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Health Indicator Report of Diabetes (Diagnosed) Prevalence

Diabetes and its frequent precursor, prediabetes, are conditions on a continuum marked by high levels of blood glucose (blood sugar) due to defects in insulin production, insulin action, or both. Insulin is a hormone needed to absorb and use glucose as fuel for the body's cells. Diabetes can lower life expectancy and increase the risk of heart disease. It is the leading cause of kidney failure, lower limb amputation, and adult-onset blindness. People with prediabetes have blood glucose levels higher than normal, but not high enough to be diagnosed as diabetes. They're more likely to develop diabetes, heart disease, and stroke. The Centers for Disease Control and Prevention estimate that 1 of 3 U.S. adults had prediabetes in 2012. Diabetes and its complications can often be prevented or delayed. People who are diagnosed with diabetes or prediabetes need to learn about their condition and build the skills and confidence necessary to successfully take care of themselves, with the help of their health care team and community resources. About one-quarter of people with diabetes don't know they have it, and most people with prediabetes don't know they have it. Unfortunately, people who are undiagnosed can't take steps to manage their condition. Data in this Profile are only about diagnosed diabetes prevalence.
Diabetes prevalence has steadily increased in NM and US over the past 20 years. In 1995, the US age-adjusted prevalence of diagnosed diabetes among adults was 4.6% and that of NM was 5.8%; by 2016, the age-adjusted prevalence estimates were 9.5% (2016 CDC BRFSS National Data Set) and 10.7%, respectively. The chart presents age-adjusted rates. In 2016, the crude (non-age-adjusted) prevalence of diagnosed diabetes among New Mexico adults was 11.5%.

Notes

Age-adjusted to U.S. 2000 population (except for rates by age group). The estimates are adjusted by several weighting factors which adjust for probability of selection of the given survey respondent and for demographic differences between the sample and the adult population of New Mexico.   Diabetes prevalence for New Mexico and the U.S. is a weighted percent, age-adjusted to the 2000 U.S. Census population. Estimates for 2011 and forward should not be compared to earlier years (please refer to Data Interpretation Issues, below). The break shown between 2010 and 2011 denotes that the data before 2011 and the data from 2011 onward are not directly comparable. Starting in 2011, CDC BRFSS included cell phones and used a different weighting method than in previous years; data from 2011 and years forward will be comparable. Nationally, nearly one-quarter of people with diabetes are unaware of the condition (National Diabetes Statistics Report, 2017), never having been diagnosed. The rates shown here are under-estimates of diabetes prevalence because these include only those who have been diagnosed with diabetes.

Data Sources

  • Behavioral Risk Factor Surveillance System Survey Data, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, together with New Mexico Department of Health, Injury and Behavioral Epidemiology Bureau.
  • U.S. Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion Chronic Disease Indicators BRFSS Data, [https://www.cdc.gov/cdi/].

Data Interpretation Issues

Data for this indicator report are from the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing survey of adults regarding their health-related behaviors, health conditions, and preventive services. Data are collected in all 50 states, D.C., and U.S. territories. Responses have been weighted to reflect the New Mexico adult population by age, sex, ethnicity, geographic region, marital status, education level, home ownership and type of phone ownership. The survey is conducted using scientific telephone survey methods for landline and cellular phones (with cellular since 2011). The landline phone portion of the survey excludes adults living in group quarters such as college dormitories, nursing homes, military barracks, and prisons. The cellular phone portion of the survey includes adults, in general, as well as adult students living in college dormitories but excludes other group quarters. Beginning with 2011, the BRFSS updated its surveillance methods by adding calls to cell phones and changing its weighting methods. These changes improved the BRFSS' ability to take into account the increasing proportion of U.S. adults using only cellular telephones as well as to adjust survey data to improve the representativeness of the estimates generated from the survey. Results have been adjusted for the probability of selection of the respondent, and have been weighted to the adult population by age, gender, phone type, detailed race/ethnicity, renter/owner, education, marital status, and geographic area. Lastly and importantly, these changes mean that the data from years prior to 2011 are not directly comparable to data from 2011 and beyond. Please see the [https://ibis.health.state.nm.us/docs/Query/BRFSS/BRFSS_fact_sheet_Aug2012.pdf BRFSS Method Change Factsheet]. The "missing" and "don't know" responses were removed before calculating a percentage.

