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Complete Health Indicator Report of Prediabetes

Definition

Prediabetes is a condition where blood sugar levels are elevated but not high enough to reach a threshold for diabetes.

Numerator

Number of adults who have been told by a doctor they have prediabetes.

Denominator

All Utah adults.

Data Interpretation Issues

Data for this indicator come from the Utah Behavioral Risk Factor Surveillance System (BRFSS), a telephone survey that asks adults to self-report whether or not they have certain conditions. Respondents were asked to report if they had ever been told by a health care professional if they had prediabetes. The term "prediabetes" is often called impaired fasting glucose or insulin resistance. It is also sometimes referred to as "borderline diabetes." An individual may actually have "prediabetes" but respond with "No," as he or she may be interpreting the question literally. Respondents who answer "Yes" to the question, "Have you ever been told by a doctor or other health professional that you have prediabetes or borderline diabetes?" are considered to have prediabetes. In addition, individuals who volunteer that they have prediabetes or borderline diabetes but answered "No" in response to the question, "Has a doctor, nurse, or other health professional EVER told you that you had diabetes?" are also counted as having prediabetes.

Why Is This Important?

The threshold for a clinical diagnosis of diabetes is 126 mg/dL (note that a diagnosis for diabetes generally requires at least two blood sugar tests for confirmation of the diagnosis). The American Diabetes Association defines "prediabetes" as a fasting plasma glucose level between 100 mg/dL and 125 mg/dL. A1C tests are commonly used for diagnosing prediabetes (greater than or equal to 5.7% and less than 6.5%). Another test used is the Oral Glucose Tolerance Test. Values between 140 mg/dL and 199 mg/dL indicate prediabetes. Diabetes can be a serious, deadly, and costly disease. Although blood sugar levels for prediabetes do not meet the clinical threshold for a diagnosis of diabetes, individuals with prediabetes still have an increased risk for type 2 diabetes, heart disease, and stroke. These individuals are at a greatly elevated risk for developing diabetes; however, many of them are unaware of their condition. Approximately half of individuals diagnosed with prediabetes progress to overt diabetes within ten years. Steps can be taken to prevent progression. Simple lifestyle changes, such as losing weight, eating more fruits and vegetables, and increasing physical activity, can reduce the risk of conversion to type 2 diabetes. In simple terms, prediabetes is what precedes diabetes. And, if you don't change some behaviors, you may get diabetes. More information about the clinical thresholds for prediabetes can be found at [http://www.diabetes.org/diabetes-basics/diagnosis].

Healthy People Objective D-1:

Reduce the annual number of new cases of diagnosed diabetes in the population
U.S. Target: 7.2 new cases per 1,000 population aged 18 to 84 years
State Target: 7.2 new cases per 1,000 population aged 18 to 84 years

How Are We Doing?

The Centers for Disease Control and Prevention (CDC) estimates that about one-third of U.S. adults (aged 20 and over) have prediabetes. Most people with prediabetes do not know they have it. Prediabetes is a fairly new term, even in the medical field, and the Utah Department of Health is working hard to increase awareness of this condition. Once individuals are aware of that they have prediabetes and an increased risk of developing diabetes and other cardiovascular complications, they can make the necessary lifestyle changes to prevent or at least delay progression to type 2 diabetes.

How Do We Compare With the U.S.?

About 86 million Americans (roughly 35% of adults aged 20 years and older) have prediabetes. The Utah Behavioral Risk Factor Surveillance System measures awareness of prediabetes. Nationally, about one of three adults aged 20 and over, actually have prediabetes but most have not been formally diagnosed. In Utah, about 5.2% (crude rate) of adults have been told by a provider that they have prediabetes (BRFSS 2016). The actual percentage is probably much higher. Adults in the U.S. generally have a higher rate of being diagnosed with prediabetes. National BRFSS data from 2016 indicated that 9.5% of adults in the U.S. had been told by a health care provider that have prediabetes. For the same year in Utah, 5.7% of adults had ever been told by a health care professional that they had prediabetes (age-adjusted rates).

