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Diabetes in America, 3rd Edition

(December 2,016)

Cover of Diabetes in America 3rd Edition

Diabetes in America, 3rd Edition, is a compilation and assessment of epidemiologic, public health, clinical, and clinical trial data ​on diabetes and its complications in the United States. It is being published by the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, during 2016–2017. The intended audience is the wide range of individuals in the research community, clinicians, health policy makers, and individuals with diabetes, as well as their caregivers and family members.

Diabetes in America, 3rd Edition, contains 42 chapters organized into three areas:

  • Section I: Spectrum of Diabetes: Descriptive epidemiology of diabetes in the United States based on national surveys and community-based studies, including prevalence and incidence; sociodemographic, metabolic, and lifestyle characteristics; genetics and risk factors for developing diabetes; and unique aspects of diabetes in younger and older populations, and in pregnant women (chapters 1–16)
  • Section II: Complications of Diabetes and Related Conditions: The myriad complications that affect patients with diabetes, including mortality (chapters 17–36)
  • Section III: Prevention and Medical Care for Diabetes: Clinical trials and studies to prevent diabetes; medication use and self-care practices, health care utilization, and quality of care; and economic aspects including health insurance and health care costs (chapters 37–42)

This page includes:

A previous report, Diabetes i​n America, 2nd Edition, is also available.


The report is available:

  • electronically using the PDF(s) linked below. Documents in PDF format require the free Adobe Acrobat Reader application for viewing.


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PDF iconCover (PDF, 0.29 MB)

PDF iconSteering Committee (PDF, 0.46 MB)​

PDF iconEditorial Board (PDF, 0.47 MB)

PDF iconAuthors (PDF, 0.13 MB)

PDF iconExternal Reviewers (PDF, 0.07 MB)

PDF iconFull List of Diabetes in America, 3rd Edition, Chapters (PDF, 0.47 MB)

Section I: Spectrum of Diabetes

PDF iconChapter 1: Classification and Diagnosis of Diabetes (PDF, 1.20 MB)
Saul M. Genuth, MD, Jerry P. Palmer, MD, and David M. Nathan, MD
zip folder iconFigures (ZIP, 1.89 MB)
PDF iconChapter 2: Prevalence and Incidence of Type 1 Diabetes Among Children and Adults in the United States and Comparison With Non-U.S. Countries (PDF, 1.35 MB)
Giuseppina Imperatore, MD, PhD, Elizabeth J. Mayer-Davis, PhD, Trevor J. Orchard, MD, and Victor W. Zhong, PhD
zip folder iconFigures (ZIP, 0.65 MB)
PDF iconChapter 4: Gestational Diabetes (PDF, 0.79 MB)
Boyd E. Metzger, MD, and Thomas A. Buchanan, MD
zip folder iconFigures (ZIP, 0.16 MB)
PDF iconChapter 6: Other Specific Types of Diabetes (PDF, 0.65 MB)
Gregory P. Forlenza, MD, Antoinette Moran, MD, and Brandon Nathan, MD
zip folder iconFigures (ZIP, 0.46 MB)
PDF iconChapter 7: Monogenic Forms of Diabetes (PDF, 2.56 MB)
Mark A. Sperling, MD, and Abhimanyu Garg, MD
zip folder iconFigures (ZIP, 7.96 MB)
PDF iconChapter 8: Sociodemographic Characteristics of Persons With Diabetes (PDF, 6.70 MB)
Mark S. Eberhardt, PhD, Sarah Stark Casagrande, PhD, and Catherine C. Cowie, PhD, MPH
zip folder iconFigures (ZIP, 2.00 MB)
PDF iconChapter 9: Physical and Metabolic Characteristics of Persons With Diabetes and Prediabetes (PDF, 1.63 MB)
Andy Menke, PhD, William C. Knowler, MD, DrPH, and Catherine C. Cowie, PhD, MPH
zip folder iconFigures (ZIP, 4.20 MB)
PDF iconChapter 10: Lifestyle Characteristics Among People With Diabetes and Prediabetes (PDF, 3.05 MB)
Rachel P. Ogilvie, MPH, Azadeh Zabetian, MD, Ali H. Mokdad, PhD, and K.M. Venkat Narayan, MD, MSc, MBA
zip folder iconFigures (ZIP, 0.76 MB)
PDF iconChapter 11: Risk Factors for Type 1 Diabetes (PDF, 2.01 MB)
Marian Rewers, MD, PhD, Lars C. Stene, PhD, and Jill M. Norris, MPH, PhD
zip folder iconFigures (ZIP, 0.75 MB)
PDF iconChapter 12: Genetics of Type 1 Diabetes (PDF, 2.26 MB)
Stephen S. Rich, PhD, Henry Erlich, PhD, and Patrick Concannon, PhD
zip folder iconFigures (ZIP, 3.09 MB)
PDF iconChapter 13: Risk Factors for Type 2 Diabetes (PDF, 1.88 MB)
Sylvia H. Ley, PhD, RD, Matthias B. Schulze, DrPH, Marie-France Hivert, MD, MMSc, James B. Meigs, MD, MPH, and Frank B. Hu, MD, PhD
zip folder iconFigures (ZIP, 3.51 MB)
PDF iconChapter 14: Genetics of Type 2 Diabetes (PDF, 1.30 MB)
Jose C. Florez, MD, PhD, Miriam S. Udler, MD, PhD, and Robert L. Hanson, MD, MPH
zip folder iconFigures (ZIP, 1.93 MB)
PDF iconChapter 15: Diabetes in Youth (PDF, 2.05 MB)
Dana Dabelea, MD, PhD, Richard F. Hamman, MD, DrPH, and William C. Knowler, MD, DrPH
zip folder iconFigures (ZIP, 0.85 MB)
PDF iconChapter 16: Diabetes in Older Adults (PDF, 2.82 MB)
Neda Laiteerapong, MD, MS, and Elbert S. Huang, MD, MPH, FACP
zip folder iconFigures (ZIP, 0.79 MB)

