PHOM Indicator Report of Diabetes Prevalence
Why Is This Important?About 142,000 Utahns have been diagnosed with diabetes. Diabetes is a disease that can have devastating consequences. It is the leading cause of non-traumatic lower-extremity amputation and renal failure. It is also the leading cause of blindness among adults younger than 75. It is one of the leading causes of heart disease.
Diabetes places an enormous burden on health care resources, approximately $245 billion is spent annually (in direct medical costs ($176 billion) and in indirect costs ($69 billion) such as disability, work loss, and premature death). (See National Diabetes Statistics Report, 2014). In Utah, more than a billion dollars each year are spent on direct and indirect costs of diabetes.
A model using simulated data projected that diabetes incidence will increase from the current rate of 8 cases per 1,000 population to about 15 in 2050 nationwide. Prevalence of diabetes (including undiagnosed cases) can be as high as one of three Americans by 2050 (http://www.pophealthmetrics.com/content/8/1/29).
Currently, about 80 million Americans aged 20 and older have pre-diabetes, a condition that puts them at high risk for developing diabetes. For many individuals, taking small steps, such as losing 5-7 percent of their weight or increasing physical activity, can help them delay or prevent developing diabetes.
Data Notes"Don't know" and "Refused" responses were eliminated from the denominator. Rates are age-adjusted using 8 age groups.
Note: At the time of this update, the BRFSS U.S. dataset did not include an age variable but did include five age categories up to age 80+ (vs. the typical weighting scheme that includes 85+). Comparisons with both weighting schemes were compared using Utah data, and the difference was about 1/100 of a percentage point.
Beginning in 2011, U.S. BRFSS data include both landline and cell phone respondent data along with a new weighting methodology called iterative proportional fitting, or raking. Utah changed to the new methodology in 2009. Utah rates using both old and new methodology are shown for 2009 and 2010. This new methodology utilizes additional demographic information (such as education, race, and marital status) in the weighting procedure. Both of these methodology changes were implemented to account for an increased number of U.S. households without landline phones and an under-representation of certain demographic groups that were not well-represented in the sample. More details about these changes can be found at: http://health.utah.gov/opha/publications/brfss/Raking/Raking%20impact%202011.pdf.
Risk FactorsBeing 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 (http://www.cdc.gov/diabetes/news/docs/dpp.htm). 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.
How Are We Doing?The prevalence of diabetes has risen and will likely continue to rise steadily, both nationally and in Utah. Several factors contribute to this increase. Increasing rates of obesity and sedentary lifestyles add to the number of people at risk for developing diabetes, while improvements in medical care mean people with diabetes are living longer (see http://www.pophealthmetrics.com/content/8/1/29).
A large number of individuals have pre-diabetes. Pre-diabetes is a condition in which blood sugar rates are elevated but not yet high enough to reach the clinical threshold of a diabetes diagnosis. An estimated 86 million Americans age 20 and older have pre-diabetes. Unless those individuals take steps to reduce their risk of diabetes, such as increasing physical activity, eating a more nutritious diet, or losing weight, the majority will have diabetes within 10 years.
What Is Being Done?The Healthy Living through Environment, Policy, and Improved Clinical Care (EPICC) Program encourages people with diabetes to enroll in a diabetes self-management education class. These classes are usually taught by a dietitian, pharmacist, or certified diabetes educator, and have been shown to help individuals develop the skills they need to manage their diabetes.
The Utah Arthritis Program supports Chronic Disease Self-Management Programs throughout the state. (This program is also called the Living Well with Chronic Conditions Program.) This six-week program is available throughout the state at no cost and taught by community members. Information is available from Rebecca Castleton, 801-538-9340, firstname.lastname@example.org.
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
Date Indicator Content Last Updated: 10/27/2014