National surveillance data show a sustained decline in the incidence rate of diagnosed diabetes, which has been heralded as a success in the battle against diabetes in the U.S. In this Perspective, we take a closer look at these data and provide additional insights to help interpret these trends. We examine multiple sources of data on the prevalence and incidence of diabetes in the U.S. as well as data on trends in diabetes risk factors to provide context for these national surveillance findings. Although some of the incidence decline may represent real progress against diabetes, it is likely that there are also nonbiological factors at play, especially changes in diagnostic criteria for diabetes. We present and discuss data that suggest improved detection and changes in screening and diagnostic practices may have resulted in the depletion of the “susceptible population.” Providing this context for the recent declines in new diabetes diagnoses observed in national data is critical to help avoid misinterpretation. We argue that it is premature to declare victory against the epidemic of diabetes in the U.S. and discuss how we might better focus current public health efforts, including a specific emphasis to address prediabetes.

国家监测数据显示，已诊断出的糖尿病的发病率持续下降，这在美国抗击糖尿病方面取得了成功。在此观点中，我们将仔细研究这些数据并提供其他见解，以帮助解释这些疾病。趋势。我们检查了有关美国糖尿病患病率和发病率的多种数据来源，以及有关糖尿病危险因素趋势的数据，以为这些国家监测结果提供背景信息。尽管某些发病率下降可能代表了针对糖尿病的真正进展，但很可能还有非生物因素在起作用，尤其是糖尿病诊断标准的改变。我们提供并讨论数据，这些数据表明改进的检测以及筛查和诊断实践的变化可能导致“易感人群”的减少。为国家数据中观察到的新的糖尿病诊断的近期下降提供这种背景对于避免误解至关重要。我们认为在美国宣布抗击糖尿病流行还为时过早，并讨论我们如何更好地关注当前的公共卫生工作，包括特别针对糖尿病的治疗。