PHOM Indicator Report of Diabetes Prevalence
Why Is This Important?About 135,000 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 annually (in direct medical costs and in indirect costs such as disability, work loss, and premature mortality). (See American Diabetes Association, http://www.diabetes.org/advocate/resources/cost-of-diabetes.html). 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. 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 79 million Americans 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. 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).
What Is Being Done?The Utah Diabetes Prevention and Control Program (DPCP) works to increase public awareness of the warning signs, symptoms, and risk factors for developing diabetes. The program seeks innovative ways to encourage people at risk to recognize that they may be at risk and need to be tested. The program is promoting A1C awareness among people already diagnosed with diabetes and has produced television and radio public service announcements stressing the urgency of getting A1C levels under control. The program also developed a brochure, "Wish You Could Reverse Time?" to complement its public service announcements. The DPCP, in conjunction with the Utah Health Plan Partnership, has also developed magnets to remind Utahns with diabetes of the importance of managing their ABCs (A1C, blood pressure, and cholesterol levels). The Program also assists community-based organizations as they work to increase awareness of diabetes and its risk factors among members of their populations.
The DPCP initiated a program, Faces of Diabetes, that allows individuals to post their personal experiences with diabetes online. This resource allows viewers to learn about diabetes management and challenges by listening to others' stories. Visit Faces of Diabetes at http://health.utah.gov/facesofdiabetes.
The 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 usually available 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: 11/01/2013