Public health surveillance of diabetes in the United States.

The Centers for Disease Control and Prevention Division of Diabetes Translation supports a national and state surveillance system that analyzes, interprets, and reports on diabetes risk behaviors, risk factors, care practices, morbidity, and mortality. Data sources include surveys, the U.S. Renal Data System, the Indian Health Service, information on hospital inpatients, birth and death certificates, and special studies to use and to better understand the usefulness of data from managed care, Medicare, and Medicaid for monitoring diabetes. These data are used to define the magnitude and burden of diabetes; monitor changes in burden over time; guide public health planning and policy making, and assess progress toward diabetes objectives, such as those in Healthy People 2010. Challenges facing the diabetes surveillance system are limitations in data sources; the capture of undiagnosed diabetes; tracking key risk factors, such as levels of glycemia and lipids; and surveillance of high- or emerging-risk populations such as racial and ethnic groups, children and youth, and those with prediabetes. Limited resources, competing priorities, and issues of data privacy also challenge surveillance. To overcome these factors, the Division of Diabetes Translation strongly emphasizes partnering with other organizations, such as the Medicare and Medicaid programs, managed care, and other chronic disease programs.