What Is Being Done?

In 2013, the Utah Department of Health (UDOH) received funding to increase awareness of prediabetes. While it may seem counter-intuitive, the UDOH is working towards increasing the prevalence of prediabetes. National data suggest that many individuals have prediabetes but have not been told so by a health care provider. The UDOH is working to increase awareness of this condition among health care providers as well as individuals at risk.

Evidence-based Practices

The Centers for Disease Control and Prevention (CDC) promotes the Diabetes Prevention Recognition Program (DPRP) as part of its efforts to prevent diabetes. The DPRP provides recognition to qualified organizations that can effectively deliver a lifestyle change intervention program. In most states, participants pay to attend the program. The program consists of 16 sessions taught by a trained lifestyle coach. The program includes at least six additional follow-up sessions. DPRP-recognized programs submit reports to DPRP every six months with data on participants' progress. More information is available at [http://www.cdc.gov/diabetes/prevention/recognition/index.htm].

Available Services

You can find and enroll in National Diabetes Prevention Program, an evidence-based health program for prediabetes below [http://livingwell.utah.gov/ws_find.php]

Health Program Information

Increasing awareness of prediabetes is one of many new activities conducted by the new Healthy Living through Environment, Policy and Improved Clinical Care (EPICC) Program. EPICC supports environmental and policy changes that will assist individuals in their efforts to increase physical activity and increase consumption of healthful fruits and vegetables and nutritious beverages. EPICC's ultimate goal is to provide a sustainable environment that promotes healthful behaviors.


Related Indicators

Health Care System Factors

Prediabetes is estimated to cost $25 billion. Diabetes related costs account for higher out-of-pocket medical costs and higher insurance premiums. [https://www.ncbi.nlm.nih.gov/pubmed/23468086 Economic Costs of Diabetes in the U.S. in 2012].

Risk Factors

Some people diagnosed with prediabetes will develop diabetes. Being overweight or obese is a major risk factor for developing diabetes. The risk of developing diabetes can be substantially reduced through weight loss and regular physical activity. The Diabetes Primary Prevention Study (DPP) showed that weight loss and participation in regular physical activity can significantly decrease the risk. The DPP clinical trial included over 3,000 people who had impaired fasting glucose and were at an increased risk for developing diabetes. Participants who engaged in moderately intense physical activity for 30 minutes per day and lost 5 to 7 percent of their body weight decreased their risk of diabetes dramatically. This behavioral activity was effective for all participants in the study, regardless of age or ethnic group (see [http://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dpp/Pages/default.aspx]). Some risk factors cannot be modified, such as older age or membership in a minority racial or ethnic group. Nevertheless, risk can be substantially reduced through adhering to a nutritious diet and participating in regular physical activity.

Related Risk Factors Indicators:


Health Status Outcomes

Diabetes can have serious consequences. It is the leading cause of non-traumatic lower extremity amputations, and is also the leading cause of blindness among working-age adults. It is a major risk factor for cardiovascular disease and end-stage renal disease. Diabetes can affect both physical and mental health. Complications from diabetes can have a significant impact on quality of life. Blindness and amputations affect one's independence and ability to conduct everyday activities. People with diabetes have an increased risk of depression. In controlled studies, the odds of having depression were twice as great in people with diabetes as in people without diabetes (Wayne J. Katon, MD, The Comorbidity of Diabetes Mellitus and Depression, ''Am J Med.'' Nov. 2008;121 (11 Suppl2): 58-15).

