sábado, 5 de julio de 2014

Preventing Chronic Disease | Prevalence of Diabetes and Associated Obesity in Pennsylvania Adults, 1995–2010 - CDC

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Preventing Chronic Disease | Prevalence of Diabetes and Associated Obesity in Pennsylvania Adults, 1995–2010 - CDC

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Prevalence of Diabetes and Associated Obesity in Pennsylvania Adults, 1995–2010

Oralia Garcia-Dominic, PhD, MS, MA; Eugene J. Lengerich, VMD, MS; Fabian Camacho, MS; Nancy R. Gallant, MS; Linda A. Wray, PhD; Frank Ahern, PhD; Greg Bogdan, PhD; Gene Weinberg, PhD; Jan S. Ulbrecht, MBBS

Suggested citation for this article: Garcia-Dominic O, Lengerich EJ, Camacho F, Gallant NR, Wray LA, Ahern F, et al. Prevalence of Diabetes and Associated Obesity in Pennsylvania Adults, 1995–2010. Prev Chronic Dis 2014;11:130330. DOI:http://dx.doi.org/10.5888/pcd11.130330External Web Site Icon.


This study examined trends in the prevalence and sociodemographic distributions of diabetes and the associations of diabetes with obesity over time in adult Pennsylvanians from 1995 through 2010.
We used Behavioral Risk Factor Surveillance Survey data collected from 1995 through 2010. Diabetes prevalence was assessed by self-report of physician diagnosis. Obesity was assessed by body mass index computed from self-report of height and weight. State-level data for diabetes and associated obesity prevalence from 1995 through 2010 were collected for each year. Data on sociodemographic factors (age, sex, race, income, education) and 1 known disease risk factor (obesity) were also collected. Logistic regression modeling was used to examine associations between diabetes, sociodemographic factors, and obesity.
Diabetes prevalence in Pennsylvania, which increased from 5.6% in 1995 to 10.5% in 2010, followed national trends but exceeded the national prevalence each year by approximately 0.6 percentage points for 12 of the 16 years. The increase in prevalence was not equal across all socioeconomic groups. Obesity became a more dominant risk factor for diabetes during these 16 years.
The burden of diabetes and obesity in Pennsylvania is substantial and increasing. Program managers and policy makers in Pennsylvania should consider these trends when allocating limited resources and designing programs for reducing diabetes-related illness. Other states may consider similar studies to monitor the prevalence of diabetes and determine whether disparities are changing and whether programs and resources should also shift.


This work was funded by the National Institutes of Health National Cancer Institute/Center to Reduce Cancer Health Disparities grant no. K01CA151752 (principal investigator, Oralia Garcia-Dominic) and diversity supplement attached to grant nos. U01CA114622 and U54CA153604-01 (principal investigator: Mark Dignan). We acknowledge the assistance of the Community Science Health Outcomes Core, Penn State Hershey Cancer Institute. The authors also thank the Pennsylvania Department of Health (Gerald Miller) and the Centers for Disease Control and Prevention (Ali Mokdad) for their technical assistance.

Author Information

Corresponding Author: Oralia Garcia-Dominic, PhD, MS, MA, Highmark, 100 Senate Ave, 6N, Camp Hill, PA 17011. Telephone: 717-302-3032. E-mail:oralia.dominic@highmark.com.
Author Affiliations: Eugene J. Lengerich, Fabian Camacho, The Pennsylvania State University and Penn State Hershey Cancer Institute, Hershey, Pennsylvania; Nancy R. Gallant, Linda A. Wray, Frank Ahern, The Pennsylvania State University, Hershey, Pennsylvania; Greg Bogdan, Gene Weinberg, The Pennsylvania Department of Health, Harrisburg, Pennsylvania; Jan S. Ulbrecht, The Pennsylvania State University and Penn State College of Medicine, Hershey, Pennsylvania.


