Diabetes refers to several conditions marked by high blood glucose levels caused by deficiencies and defects related to the production and use of insulin in the body.(1) Type 2 diabetes is the most common variety, accounting for 90-95% of all cases and affecting primarily adults.(1) Type 2 risk factors include obesity, age, family history, lack of physical activity, race, and ethnicity.(1) Formerly called juvenile diabetes, the onset of Type 1 diabetes is most common among children and young adults.(2) Less is known about Type 1 diabetes, and clinical preventive strategies are currently being studied.(1) Gestational diabetes refers to the onset of diabetes during pregnancy, typically at 28 weeks or later.(2)

Diabetes is associated with many complications, including heart, kidney, dental, and nervous system disease, blindness, limb amputations, and vulnerability to conditions that can cause death.(1) Despite the numerous complications that individuals with diabetes may experience, behavior modification and health management can go a long way in treating the condition and maintaining health. Those who have diabetes are advised by their providers to stick to a healthy diet, remain physically active, and monitor their blood sugar. Some individuals will require oral medication or insulin injections as part of their diabetes management regimen.

In recognition of November as American Diabetes Month, this article presents information from the Community Health Data Base on the prevalence of diabetes and risk factors among adults 18 years of age and older residing in the Southeastern Pennsylvania (SEPA) region. Most data presented here are from the 2008 Southeastern Pennsylvania Household Health Survey, a biennial, random digit dial telephone survey of over 10,000 households in the five county area of Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties.

Prevalence of Diabetes and Associated Risk Factors

One in ten (10.4%) adults in Southeastern Pennsylvania have been told by a healthcare provider that they have diabetes, representing some 307,000 adults in the region. The prevalence of diabetes among men and women is fairly comparable (11.2% and 9.8%, respectively). The likelihood of having diabetes increases with age (Figure 1). For example, 2.4% of adults 18-39 have diabetes compared to 20.3% of adults aged 60-74.

Racial and ethnic disparities exist in regards to the local prevalence of diabetes. Non-Latino Blacks (15.8%) and Latinos (10.3%) are more likely to have been diagnosed with diabetes than Non-Latino Whites (8.8%) and Asians (7.4%).

Adults living at or below the Federal Poverty Level are nearly twice as likely as adults living above the FPL to have diabetes; 17.8% of poor adults have a diagnosis compared to 9.5% of non-poor adults.

Adults who are obese are about twice as likely as adults who are overweight and about five times as likely as adults who have normal weight to have diabetes (21.2% compared to 9.1% and 4.4%, respectively; Figure 2).

Access to and Receipt of Healthcare Among Local Adults with Diabetes

 Among adults between the ages of 18 and 64 who have diabetes, 93.5% are insured. The vast majority of adults (94.8%) with diagnosed diabetes have a regular source of clinical healthcare; this is a higher percentage than among adults without diabetes (89.0%). A very small percentage (3.4%) of adults with diabetes did not see a medical provider in the past year compared to 16.5% among adults without diabetes.

Adults who have been diagnosed with diabetes are more likely to have visited an emergency room in the past year than adults who do not have diabetes (36.0% versus 21.8%).

Among the nearly one in five (18.7%) adults with diabetes who smoke every day or some days, three quarters (75.9%) of them were advised by a healthcare provider in the past year to quit smoking compared to about half of smokers without diabetes (55.4%).

Conclusion

The large number of adults in Southeastern Pennsylvania that have been told by a health care provider that they have diabetes (307,000) speaks to the need for targeted prevention efforts to reduce disparities among the poor, Blacks, and Latinos, as well as intervention efforts to supports adults living with diabetes in maintaining their health and managing their disease.

For more information about the Community Health Data Base or about diabetes in our area, please contact Rose Malinowski Weingartner at rosemw@phmc.org or 215.985.2572.

^{2 American Diabetes Association. (2010.) Diabetes basics. Retrieved online on October 26, 2010, at http://www.diabetes.org/diabetes-basics/?utm_source=WWW&utm_medium=GlobalNavDB&utm_campaign=CON.}