-0022.