North America and Caribbean

North America and Caribbean at a Glance
 
2010
2030
Total population (millions)
477
555
Adult population (20-79 years, millions)
320
390
 
 
 
Diabetes and IGT (20-79 years)
Diabetes
 
 
Regional prevalence (%)
11.7
13.6
Comparative prevalence (%)
10.2
12.1
Number of people with diabetes (millions)
37.4
53.2
IGT 
 
 
Regional prevalence (%)
11.4
12.6
Comparative prevalence (%)
10.4
11.6
Number of people with IGT (millions)
36.6
49.1
 
 
 
Type 1 diabetes (0-14 years)
 
 
Number of children with type 1 diabetes (thousands)
96.7
 
Number of newly-diagnosed cases per year (thousands)
14.7
 
 
 
 
Diabetes mortality (20-79 years)
 
 
Number of deaths, male (thousands)
141.0
 
Number of deaths, female (thousands)
172.2
 
 
 
 
Health expenditure for diabetes (USD)
 
 
Total health expenditure, R=2, (billions) 214.2 288.7

The North America and Caribbean Region has the highest comparative prevalence of diabetes among the IDF regions with 10.2% in the adult population affected by the disease. The majority of the population in this region lives in the United States of America, Mexico and Canada. Although the region comprises 26 countries and territories, 68% of the adult population currently reside in the USA, with a further 21% living in Mexico and 8% in Canada, so that only 3% of the region’s adult population reside in the other 23 smaller nations.

Diabetes and IGT prevalence

An estimated 37.4 million people with diabetes live in this region, and the number is expected to increase by more than 40% to 53.2 million in 2030. The NAC Region is expected to continue to have the highest comparative prevalence in 2030 when 12.1% of adults are anticipated to have diabetes.

The high prevalence of abnormal glucose tolerance in the adult population for Canada and the USA are very much a consequence of their older age distribution, such that in 2010, 32% of their population will be over 50 years of age, and this is expected to rise to 36% by 2030 1 . This is in contrast to 18% of the Mexican population and 16% of the Caribbean population being over 50 years of age, increasing to 24% and 19%, respectively, by 2030.

As all the Caribbean islands other than Barbados, Guadeloupe, Haiti and Martinique had their estimates extrapolated from Jamaican data  2 , the differences in prevalence between these countries are a consequence only of their different age distributions.

There are an estimated 97,000 children with type 1 diabetes in the region. The USA estimate accounts for almost 90% of the region’s total, and to a lesser extent, the estimate for Canada predominates (see Data Tables).

There also has been a marked increase in the estimate of the number of adults with IGT for this region, indicating an urgent need for diabetes prevention programmes.

Mortality

More than 15% of all deaths in the 20-79 age group may be attributed to diabetes in the NAC Region in 2010. This amounts to more than 300,000 deaths. Diabetes-related events are expected to cause significantly more deaths in middle-aged women than men, and account for almost 30% of all deaths in women in the 50-59 age group (see Figure 3.4).

Healthcare expenditure

Healthcare expenditure for diabetes in the NAC Region is predicted to account for 57% of global spending. The USA alone will account for most of the USD214 billion expected to be spent in the region. Healthcare spending in this region is not significantly higher for women than for men, even though more deaths related to diabetes are thought to occur for middle-aged women than men in the same age group.

National Diabetes Programmes

The NAC Region had a relatively low response rate to the IDF member association survey on national diabetes programmes, with only one-third responding. Of these, slightly more than half reported having a NDP. Primary and secondary prevention as well psychological and behavioural issues were some of the important topics addressed by the NDPs. Several critical issues such as cost to the health system and individual, and prevalence and incidence of the disease were monitored by the NDPs in this region.

Map 3.4 Prevalence (%) estimates of diabetes (20-79 years), 2010, North America and Caribbean Region

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1: United Nations. World Population Prospects: The 2006 Revision. Geneva: United Nations; 2007.

2: Wilks R, Rotimi C, Bennett F, et al. Diabetes in the Caribbean: results of a population survey from Spanish Town, Jamaica. Diabet Med 1999; 16 (10): 875-883.