State-Specific Incidence of Diabetes Among Adults — Participating States, 1995–1997 and 2005–2007
Source: Morbidity and Mortality Weekly Report (CDC)

This report is the first to provide state-specific incidence rates for diagnosed diabetes among adults and the first to describe geographic patterns in diabetes incidence. The findings indicate that the incidence of diagnosed diabetes has been particularly high in the South and the age-adjusted incidence for 33 states was 90% higher during 2005–2007 than during 1995–1997. These findings affirm previous projections that diabetes will continue to be a major public health problem.

The 1995–1997 overall incidence of 4.8 per 1,000 for the 33 states is similar to a 1997 estimate of diabetes incidence (4.9 per 1,000) using National Health Interview Survey (NHIS) data. Although few diabetes incidence studies have been published, the state-based data in this report appear consistent with NHIS data indicating that the incidence of diabetes is increasing. Factors associated with an increased risk for diabetes included older age, lower educational attainment, physical inactivity, obesity, weight gain, and being categorized in a racial/ethnic minority population. Of these factors, obesity has been identified as a major risk factor in the increasing incidence of diabetes; the growth in diabetes prevalence has been concomitant with growth in obesity prevalence.

The pattern of high incidence rates in the South is consistent with previously documented high prevalence of diabetes in this region.¶ The South also has high prevalences of modifiable risk factors for type 2 diabetes (90%–95% of all diabetes in the United States is type 2), including obesity and physical inactivity. A recent study found the prevalence of obesity in 2007 was greatest in the South (27.3%) followed by the Midwest (26.5%), Northeast (24.4%), and West (23.1%). Obesity prevalence exceeded 30% in three southern states: Alabama, Mississippi, and Tennessee. Similar regional patterns have been found for physical inactivity, for which the South had greater prevalence (17.4%), compared with the Northeast (15.7%), Midwest (14.1%), and West (11.2%). Effective population-based approaches to prevent obesity and increase physical activity might help to reduce the incidence of diabetes. Efforts to prevent diabetes also should focus on persons at high risk for type 2 diabetes. In a study of persons at high risk, a 5%–10% reduction in body weight coupled with 30 minutes of moderate physical activity 5 days a week resulted in a 58% reduction in diabetes over a 3-year period.

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