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2004 National Healthcare Quality Report

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Effectiveness: Diabetes

Importance and Measures

There are three forms of diabetes. All forms of diabetes are characterized by elevated blood glucose, which can cause a number of complications over time if not controlled1.

Prevalence and Incidence

  • In 2003, the number of adults with diagnosed diabetes was 13 million. With the addition of 5.2 million undiagnosed cases, the total prevalence of diabetes was 6.3%.
  • According to the Centers for Disease Control and Prevention (CDC), in 2002 the number of new cases of diabetes in adults was 1.3 million.
  • The number of cases of diagnosed diabetes is projected to increase 165% between 2000 and 2050, from 12 million to 39 million2.

Morbidity and Mortality

  • Diabetes is the leading cause of blindness, nontraumatic lower extremity amputation, and end stage renal disease and increases the risk of complications with pregnancy.
  • Diabetes was the sixth leading cause of death in the United States in 20013.
  • People with diabetes are generally at twice the risk of death and are two to four times more likely to die from heart disease or stroke than those without diabetes1.


  • In 2002, costs of diabetes totaled $132 billion, including about $92 billion in direct medical expenditures and about $40 billion in lost productivity and premature death4.


The NHQR diabetes measures include five recommended diabetes interventions and measures of associated outcomes (such as cholesterol and blood pressure levels and diabetes-related complications and hospital admissions). Measures highlighted in this section include:

  • Receipt of recommended interventions for diabetes management
  • State variation in HbA1c testing
  • Hospital admission rates for long-term diabetes complications (renal, eye, neurological, circulatory, or complications not otherwise specified, excluding pregnancy-related diabetes)


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AHRQ Advancing Excellence in Health Care