2004. Differences in diabetes prevalence, incidence, and mortality among the elderly of four racial/ethnic groups: Whites, blacks, Hispanics, and Asians

among fee-for-service Medicare beneficiaries 67 years of age. RESEARCH DESIGN AND METHODS — This study was a retrospective analysis of a 5 % random sample of Medicare fee-for-service beneficiaries 65 years of age in each year. RESULTS — In 1993, the prevalence of diabetes among those67 years of age was 145 cases per 1,000 individuals. By 2001, it was 197/1,000, an increase of 36.0%. The 2001 prevalence among Hispanics (334/1,000) was significantly higher than among blacks (296/1,000), Asians (243/1,000), and whites (184/1,000, P 0.0001). During the 7-year period the greatest increase in diabetes prevalence was among Asians (68.0%). Between 1994 and 2001, the annual rate of newly diagnosed elderly individuals with diabetes increased by 36.9%. Hispanics had the great-est increase at 55.0%. The mortality rate among individuals with diabetes decreased by 5% between 1994 and 2001 from 92.1/1,000 to 87.2/1,000 (P 0.001), due to a 6 % decrease among whites. No decrease in mortality was seen among elderly individuals without diabetes, it was 55/1,000 in 1994 and 54/1,000 in 2001. CONCLUSIONS — The dramatic increase in the incidence and prevalence of diabetes likely reflect a combination of true increases, as well as changes in the diagnostic criteria and increased interest in diagnosing and appropriately treating diabetes in the elderly. Improved treatment may have had an impact on mortality rates among individuals with diabetes, although they could have been influenced by the duration of diabetes before diagnosis, which has likely decreased. Changes in incidence, prevalence, and mortality in elderly individuals with diabetes need to continue to be monitored. Diabetes Care 27:2317–2324, 2004 The number of individuals reportedto have diabetes in the U.S. has in-creased by100 % over the past two decades, and by 2050, it is expected to increase by an additional 165 % (1–6). The current burden of diabetes is greatest in the population 65 years of age (1– 4,7–9), and the greatest increases in prev-alence are expected among the elderly: from 252 % among women 65–74 years of age to 537 % among men75 years of ag