Diabetes was the eighth leading cause of death in the United States in 2020. People with diabetes are twice as likely to develop heart disease or stroke as people without diabetes. There are three types of diabetes: Type 1, Type 2, and gestational (diabetes while pregnant). Type 2 diabetes accounts for 90%-95% of all cases.In 2017, approximately 24.7 million people were diagnosed with diabetes in the United States, approximately 7.6% of the total population (and 9th in the world). Diabetes is the leading cause of kidney failure, non-traumatic lower-limb amputations, and blindness in adults. Approximately 37.3 million adults currently have diabetes, of which 8.5 million remain undiagnosed. Diabetes cost the United States approximately $327 billion in direct medical costs and lost productivity in 2017. Prevalence The prevalence of diabetes is higher among: Men compared with women. Adults ages 65 and older compared with adults ages 18-64. Black and American Indian/Alaska Native adults compared with Asian adults. Adults with less than a high school education compared with those with higher levels of education; the prevalence decreases as educational attainment increases. Adults with an annual household income of less than $25,000 compared with those with higher levels of income. Adults living in non-metropolitan areas are compared with those in metropolitan areas. Diabetes is the leading cause of kidney failure, non-traumatic lower-limb amputations and blindness in adults. Approximately 37.3 million adults currently have diabetes, of which 8.5 million remain undiagnosed. Geographically, the United States has a diabetes belt with high diabetes prevalence estimates that includes Mississippi and portions of Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and West Virginia. . Prevention Type 2 diabetes is affected by risk factors that can change, such as B. smoking, overweight and obesity, physical inactivity and high blood pressure and high cholesterol levels. Research shows that the onset of type 2 diabetes is largely preventable through weight loss, increased physical activity, and improvement. The National Diabetes Prevention Program, a partnership of public and private organizations working to prevent or delay type 2 diabetes, includes an evidence-based lifestyle change program that focuses on healthy eating and physical activity. Through the program, people with prediabetes have reduced their risk of developing Type 2 diabetes by 58%. The National Clinical Care Commission report from the U.S. Department of Health and Human Services (HHS) discusses population-level strategies for federal programs in order to