According to the NC State Center for Health Statistics, 81% of adults age 65+ have at least one chronic condition, and 51% of those have two or more chronic diseases. Among participants who have enrolled in NC CDSME programs since 2010, the top three health conditions reported include hypertension, diabetes, and arthritis, with over half participants reporting two or more chronic conditions.

Diabetes is the seventh leading cause of death in both the United States and NC. Over 50,000 NC adults are diagnosed with diabetes annually, and only half of those diagnosed with diabetes have taken a class to manage the chronic disease. The disease has many co-morbidities and complications, and a large proportion of adults are unable to work as a result. The prevalence of diabetes is higher among African Americans as compared to Whites, and it is the 5th leading cause of deaths for African Americans. Diabetes death rates are highest in rural eastern NC communities, where there is a high need for diabetes management programs that are culturally appropriate and support populations with low literacy.

Diabetes alone costs $3.8 billion in direct and indirect costs among the population age 65+ in NC,6 including $2.2 billion in Medicare costs and over $700 million in Medicaid costs. NC’s Medicaid Program incurred nearly one-third of the estimated annual diabetes-attributable medical costs among people age 65+ in 2013 (https://www.diabetesnc.com/diabetes-management/management-facts/).