Related Health Status Outcomes Indicators:




Graphical Data Views

Percentage of Adults With Prediabetes, by Year, Utah and U.S., 2011-2016

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confidence limits

In 2016 Utah reported a lower adult prediabetes rate (5.7%) than the U.S. (9.5%).
Utah vs. U.S.YearAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 11
Utah20115.7%4.7%6.9%
Utah20125.8%4.8%7.0%
Utah20136.6%5.5%7.8%
Utah20145.9%5.2%6.7%
Utah20165.7%4.9%6.5%
U.S.20116.9%6.6%7.2%
U.S.20127.2%7.0%7.4%
U.S.20137.8%7.6%8.0%
U.S.20148.2%8.0%8.4%
U.S.20158.2%7.9%8.5%
U.S.20169.5%9.3%9.8%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Prediabetes questions were not asked in Utah in 2015. Age-adjusted to U.S. 2000 standard population. [[br]] U.S. data does not include U.S. territories, but does include Dist. of Columbia. [[br]] Beginning in 2011, BRFSS data include both landline and cell phone respondent data along with a new weighting methodology called iterative proportional fitting, or raking. Comparisons between 2011 and prior years should be made with caution. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Data Sources

  • Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health
  • U.S. Data: Behavioral Risk Factor Surveillance System (BRFSS), Division of Behavioral Surveillance, CDC Office of Surveillance, Epidemiology, and Laboratory Services


Prediabetes Age-adjusted Rates by Hypertension Status, Utah, 2014 and 2016

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confidence limits

Adults with hypertension have a higher rate of prediabetes diagnosis than adults without hypertension. The estimate shown for this view combines two years of data (2014 and 2016).
Hypertension StatusAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 2
Hypertension10.6%8.7%13.0%
No Hypertension4.4%3.6%5.4%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to 2000 U.S. standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Prediabetes Age-adjusted Rates by Local Health District, Utah, 2011-2014 and 2016

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confidence limits

Higher rates in the graph may indicate higher prevalence of prediabetes; however, higher rates may also mean that some local health districts have higher detection rates of prediabetes.
Local Health DistrictAge-adjusted Percentage of AdultsLower LimitUpper LimitNote
Record Count: 14
Bear River5.6%4.3%7.4%
Central6.1%4.0%9.2%
Davis County6.4%5.2%7.7%
Salt Lake County6.2%5.5%7.0%
San Juan6.9%3.1%14.7%*Estimate may not be reliable.
Southeast5.9%4.2%8.1%
Southwest6.4%4.2%9.5%
Summit5.2%3.5%7.6%
Tooele6.5%4.8%8.6%
TriCounty4.6%2.3%8.9%*Estimate may not be reliable.
Utah County5.2%4.3%6.3%
Wasatch5.3%3.3%8.3%
Weber-Morgan6.7%5.2%8.6%
State of Utah5.9%5.5%6.4%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to U.S. 2000 standard population. *Use caution in interpreting. The estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health standards. Prior to 2015 San Juan County was part of the Southeast Local Health District. In 2015 the San Juan County Local Health District was formed. Data reported are for all years using the current boundaries.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Prediabetes Crude Rates by Local Health District, Utah, 2011-2014 and 2016

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confidence limits

Five years of data were combined to produce reliable estimates.
Local Health DistrictCrude Percentage of AdultsLower LimitUpper LimitNote
Record Count: 14
Bear River4.8%3.5%6.7%
Central6.1%3.9%9.5%
Davis County5.5%4.5%6.8%
Salt Lake County5.7%5.0%6.4%
San Juan6.3%2.8%13.4%*Estimate may not be reliable.
Southeast6.2%4.4%8.6%
Southwest6.5%4.2%10.1%
Summit4.8%3.2%7.0%
Tooele6.0%4.4%8.1%
TriCounty4.4%2.1%9.0%*Estimate may not be reliable.
Utah County4.2%3.5%5.2%
Wasatch6.0%3.5%9.9%
Weber-Morgan6.4%4.9%8.3%
State of Utah5.4%5.0%5.9%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   *Use caution in interpreting. The estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health standards. Prior to 2015 San Juan County was part of the Southeast Local Health District. In 2015 the San Juan County Local Health District was formed. Data reported are for all years using the current boundaries.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Prediabetes by Age, Utah, 2013, 2014, and 2016

