Diabetes Prevalence Sharply Increased in all US Regions

Joe Barber Jr, PhD

November 15, 2012

The prevalence of diabetes is rapidly increasing in all regions of the United States and Puerto Rico, according the findings of a retrospective study.

Linda S. Geiss, MA, from the Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, and colleagues published their findings in the November 16 issue of the Morbidity and Mortality Weekly Report.

To establish whether the increase in prevalence has been greater in specific US regions, the authors analyzed data collected between 1995 and 2010 by the Behavioral Risk Factor Surveillance System (BRFSS), which gathers data on health behaviors and conditions using state-based random telephone surveys. The prevalence of diabetes was calculated for each year as the percentage of people who said they had been told by a doctor that they had diabetes.

The analysis revealed that the age-adjusted prevalence of diabetes was at least 6% by 2010 in all 50 states, the District of Columbia, and Puerto Rico, whereas the prevalence exceeded this level in only 3 states, the District of Columbia, and Puerto Rico in 1995. The overall median prevalence for the entire United States and Puerto Rico increased from 4.5% to 8.2% between 1995 and 2010.

The age-adjusted prevalence of diabetes was higher in the South (9.8%) than in the Midwest (7.5%), Northeast (7.3%), and West (7.3%). In 2010, Alabama, Mississippi, South Carolina, Tennessee, Texas, West Virginia, and Puerto Rico had a diabetes prevalence of at least 10%, whereas 12 states had a prevalence of less than 7%. In addition, the age-adjusted prevalence increased by at least 50% in 42 states and by at least 100% in 18 states.

The authors note that the study was limited by the exclusion of people without landline telephones from BRFSS surveys, the fact that approximately one fourth of all adults with diabetes are undiagnosed, and the lack of differentiation between type 1 and type 2 diabetes in the surveys.

The authors indicate that strategies that target the entire population and high-risk groups are needed to reverse the increasing prevalence of diabetes across the country. "With the goal of preventing or delaying the onset of type 2 diabetes in high-risk persons, the National Diabetes Prevention Program supports the nationwide implementation of evidence-based, community, lifestyle programs that promote modest weight loss, good nutritional practices, and increased physical activity among persons at high risk," the authors write. "Continued surveillance of diabetes prevalence and incidence, its risk factors, and prevention efforts is important to measure progress toward reducing the incidence of diabetes across the United States."

The authors of the study are all Centers for Disease Control and Prevention employees.

Morb Mortal Wkly Rep. 2012;61:918-921. Full text