Section II: Complications of Diabetes and Related Conditions

PDF iconChapter 17: Acute Metabolic Complications in Diabetes (PDF, 1.97 MB)
Arleta Rewers, MD, PhD
zip folder iconFigures (ZIP, 0.33 MB)
PDF iconChapter 18: Heart Disease and Diabetes (PDF, 1.10 MB)
Elizabeth Barrett-Connor, MD, Deborah Wingard, PhD, Nathan Wong, PhD, and Ron Goldberg, MD
zip folder iconFigures (ZIP, 0.60 MB)
PDF iconChapter 19: Stroke and Diabetes (PDF, 0.49 MB)
Aleksandra Pikula, MD, Barbara V. Howard, PhD, and Sudha Seshadri, MD
zip folder iconFigures (ZIP, 1.82 MB)
PDF iconChapter 20: Peripheral Arterial Disease, Foot Ulcers, Lower Extremity Amputations, and Diabetes (PDF, 3.56 MB)
Edward J. Boyko, MD, MPH, Matilde Monteiro-Soares, DPM, PhD, and Stephanie G.B. Wheeler, MD, MPH
zip folder iconFigures (ZIP, 3.86 MB)
PDF iconChapter 21: Epidemiology of Ocular Functions and Diseases in Persons With Diabetes (PDF, 1.57 MB)
Ronald Klein, MD, MPH, and Barbara E. K. Klein, MD, MPH
zip folder iconFigures (ZIP, 1.65 MB)
PDF iconChapter 22: Kidney Disease in Diabetes (PDF, 7.7 MB)
Meda E. Pavkov, MD, PhD, Allan J. Collins, MD, Josef Coresh, MD, PhD, and Robert G. Nelson, MD, PhD
zip folder iconFigures (ZIP, 10.3 MB)
PDF iconChapter 23: Peripheral and Autonomic Neuropathy in Diabetes (PDF, 0.55 MB)
Rodica Pop-Busui, MD, PhD, Andrew J. M. Boulton, MD, DSc (Hon), FACP, FICP, FRCP, and Jay M. Sosenko, MD
zip folder iconFigures (ZIP, 0.18 MB)
PDF iconChapter 24: Diabetes and Cognitive Impairment (PDF, 2.04 MB)
José A. Luchsinger, MD, MPH, Christopher Ryan, PhD, and Lenore J. Launer, PhD
zip folder iconFigures (ZIP, 1.21 MB)
PDF iconChapter 25: Impact of Sleep and Circadian Disturbances on Glucose Metabolism and Type 2 Diabetes (PDF, 1.00 MB)
Sirimon Reutrakul, MD, CDE, Naresh M. Punjabi, MD, PhD, and Eve Van Cauter, PhD
zip folder iconFigures (ZIP, 0.79 MB)
PDF iconChapter 26: Liver and Gallbladder Disease in Diabetes (PDF, 2.21 MB)
Constance E. Ruhl, MD, PhD, Jeanne M. Clark, MD, MPH, and James E. Everhart, MD, MPH
zip folder iconFigures (ZIP, 0.46 MB)
PDF iconChapter 27: Gastrointestinal Manifestations of Diabetes (PDF, 1.36 MB)
Adil E. Bharucha, MD, G. Richard Locke, MD, and Joseph A. Murray, MD
zip folder iconFigures (ZIP, 0.84 MB)
PDF iconChapter 28: Urologic Diseases and Sexual Dysfunction in Diabetes (PDF, 0.96 MB)
Aruna V. Sarma, PhD, Mary K. Townsend, ScD, Francine Grodstein, ScD, Benjamin N. Breyer, MD, and Jeanette S. Brown, MD
zip folder iconFigures (ZIP, 0.08 MB)
PDF iconChapter 29: Cancer and Diabetes (PDF, 0.56 MB)
Hsin-Chieh Yeh, PhD, Asieh Golozar, MD, PhD, MHS, MPH, and Frederick L. Brancati, MD, MHS
zip folder iconFigures (ZIP, 0.08 MB)
PDF iconChapter 30: Infections Associated With Diabetes (PDF, 1.74 MB)
Leonard E. Egede, MD, MS, Beatrice J. Hull, MD, and Joni S. Williams, MD, MPH
zip folder iconFigures (ZIP, 3.76 MB)
PDF iconChapter 32: Bone and Joint Complications in Diabetes (PDF, 1.74 MB)
Ann V. Schwartz, PhD, and Nancy E. Lane, MD
zip folder iconFigures (ZIP, 1.30 MB)
PDF iconChapter 33: Psychiatric and Psychosocial Issues Among Individuals Living With Diabetes (PDF, 0.82 MB)
Jeffrey S. Gonzalez, PhD, Korey K. Hood, PhD, Sabrina A. Esbitt, PhD, Shamik Mukherji, MD, Naomi S. Kane, MA, and Alan Jacobson, MD
zip folder iconFigures (ZIP, 0.23 MB)
PDF iconChapter 34: Diabetes and Disability (PDF, 0.57 MB)
Edward W. Gregg, PhD, and Andy Menke, PhD
zip folder iconFigures (ZIP, 0.69 MB)
PDF iconChapter 35: Mortality in Type 1 Diabetes (PDF, 1.04 MB)
Aaron M. Secrest, MD, PhD, Raynard E. Washington, PhD, and Trevor J. Orchard, MBBCh, MMedSci
zip folder iconFigures (ZIP, 1.21 MB)
PDF iconChapter 36: Mortality Trends in Type 2 Diabetes (PDF, 1.22 MB)
Klara J. Rosenquist, MD, and Caroline S. Fox, MD, MPH
zip folder iconFigures (ZIP, 1.22 MB)