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confidence limits

Rates of prediabetes diagnosis increase with age. The estimate shown for this view combines three years of data (2013, 2014 and 2016).
Age GroupPercentage of AdultsLower LimitUpper Limit
Record Count: 3
<453.1%2.6%3.7%
45-648.5%7.4%9.7%
65+10.0%8.6%11.5%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Prediabetes Age-adjusted Rates by Ethnicity, Utah, 2013, 2014, and 2016

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confidence limits

The prediabetes rates for ethnicity groups were comparable to the state rate. The estimate shown for this view combines three years of data (2013, 2014, 2016).
Hispanic EthnicityAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 3
Hispanic4.9%3.1%7.5%
Non-Hispanic6.2%5.7%6.8%
All Utahns6.1%5.5%6.6%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to U.S. 2000 standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Prediabetes Crude Rates by Ethnicity, Utah, 2013, 2014, and 2016

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confidence limits

Hispanics have a lower prediabetes rate when compared to the state rate. Hispanics on average are a younger aged population, which might explain the lower rate.
Hispanic EthnicityCrude Percentage of AdultsLower LimitUpper Limit
Record Count: 3
Hispanic3.5%2.4%5.1%
Non-Hispanic5.8%5.2%6.3%
All Utahns5.5%5.0%6.0%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Prediabetes Age-adjusted Rates by Sex, Utah, 2013, 2014, and 2016

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confidence limits

Prediabetes rates for male and female were comparable to the state rate.
SexAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 3
Male6.1%5.4%7.0%
Female6.0%5.4%6.8%
All6.0%5.5%6.6%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to U.S. 2000 standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Prediabetes Age-adjusted Rates by Education, Utah Adults 25+, 2014 and 2016

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confidence limits

Prediabetes rates for all education groups were comparable to the state rate.
Education LevelAge-adjusted Percentage of Adults 25+Lower LimitUpper Limit
Record Count: 5
Less Than High School5.0%3.1%8.0%
H.S. Grad or G.E.D.6.9%5.7%8.3%
Some Post High School6.7%5.7%7.9%
College Graduate6.1%5.2%7.2%
Total6.5%5.9%7.1%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to U.S. 2000 standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Prediabetes Age-adjusted Rates by Body Mass Index, Utah, 2014 and 2016

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confidence limits

Individuals with a Normal weight had a lower rate compared to the state. Normal BMI (<25) includes individuals that are underweight.
Weight CategoryAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 3
Normal2.9%2.2%3.6%
Overweight4.9%4.1%5.8%
Obese10.8%9.4%12.5%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to U.S. 2000 standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Prediabetes Age-adjusted Rates by Cholesterol Level, Utah, 2013

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confidence limits

Adults with high cholesterol have a higher rate of prediabetes diagnosis than adults without high cholesterol. Increased Low-density lipoprotein (LDL) cholesterol is an underlying symptom that is part of the metabolic syndrome associated with prediabetes.
Cholesterol LevelAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 2
High Cholesterol14.0%10.6%18.2%
No High Cholesterol4.0%3.1%5.2%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to 2000 U.S. standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Prediabetes Age-adjusted Rates by Arthritis Status, Utah, 2014 and 2016

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confidence limits

Adults with arthritis have a higher rate of prediabetes diagnosis than adults without arthritis.
Arthritis StatusAge-adjusted Percentage of AdultsLower LimitUpper Limit
Record Count: 2
Arthritis10.7%8.4%13.4%
No Arthritis4.7%4.1%5.4%

Data Notes

In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.   Age-adjusted to 2000 U.S. standard population.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 10/27/2017, Published on 11/29/2017
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sun, 23 September 2018 9:48:54 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Wed, 29 Nov 2017 15:41:28 MST