Diabetes mellitus is a growing health problem worldwide. In the United States, the number of people with diabetes has grown since 1990 at a rate much greater than that of the general population; it was estimated at 20.8 million in 2005. Total costs of diabetes in the United States in 2002 were estimated at 2 billion.

Health planners in the National Center for Chronic Disease Prevention and Health Promotion of the Centers for Disease Control and Prevention used system dynamics simulation modeling to gain a better understanding of diabetes population dynamics and to explore implications for public health strategy. A model was developed to explain the growth of diabetes since 1980 and portray possible futures through 2050.

The model simulations suggest four characteristic dynamics of the diabetes population.

First, it shows obesity’s role in driving the growth of prediabetes and diabetes prevalence.

Second, the model quantifies the “backing up” phenomenon (in which reduced outflow from a population stock causes a buildup in that stock) that may undercut the benefits of management and control efforts. Third, management and control efforts alone are unable to reduce diabetes prevalence in the long term. Fourth, there are significant delays between primary prevention efforts and downstream improvements in diabetes outcomes.

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