Definition

Diabetes prevalence is the estimated percentage of adult New Mexicans 18 years and older with diagnosed diabetes.

Numerator

Number of adult (18 and older) New Mexico respondents who responded, "yes" (within the survey year) to the BRFSS question: "Has a doctor, nurse, or other health professional ever told you that you have diabetes?".

Denominator

Number of adult (18 and older) New Mexico respondents who responded to the BRFSS within the survey year.

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 Objectives

There are 16 major Healthy People 2020 objectives for diabetes. Diabetes objectives D-5 to D-14 are about self-management and care behaviors among those with diagnosed diabetes. Objective D-15 is "Increase the proportion of people with diabetes whose condition has been diagnosed". (www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=8)

How Are We Doing?

Diabetes prevalence has steadily increased in NM and US over the past 20 years. In 1995, the US age-adjusted prevalence of diagnosed diabetes among adults was 4.6% and that of NM was 5.8%; by 2016, the age-adjusted prevalence estimates were 9.9% (2016 CDC BRFSS National Data Set) and 10.7%, respectively. In 2016, the crude (non-age-adjusted) prevalence of diagnosed diabetes among New Mexico adults was 11.5%. Sex and Age: In the triannual period 2014-2016, the crude prevalence rate for males was 11.2% and 10.2% for females. Age strongly influences the prevalence of chronic conditions, including diabetes. Prevalence increases with age, as seen in the graph by age group and sex for 2014-2016. The younger age groups (less than 55) had lower rates than the older age groups. Rates in the oldest age groups (65-74 and 75+) were three times higher than the rate in the youngest age group (35-44). The rates for males and females within each age group were not statistically different. Within each gender, the rate for each older age group was statistically different from the preceding age group. Among Males, the rate of the oldest (75+) age group was fifteen times higher than the rate of the youngest (18-34) group. Among females, the rate of the oldest (75+) age group was ten times higher than the rate of the youngest (18-34) group. The aging of the state's population helps drive the increasing prevalence of diabetes. In New Mexico, the population of individuals 55 and older has grown from 27% of all adults in 1990 to 39% of all adults in 2016, a 44% increase. Prevalence by race/ethnicity: Disparities by race/ethnicity remain. The American Indian/Alaska Native rate was highest and was 2.5 times the White rate; the Hispanic rates was twice the White rate. This has been a long-term pattern. While the rate for Black/African American and AsianNHOPI were second highest and second lowest, respectively, small sample size precluded effective comparison of these rates to those of other groups. Prevalence by race/ethnicity and sex: Within each Race/Ethnic group, the rates for males and females were statistically similar. Among males, the American Indian rate was nearly 3 times the White rate and the Hispanic rate was nearly twice the White rate. The AsianNHOPI, Black/African American, and Hispanic rates were similar. Among females, the highest rate was among Black/African American and American Indian women, these rates being 3.5 and 2.5 times the White rate. and Hispanic rate was two times the White rate. Household Income: Income and wealth influence the health of communities and individuals. Diabetes prevalence is highest among adults living in households with lower annual income. The highest diabetes prevalence was in the lowest household income group (<$15,000); the lowest diabetes rate was in the two highest income groups. As in previous years, the rate of diagnosed diabetes in the lowest income group was two times that of the rate of the highest income groups. This inverse pattern between income and prevalence of disease is common in the US and worldwide. County rates: In 2014-2016, nine county rates were lower than the statewide age-adjusted prevalence rate of 10.7%: Bernalillo, Catron, Grant, Lincoln, Los Alamos, Otero, Quay, Santa Fe, Sierra, and Taos. Union, San Miguel, Cibola, and McKinley, in that order, had the highest rates. The rates for De Baca, Guadalupe, and Harding counties were statistically highly unreliable, and so are not presented. Urban and Rural: Though Mixed Urban/Rural and Rural counties had slightly higher rates than Metropolitan and Small Metropolitan counties, there were no statistically significant differences.

How Do We Compare With the U.S.?

Generally, both New Mexico and the U.S. prevalence have remained similar since the mid-1990s. The graph shows trends of increasing prevalence since 2000 for NM and the US. Although the recent New Mexico rates appear to be slightly higher, the NM and US rates are statistically similar.

What Is Being Done?

