DefinitionPercentage of adults who have ever been told by a doctor or other health professional that they have prediabetes or borderline diabetes.
Prediabetes is a condition in which an individual's blood sugar level is elevated but not high enough to reach a clinical diagnosis for diabetes.
NumeratorNumber of adults who have been told by a doctor they have prediabetes.
DenominatorAll Utah adults.
Data Interpretation IssuesData for this indicator come from the Utah Behavioral Risk Factor Surveillance System (BRFSS), a telephone survey that asks respondents 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 the health care provider may not have actually said he/she had "prediabetes" or "borderline diabetes."
Why Is This Important?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. A1C levels between 5.7% to 6.4% are used to indicate prediabetes. Another test used is the Oral Glucose Tolerance Test. Values between 140 mg/dL and 199 mg/dL indicate prediabetes.
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 heart disease, stroke, and type 2 diabetes.
However, many people with prediabetes are unaware of their condition. Once individuals are aware that they have prediabetes and of their increased risk of developing diabetes and cardiovascular complications, they can make the necessary lifestyle changes to prevent or at least delay progression to type 2 diabetes.
Simple lifestyle changes, such as losing weight, eating more fruits and vegetables, and increasing physical activity, can reduce the risk of developing type 2 diabetes. Without making lifestyle changes, approximately half of individuals diagnosed with prediabetes progress to diabetes within ten years.
More information about the clinical thresholds for prediabetes can be found at http://www.diabetes.org/diabetes-basics/diagnosis.
Healthy People Objective D-16:Increase prevention behaviors in persons at high risk for diabetes with pre-diabetes
U.S. Target: Not applicable, see subobjectives in this category
Other ObjectivesHealthy People 2030 objectives: reduce the number of diabetes cases diagnosed yearly (D-01), reduce the proportion of adults who don't know they have prediabetes (D-02), and increase the proportion of eligible people completing CDC-recognized type 2 diabetes prevention programs (D-D01).
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. The Utah Department of Health and Human Services (DHHS) has been working to increase awareness of prediabetes. In 2016, 5.2% of adults reported they had been told by a health care provider that they had prediabetes (crude rates). Data collected in 2020 (Behavioral Risk Factor Surveillance System) showed this percentage increased to 10.2% (crude rates). While this increased rate may be partly due to a true increase, it likely reflects increased awareness by providers and patients.
How Do We Compare With the U.S.?Adults in the U.S. generally have a similar rate of being diagnosed with prediabetes than adults in Utah. National data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS) indicated that 11.9% (age- adjusted) of adults in the U.S. had been told by a doctor or other health professional that they have prediabetes. In Utah, about 11.1% (age- adjusted) of adults have been told by a provider that they have prediabetes (BRFSS 2020).
The actual percentages are probably much higher. About 86 million Americans (roughly 35% of adults aged 20 years and older) may actually have prediabetes.
What Is Being Done?In 2015, DHHS received funding to increase awareness and prevention of prediabetes. National data suggest that many individuals have prediabetes but have not been diagnosed by a healthcare provider and are not aware they have it due to its unclear symptoms. DHHS is working to increase awareness of this condition among health care providers, as well as individuals at risk by promoting and supporting different programs that target different stages of diabetes prevention.
Evidence-based PracticesThe 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 6 additional follow-up sessions (for a total of 22 or more sessions). DPRP-recognized programs submit reports to DPRP every 6 months with data on participants' progress.
More information is available at http://www.cdc.gov/diabetes/prevention/recognition/index.htm.
Health Program InformationThe Utah Department of Health and Human Services, Healthy Environments Active Living program plays a key role in improving the health of residents in the state of Utah. The program was formed in July 2013 (as EPICC), through a new funding opportunity from the Centers of Disease Control and Prevention (CDC) that allowed for the merging of three previously existing programs: the Heart Disease and Stroke Prevention Program, the Diabetes Prevention and Control Program, and the Physical Activity, Nutrition and Obesity Program, as well as the addition of a school health program. The Healthy Environments Active Living Program (HEAL) was recently restructured as part of this strategic planning process and the new program model focuses on working together with staff and partners to address the social determinants of health while advancing health equity and increasing policy, systems and environment changes.
HEAL champions public health initiatives and addresses the challenges of making health awareness and access truly universal and equitable in eight key areas: nutrition, heart health, diabetes, physical activity, schools, child care, community health workers, and worksites. Visit [https://heal.health.utah.gov/ HEAL?s website] for more information.