Section III: Prevention and Medical Care for Diabetes

PDF iconChapter 37: Prevention of Type 1 Diabetes (PDF, 1.39 MB)
Jay S. Skyler, MD, MACP, Jeffrey P. Krischer, PhD, Dorothy J. Becker, MD, MBBCh, and Marian Rewers, MD, PhD
zip folder iconFigures (ZIP, 0.20 MB)
PDF iconChapter 39: Medication Use and Self-Care Practices in Persons With Diabetes (PDF, 0.84 MB)
Sharon H. Saydah, PhD
zip folder iconFigures (ZIP, 0.40 MB)
PDF iconChapter 40: Health Care Utilization and Costs of Diabetes (PDF, 3.64 MB)
Laura N. McEwen, PhD, MPH, and William H. Herman, MD, MPH
zip folder iconFigures (ZIP, 7.64 MB)
PDF iconChapter 41: Quality of Care in People With Diabetes (PDF, 1.55 MB)
Elizabeth Selvin, PhD, MPH, FAHA, K. M. Venkat Narayan, MD, MSc, MBA, and Elbert S. Huang, MD, MPH, FACP
zip folder iconFigures (ZIP, 1.37 MB)
PDF iconChapter 42: Health Insurance and Diabetes (PDF, 0.77 MB)
Sarah Stark Casagrande, PhD, and Catherine C. Cowie, PhD, MPH
zip folder iconFigures (ZIP, 1.31 MB)


PDF iconAppendix 1 Conversions (PDF, 0.76 MB)


An index will be developed after all the chapters are posted.

Additional Information

Suggested Citation

[Author(s): Chapter title. Chapter # in] Diabetes in America, 3rd ed. Cowie CC, Casagrande SS, Menke A, Cissell MA, Eberhardt MS, Meigs JB, Gregg EW, Knowler WC, Barrett-Connor E, Becker DJ, Brancati FL, Boyko EJ, Herman WH, Howard BV, Narayan KMV, Rewers M, Fradkin JE, Eds. Bethesda, MD, National Institutes of Health, NIH Pub No. 17-1468, 2017[, p. #.x–#.x]


Diabetes in America is in the public domain of the United States. You may use the work without restriction in the United States.


A number of the authors of chapters in Diabetes in America are employees of the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), or the Veterans Health Administration (VHA). The findings and conclusions in this compendium are those of the authors and do not necessarily represent the official position of NIH, CDC, or VHA.​​​​​