Estimate diagnosed diabetes, hyperglycemia, and hypoglycemia prevalence among US adults aged 18 to 64 years from 2018 through 2024 using multipayer medical claims.
Approach:
Design and data: Cross-sectional analysis of deidentified HealthVerity claims, including 285,213,216 person-years. Measures were age- and sex-adjusted.
Case definitions: Diabetes required at least 2 outpatient diagnoses more than 7 days apart or 1 inpatient diagnosis. Hyperglycemia and hypoglycemia were measured as the share of people with diabetes who had at least 1 corresponding coded diagnosis during the year.
Comparisons: Prevalence was assessed by year, sex, insurance category, and state.
Key Findings:
Diabetes prevalence increased from 8.99% in 2018 to 10.61% in 2024, a rise of 1.63 percentage points (95% CI, 1.62-1.64); similar patterns occurred in men and women.
Among commercial insurance enrollees, prevalence rose from 7.49% to 9.46% (1.97 percentage points; 95% CI, 1.96-1.98), the fastest increase among the reported insurance groups.
Among people with diabetes, diagnosed hyperglycemia increased from 33.96% to 37.32% (3.36 percentage points; 95% CI, 3.29-3.42). Diagnosed hypoglycemia changed little.
In 2024, state diabetes prevalence ranged from 6.01% in Montana to 14.88% in Mississippi. Diagnosed hyperglycemia ranged from 20.43% in Colorado to 44.71% in Arizona.
Diabetes prevalence increased over time in every state, with substantial geographic variation.
Interpretation:
The authors report increasing diagnosed diabetes and hyperglycemia rates across sex and insurance categories, alongside substantial state-level variation. They note that claims data can help document and monitor chronic disease patterns.
Limitations:
Claims capture diagnosed diabetes rather than true prevalence; increases may partly reflect greater detection.
Differences in screening and billing practices across insurance plans or over time may affect coded hyperglycemia rates.
One commercial plan was removed in 2024, reducing sample sizes in several states and potentially changing state enrollee composition.
The analysis cannot determine the reasons for state-level differences.
Conclusion:
The study found rising diagnosed diabetes and hyperglycemia prevalence from 2018 through 2024, with substantial geographic variation.