  1. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP. The continuing epidemics of obesity and diabetes in the United States. JAMA 2001;286(10):1195–200. PubMedExternal Web Site Icon
  2. Hotu S, Carter B, Watson PD, Cutfield WS, Cundy T. Increasing prevalence of type 2 diabetes in adolescents. J Paediatr Child Health 2004;40(4):201–4. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  3. Pinhas-Hamiel O, Dolan LM, Daniels SR, Standiford D, Khoury PR, Zeitler P. Increased incidence of non-insulin-dependent diabetes mellitus among adolescents. J Pediatr 1996;128(5 Pt 1):608–15. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  4. Nielsen SJ, Siega-Riz AM, Popkin BM. Trends in energy intake in U.S. between 1977 and 1996; similar shifts seen across age groups. Obes Res 2002;10(5):370–8. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  5. Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997;20(4):537–44. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  6. Reaven GM. Role of insulin resistance in human disease. Diabetes 1988;37(12):1595–607. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  7. Ford ES, Li C, McGuire LC, Mokdad AH, Liu S. Intake of dietary magnesium and the prevalence of the metabolic syndrome among U.S. adults. Obesity (Silver Spring) 2007;15(5):1139–46. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  8. Mann JI. Nutrition recommendations for the treatment and preventions of type 2 diabetes and metabolic syndrome: an evidenced-based review. Nutr Rev 2006;64(9):422–7. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  9. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002;288(14):1723–7. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  10. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 2004;291(23):2847–50. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  11. Kuczmarksi RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, et al. 2000 CDC growth charts for the United States: methods and development. Vital Health Stat, Series 11, No. 246. National Center for Health Statistics; 2002. http://www.cdc.gov/growthcharts/2000growthchart-us.pdf. Accessed April 16, 2014.
  12. Pennsylvania Department of Health. Behavioral Risk Factor Surveillance Survey (BRFSS). https://apps.health.pa.gov/EpiQMS/asp/ChooseDataset.asp. Accessed March 5, 2014.
  13. Pennsylvania Department of Health. The Pennsylvania diabetes action plan 2007. http://www.dsf.health.state.pa.us/health/lib/health/diabetes/PADiabetesActionPlan.pdf. Accessed March 5, 2014.
  14. Pennsylvania Department of Health. The burden of diabetes in Pennsylvania 2010. http://www.portal.state.pa.us/portal/server.pt/community/diabetes/14160/diabetes_publications___documents/557820. Accessed March 5, 2014.
  15. Knowler WC, Pettitt DJ, Savage PJ, Bennett PH. Diabetes incidence in Pima Indians: contributions of obesity and parental diabetes. Am J Epidemiol 1981;113(2):144–56. PubMedExternal Web Site Icon
  16. Wing RR, Venditti E, Jakicic JM, Polley BA, Lang W. Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care 1998;21(3):350–9. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  17. Centers for Disease Control and Prevention. BRFSS 2001 survey data and documentation: 2001 survey data information: comparability of data. http://www.cdc.gov/brfss/annual_data/annual_2001.htm. Updated March 19, 2013. Accessed March 5, 2014.
  18. US Census Bureau. 1995 Population estimate. http://www.census.gov/population/projections/state/9525rank/paprsrel.txt. Accessed March 5, 2014.
  19. US Census Bureau. American factfinder. Pennsylvania Census 2010 total population. http://factfinder2.census.gov/faces/nav/jsf/pages/community_facts.xhtml#none. Accessed May 12, 2014.
  20. Templ M, Kowarik A, Filzmoser P. Iterative stepwise regression imputation using standard and robust methods. Comput Stat Data Anal 2011;55(10):2793–806. CrossRefExternal Web Site Icon
  21. Raghunathan TE, Lepkowski JM, Hoewyk JV, Solenberger P. A multivariate technique for multiply imputing missing values using a sequence of regression models. Surg Methodology 2001;27(1): 85–95.
  22. Korn E, Graubard B. Analysis of health surveys. New York (NY): John Wiley and Sons, Inc; 1999.
  23. Bieler GS, Brown GG, Williams RL, Brogan DJ. Estimating model-adjusted risks, risk differences, and risk ratios from complex survey data. Am J Epidemiol 2010;171(5):618–23. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  24. Danaei G, Friedman AB, Oza S, Murray CJL, Ezzti M. Diabetes prevalence and diagnosis in US states: analysis of health surveys. Popul Health Metr 2009;7:16. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  25. Ackermann RT, Finch EA, Brizendine E, Zhou H, Marrero DG. Translating the Diabetes Prevention Program into the community. The DEPLOY Pilot Study. Am J Prev Med 2008;35(4):357–63. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  26. Centers for Disease Control and Prevention. National Diabetes Prevention Program. http://www.cdc.gov/diabetes/prevention/recognition/standards.htm. Accessed March 15, 2014.
  27. Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003;289(1):76–9. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  28. American Diabetes Association. Health policy models, recommendations and standards of practice. Federal legislative priorities for the 110th congress; 2008. http://www.diabetes.org/advocacy-and-legalresources/federal_legislation/overview.jsp. Accessed March 15, 2014.
  29. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, IIanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344(18):1343–50. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  30. Diabetes Prevention Program Research Group. The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care 2002;25(12):2165–71. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  31. Rejeski WJ, Ip EH, Bertoni AG, Bray GA, Evans G, Gregg EW, et al. Lifestyle change and mobility in obese adults with type 2 diabetes. N Engl J Med 2012; 366:1209–1217. PubMedExternal Web Site Icon
  32. Pennsylvania Department of Health. 2013 Pennsylvania diabetes fact sheet. http://www.portal.state.pa.us/portal/server.pt/community/diabetes/14160/diabetes___risk_factors/557815. Accessed April 28, 2014.

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