The NM Department of Health Diabetes Prevention and Control Program (DPCP) works with health care providers and community partners, agencies and coalitions to provide multiple diabetes prevention and management services and programs. Services and programs include: professional development trainings and resources for diabetes prevention and management; the National Diabetes Prevention Program (National DPP), a proven community-based physical activity and nutrition intervention to prevent or delay diabetes in persons at high risk; community resources to help people manage their diabetes through skill building, such as Kitchen Creations cooking schools; and health system interventions to improve disease management indicators such as blood glucose, blood pressure, and cholesterol. The DPCP and its partners conduct education campaigns about prediabetes and diabetes and support built environment improvements so people at risk for or with diabetes can be physically active. The DPCP consults with populations that are disproportionately affected by diabetes and/or those that serve them to develop programs and services that are culturally appropriate for these populations.

Evidence-based Practices

Diabetes and its complications can be prevented and managed through these strategies: 1. Improve quality of clinical care to improve control of A1C, blood pressure, and cholesterol, and to promote tobacco cessation. 2. Increase access to sustainable self-management education and support services to improve control of A1C, blood pressure, and cholesterol, and to promote tobacco cessation. 3. Increase use of CDC-recognized lifestyle change programs (National DPP) to prevent or delay onset of type 2 diabetes among people at high risk. CDC recommends these major activities to implement the strategies above. 1) Improve quality of clinical care for people with and at risk for diabetes. - Support health care organizations to improve quality of care through use of the Planned Care Model, Patient Centered Medical Home, and Electronic Health Record. Within these organizations, support policy and protocol implementation that institutionalize and help sustain quality care improvements. 2) Increase access to sustainable self-management education and support services for people with diabetes. - Expand access to the following: a. diabetes self-management education/training (DSME/T) programs that meet national standards and demonstrate improved behavioral and/or clinical outcomes; b. diabetes or chronic disease self-management support (CDSM) programs that demonstrate improved behavioral and/or quality of life outcomes. - Promote the sustainability of DSME/T or CDSM programs, such as insurance or Medicaid reimbursement for DSME/T or CDSM programs. - Implement evidence-based worksite programs and policies that promote tobacco cessation and that help employees improve control of their A1C, blood pressure, and cholesterol. - Increase access to tobacco cessation services. - Expand the role of allied health professionals by replicating and scaling evidence-based programs based on the principles of the Asheville Project and the Diabetes 10-City Challenge. - Promote the sustainability of Community Health Workers (CHWs) involved in providing diabetes self-management education and support services. 3) Increase use of lifestyle change programs. - Lead/coordinate CDC approved health communication and marketing campaigns or coalition initiatives to raise awareness, among people at high risk, about prediabetes risk factors, the locations of CDC-recognized lifestyle change programs and how to enroll in these programs. - Work with health care providers to recognize and treat prediabetes and/or refer people with prediabetes or at risk for diabetes to the National DPP. - Partner with state and local government agencies to recommend that the CDC recognized lifestyle change program be offered as a covered benefit for public employees and/or Medicaid recipients. - Lead/coordinate use of National Diabetes Education Program primary prevention tools with populations at high risk for developing type 2 diabetes to increase awareness of and support lifestyle change behaviors. As a complement to these strategies, promote health communication campaigns or coalition initiatives to increase access to self-management education and support services or improve the quality of clinical care, and support other chronic disease prevention programs in implementing environmental approaches to change modifiable risk factors.

Available Services

-Professional development opportunities, including online trainings with continuing education credits on Diabetes & Depression, Smoking & Diabetes, and Prediabetes -Technical assistance to clinics and primary care providers to support system changes that improve health outcomes (e.g. AIC, blood pressure, LDL cholesterol and smoking cessation) -Support for community-based prevention and management initiatives such as the National Diabetes Prevention Program, Kitchen Creations cooking schools for people with diabetes and development of walking trails -Technical assistance with data, surveillance, and epidemiology All are free of charge. For more information on any programs or services provided by the NM Department of Health, Diabetes Prevention and Control Program, go to http://archive.diabetesnm.org/ or call 1-888-523-2966.
Page Content Updated On 02/14/2018, Published on 02/14/2018
The information provided above is from the New Mexico Department of Health's NM-IBIS web site (http://ibis.health.state.nm.us). The information published on this website may be reproduced without permission. Please use the following citation: "Retrieved Fri, 21 September 2018 from New Mexico Department of Health, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.nm.us".

Content updated: Wed, 14 Feb 2018 16:20:17 MST