Ten States to Bear Brunt of Diabetes Burden


New Study Shows Ten States to Carry More Than Half of U.S. Diabetes Population and Costs Through 2025

WASHINGTON, D.C. (March 17, 2011)A new study conducted by the Institute for Alternative Futures (IAF) identified California, Texas, Florida, New York, Ohio, Illinois, Georgia, Pennsylvania, North Carolina and Michigan as “diabetes hot spots,” where the burden of diabetes will be greatest in the next 15 years.  “United States’ Diabetes Crisis: Today and Future Trends,” is the first study to provide detailed diabetes prevalence and cost forecasts individually for all 50 states. The study was commissioned and funded by Novo Nordisk to provide insights into how the growing diabetes epidemic will spread geographically in the United States and how this demographic shift might affect local economies.


The IAF diabetes model estimates that the overall number of people in the United States living with diabetes will increase 64 percent by 2025 from 32.3 million today to 53.1 million.[i] This equates to 1 in 7 Americans.  The resulting medical and societal cost of diabetes will be almost $514 billion – a 72 percent increase from 20101 and comparable to the total budget for Medicare in 2010.[ii] Currently, the ten states identified as diabetes hot spots shoulder nearly 60 percent of the cost from diabetes, or approximately $176 billion1 of the total $299 billion.1 In fifteen years, the cost of diabetes to these ten states is projected to jump to $297 billion,1 or nearly the cost of diabetes to the entire United States today. The breakdown of Americans with diabetes in 2025 within the ten diabetes hot spots and the cost to each state are predicted to be as follows:

1.    California: Projected cost of $63.63 billion,6.6 million people with diabetes1

2.    Texas: Projected cost of $52.17 billion, 5.5 million people with diabetes1

3.    Florida: Projected cost of $40.43 billion, 4.2 million people with diabetes1

4.    New York: Projected cost of $28.38 billion, 2.9 million people with diabetes1

5.    Ohio: Projected cost of $19.76 billion, 2.1 million people with diabetes1

6.    Illinois: Projected cost of $19.67 billion, 2 million people with diabetes1

7.    Georgia: Projected cost of $19.54 billion, 2 million people with diabetes1

8.    Pennsylvania: Projected cost of $18.37 billion, 1.9 million people with diabetes1

9.    North Carolina: Projected cost of $17.91 billion, 1.9 million people with diabetes1

10. Michigan: Projected cost of $15.85 billion, 1.6 million people with diabetes1

For an interactive map illustrating the state by state findings of the study, please go to: www.altfutures.org/diabetes2025.

Study projections indicate that these ten diabetes hot spot states will carry half the population burden of diabetes in the United States, with more than 50 percent of Americans with diabetes living in these areas.1

“This research maps the alarming demographic realities of diabetes through 2025 if we don’t make fundamental changes, particularly in our lifestyles and health system,” said William Robert Rowley, M.D., Senior Fellow at the Institute for Alternative Futures and lead author of the study.  “The burden of diabetes will not fall equally. To change this tragic trajectory, it is imperative that public and private agencies work together on national, as well as state and local levels.”

The study includes state specific data on minority populations and seniors, providing a focus on vulnerable communities often affected disproportionately by diabetes. Nearly one quarter of senior citizens living in the United States in 2010, or approximately 10.8 million,1 have diabetes. Of these, 7.9 million had diagnosed diabetes and another 2.9 million had diabetes that had not been yet diagnosed.1 Medicare currently covers diabetes screening, but the utilization rate is low.[iii] In 2010, approximately 15.9 million (39 percent) African-Americans and 17.7 million (36 percent) Hispanic-Americans have either diabetes or pre-diabetes.1

“There are very few sources projecting the future burden of diabetes at the state and metropolitan level,” said Mike Mawby, Chief Government Affairs Officer at Novo Nordisk. “By sponsoring projections and cost studies that drill down locally, our goal is to provide hard evidence that can spur action to address the need for better preventative and management programs across the country.”

Novo Nordisk is working with a variety of public and private partners to help change the current course of the diabetes epidemic, in particular through initiatives that focus on targeted screening of people with known risk factors for diabetes and prevention programs that promote positive lifestyle changes.  This is urgently needed to help reduce the future burden of diabetes in the United States.


“It is clear that diabetes is a growing threat to the public’s health. The projections in this study provide another compelling case for the need to aggressively prevent the spread of diabetes,” said Jonathan Lever, Vice President for Health Strategy and Innovation at YMCA of the USA. “The good news is that there are programs that can help prevent the frightening future presented in this report, such as the YMCA’s Diabetes Prevention Program, a group-based program that supports people in their struggle to eat healthier and get more physical activity.  We all have to do more to get people into these programs and help them stay healthy.”


The YMCA’s Diabetes Prevention Program is designed especially for people at high risk of developing type 2 diabetes and is based on the landmark Diabetes Prevention Program funded by the National Institutes of Health and the Centers for Disease Control and Prevention.



About the Study

This study is based on available national diabetes data, including the recent CDC projections to 2050, and population projections. It assumes a steady, but conservative, reduction in the number of people with complications due to better awareness of the risks of diabetes, earlier screening and intervention, and more effective therapies. For details on study methodology and data sources, go to www.altfutures.org/diabetes2025.

[i] Diabetes Data & Forecasts. 2025 Diabetes Forecasts for State and Metropolitan Areas Study by the Institute for Alternative Futures. This study utilizes: a national model from Narayan. Impact of Recent Increase in Incidence on Future Diabetes Burden. Diabetes Care 2006, 29:2114-2116; the latest CDC projections by Boyle; US Census Bureau population estimates; and latest CDC national diabetes statistics and state prevalence rates. www.altfutures.org/diabetes2025

[ii] U.S. Department of Health and Human Services, Fiscal Year Budget in Brief. http://dhhs.gov/asfr/ob/docbudget/2010budgetinbriefl.html. Website accessed January 14, 2011

[iii] Centers for Medicare and Medicaid Services website. “Medicare Claims Data.” http://www.cms.gov/PrevntionGenInfo/20_prevserv.asp Website accessed February 4, 2011

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Bernard Farrell
11 years ago

I blogged about this Diabetes 2025 report last night. These estimates certainly look bad, but all of us could benefit from better nutritional and exercise choices. Whether we have any type of diabetes or not. I think it’s important to emphasize that this is not a guaranteed future and we can positively improve things.

11 years ago

clearly these states are burdened, but these are also the most populous states, so I would expect them to have the most number of people with diabetes. But, it is clear once you look at percentages of the state population, some other states are going to be far more overburdened because they are not only relatively poor states, but also unhealthy states- Alabama, Mississippi, West Virginia, Louisiana. How much MORE will these states have to deal with diabetes, and be less well equiped to do so? These are also the states with highest obesity rates. What do we do to… Read more »

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